Testosterone: medicine or needless supplement?

Testosterone: the male hormone (that women also have) has been doing the rounds in the news of late. According to some doctors it is over prescribed and costing the tax payer millions. It also has no benefits when given to men low in the hormone according to a new report. It seems the time to put of the wellies and wade into the debate.

Testosterone is a hormone, a natural chemical we all make in our bodies. Exactly what is does is complex but it plays a role in a wide arrangement of the bodies activities affecting: bone mass, fat distribution, strength, muscle mass, red blood cell production, sex drive , aggression and more. The human body likes to be efficient so it uses testosterone in every nook and cranny it can.

With that in mind it might seems obvious that someone who is a little short of the hormone would benefit from a top up. Men with low levels of testosterone can experience mood swings, fat moving to the wrong places (man boobs if you will), insomnia, erectile dysfunction and well you get the point. Testosterone does a lot and not having enough is bad, right?  

So some men are getting themselves a top up. In the UK that means going to your doctor and being referred to an endocrinologist who will test your levels and work out if something needs to be done. Assuming you aren’t the sort to just buy it off the internet missing out on all the advice and support those clever doctors can provide and running the risk that the supplier isn’t giving you what they say they are.

As men age their testosterone levels fall slowly in what has been described as the male-menopause. This seems a little unfair as testosterone falls slowly – a gentle reduction in production compared the menopauses’ dramatic hormonal swings. It is normally a natural and healthy process. Regardless the male-menopause has gotten some publicity of late suggesting that the problems men experience could have something to do with testosterone and leading some men to seek help. This is great. Getting men into the doctors has proven difficult in the past.

Unfortunately the many symptoms of low testosterone levels can also be caused by being overweight, drinking too much, smoking, stress and living in the modern world in general. So men could be getting prescribed testosterone for problems with a different cause. This is a worry for some doctors – the number of NHS prescriptions of testosterone has doubled in the past decade despite the numbers of people with low testosterone being steady.

To add fuel to the fire a study has come out saying that testosterone has no benefit when given to men with low testosterone. It lands with some authority as it looks at 156 studies for benefits above those offered by placebo. It found none; well it found a mixed and confusing message in some areas but nothing that would suggest we should be giving men testosterone. It is important to note that they did not look at studies that included men with damaged or missing testicles or those who had a genetic condition. So people with an underlying condition may still benefit from testosterone.

It is difficult to know if doctors are over prescribing or, as other doctors have suggested, this is a result of more men coming forward with difficulties like erectile dysfunction that might be caused by underlying conditions that do benefit from testosterone supplementation.

What we shouldn’t do is demonise the men taking testosterone. They have gone to their doctors and asked for help for a difficulty, something that men have a history for neglecting to do.  This is something to celebrate and hopefully a sign of things to come.

Image by Eduardo García Cruz originally found on Flickr used under creative commons licence.