Men’s Health: Should I Take Testosterone?

Serena H. Chen, M.D.
Dr. Chen ART

The short answer for most men is: “NO!”

Do you have low T? Low Testosterone levels?

Many men think they might have low T. However, most men who think they have low testosterone do not, and many men who do have low testosterone do not understand the significant risks and downsides of taking testosterone.

Low Testosterone levels or “Low T” is the latest health epidemic to affect American men, at least according to the multiple, million-dollar advertising campaigns you see on TV, hear on the radio, and see in the glossy magazines. Don’t believe everything you hear on TV or from Dr Google. Take it from me, a board-certified specialist in Reproductive Endocrinology and Infertility, you do not have low T. Yes, I am talking about you! The guy sitting in my office who is tired and stressed ,not sleeping well, and whose libido is just not what it was when he was younger and did not have a mortgage and a crazy boss. I know, you want to feel better, and taking a pill, or a shot, or some gel sounds like a good idea. What could be the harm?

First of all, why do you think you have low T? Low energy and low libido could be caused by hundreds of things, and Low T is not even in the top 10 causes. Stress, lack of sleep, a bad diet, those extra 20 pounds, smoking, lack of exercise….Is it possible these things might have something to do with you not feeling at your best?

You are in my office and are growing a beard as we speak. You are not really having problems with erection or ejaculation (except when you have way too many drinks) and you and your partner are here to see me because you are trying to have a baby. You complained to your family doctor about being tired a few months ago and you were given a prescription for testosterone gel or testosterone shots. Or some guys at the gym got you some “stuff” – anabolic steroids to help you build up your muscles, raise your energy level. Well, guess what, testosterone can shut your testicles down. For some reason the people that are giving out testosterone like it is a multivitamin forgot to tell you that taking testosterone tells your testicles that they can take a break. They don’t need to do their normal job of making testosterone because there is already a lot of testosterone around. The problem is when the testicles stop producing testosterone, they often stop producing sperm as well. The testicles actually will physically shrink in size with testosterone treatment. Theoretically, once you stop the testosterone the testicles should resume normal function, normal size and normal sperm production, but some men can permanently damage their testicles if they take enough testosterone for long enough. And some men will become completely azoospermic (no sperm at all, zero, nada, nothing).

Besides having a very negative impact upon sperm production, testosterone supplementation can increase the risk for heart attack, stroke, blood clots and prostate cancer.

So….what am I saying? Perhaps you could try eating a healthy diet (a low glycemic one – more veggies, less bread and pasta), try losing those extra pounds, getting some regular exercise, getting 7 to 8 hours of sleep at night, quitting smoking and maybe have just one glass of wine or beer with dinner instead of the bottle or the six pack. Perhaps you just might start feeling a lot less tired and a lot healthier. If these things still do not work or you can’t grow a beard or are having problems with getting or maintaining an erection, then see a qualified specialist about possible Low T.

If you really have low T and are trying to conceive, then your doctor should be able to raise your testosterone level without using testosterone, to maintain sperm production. You may need to see a medical endocrinologist for a full assessment and treatment. Most primary care doctors are not experienced in this type of assessment or treatment.

Low T is not an epidemic and treating low T with testosterone will stop sperm production in its tracks. Make sure you get expert advice and think about finishing your family before taking this very potent and potentially destructive hormone.

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