Men's Testosterone Supplements May Be Losing Appeal
The "low-T" craze appears to be waning, with fewer men in the United States turning to testosterone therapy as a way to stave off aging and sexual decline.
A steep decrease in testosterone prescriptions occurred between 2013 and 2016, coinciding with public warnings that hormone therapy could increase men's risk of heart health issues and prostate cancer.
"We found that there was a very dramatic decrease in a short period of time," said lead researcher Jacques Baillargeon. He's a professor of preventive medicine and community health with the University of Texas Medical Branch at Galveston.
The number of men receiving testosterone therapy declined by 48 percent between 2013 and 2016, following a sixfold increase in prescriptions during the prior decade, researchers found.
There also was a 62 percent decrease in new testosterone users, the findings showed.
The decrease is "definitely a good thing," said Dr. Shalender Bhasin, an endocrinologist with Brigham and Women's Hospital in Boston.
"It's a hopeful sign that educational efforts in science do matter, and people pay attention to both the science and the information from clinical studies that's being put out by scientists," said Bhasin. He chairs the Endocrine Society's testosterone guidelines committee.
By reviewing health insurance records for almost 10 million men aged 30 and older, the investigators found that total testosterone use increased from 0.52 percent of men in 2002 to 3.2 percent in 2013.
This mirrors other data showing that testosterone prescription sales increased from $70 million in 2000 to nearly $2.8 billion in 2013, Bhasin said. Testosterone therapy typically costs between a few hundred to a few thousand dollars a year.
Bhasin believes the increase was driven by ads aimed at aging baby boomers touting testosterone therapy as a means of retaining vitality and sexual prowess.
"From being a drug that no big company was interested in to joining the billion-dollar club in such a short period of time was quite a remarkable testimony to both the demographic trends and the power of direct consumer advertising," Bhasin said.
But 2013 was the year in which the "low-T" wave crested. After that, the popularity of testosterone therapy waned sharply, falling to less than 2 percent of men by 2016.
The decline in overall use of testosterone appears linked to an advisory put out by the U.S. Food and Drug Administration in 2013, the researchers said.
The FDA advisory warned that men using testosterone to ward off aging might be putting themselves at increased risk of a heart attack or stroke.
New prescriptions for testosterone started declining even before that, however. The number of men beginning the therapy started to level off in 2012.
This coincided with the publication of clinical trials associating testosterone therapy with increased risk of heart health problems, Baillargeon said. Those trial results preceded the FDA's announcement by a year.
Testosterone therapy is only recommended for men with a medical condition that causes a confirmed deficiency in the hormone, Bhasin said. It's not for men going through the usual decline in testosterone levels that occurs with aging.
"We suspect there are a substantial percentage of men over the last decade who were receiving testosterone therapy who did not have a clear indication for it," Baillargeon said. He cited a previous study that found that a quarter of new users had not had their hormone levels tested before getting a prescription.
Baillargeon said he's now concerned that men with true testosterone deficiency might have been frightened away from the hormone therapy they need.
Without testosterone supplementation, these men are at risk of the bone-thinning disease osteoporosis, loss of lean muscle mass, excess weight, diabetes, depression and fatigue, Baillargeon said.
"For these men who perhaps were scared by some of that publicity, what are their short-term and long-term risks after they discontinue testosterone therapy?" he asked.
His team will next look at whether or not the right men -- those using testosterone as a "fountain of youth" -- dropped hormone therapy in recent years.
The new study was published July 10 in the Journal of the American Medical Association.
The U.S. Food and Drug Administration has more about testosterone therapy.
SOURCES: Jacques Baillargeon, Ph.D., professor, preventive medicine and community health, University of Texas Medical Branch at Galveston; Shalender Bhasin, M.D., endocrinologist, Brigham and Women's Hospital, Boston; July 10, 2018, Journal of the American Medical Association