ST. LOUIS – More people are turning to testosterone replacement therapy. In fact, it’s estimated that prescriptions for the treatment exceeded 11 million in 2024.
“I think one big misconception of testosterone therapy is that it’s just about, you know, sexual function or erectile function,” Dr. Joshua Gonzalez, a urologist and sexual medicine specialist in Los Angeles, said.
Dr. Gonzalez says between 20 million and 30 million men in the United States have low testosterone.
“Starting at around age 35, our testosterone declines every year by a certain percent. On average, about 1% to 2% per year. Men will start to experience brain fog, cognitive dysfunction, trouble rendering things,” he said. “It’s also important for cardiovascular health. Muscle strength is a big thing. As we get older, our muscle strength declines, and that is an independent risk factor for sort of declining health. And so, it helps all of those functions.”
Blood tests are used to determine testosterone levels and, depending on the results, a treatment plan can be developed. Current FDA-approved testosterone formulations include oral, topical gel, transdermal patch, and injection.
“It’s much easier to do because it’s a pill that you take, as opposed to having to draw up a medication and self-administer it through an injection,” Gonzalez said.
He says results from his patients are encouraging.
“It’s not that they feel like they’re 18 years old again, but they feel like themselves again. They feel like they’ve gotten themselves back,” Gonzalez said.
In February, the Food and Drug Administration issued new labeling changes for testosterone products. Clinical trials found no extra risk of adverse cardiovascular outcomes in men using testosterone for hypogonadism, a condition where the body doesn’t produce enough sex hormones. The FDA is recommending adding results from the trial to the labeling in all testosterone products, and removing language related to an increased risk of adverse cardiovascular outcomes.
According to the FDA, testosterone is approved only for use in men who lack or have low levels of the hormone associated with a medical condition.
“I would say, you know, talk to your doctor about the possibility that you might have low testosterone, because now, more than ever, especially with the advent of these new oral testosterone options, it’s a very easy thing to replace, and it can really make a profound impact on your life,” Gonzalez said.