DID YOU SEE: New York Times op-ed piece on “Low T”

It’s been clear for some time that the pharmaceutical industry has been preying on adult men’s fear of aging and losing sexual vitality to overprescribe testosterone supplements. In a New York Times op-ed piece published yesterday, physician John La Puma reports on a study that just came out finding that taking prescription testosterone doubled the rate of heart attacks in men 65 and older, as well as in younger men who had heart disease, within three months.
This is serious business and worth reading by men who are taking or considering taking male hormone supplements.

Fortunately, La Puma doesn’t just critique the pharmaceutical industry but offers concrete advice to men on how to address the crucial health issues for which they tend to seek testosterone supplements:

Too many doctors are now writing testosterone prescriptions without even measuring the patient’s hormone levels, much less re-testing for confirmation and adjusting the dose after prescription. Up to a quarter of these prescriptions are dispensed without a blood test.

From a psychological perspective, this isn’t helping men. From a medical perspective, it’s devastating. In addition to the cardiac risks, prescription T can mean a permanent shut-off in men’s own, albeit diminished, testosterone production. In other words, once you start, you may well be hooked for life.

Instead of heading to the pharmacy to get their fix, men should address the leading cause of the problem. Losing weight is a tried and true way to naturally boost testosterone levels. According to findings presented at the annual meeting of the Endocrine Society in 2012, obese men who lost an average of 17 pounds saw their testosterone levels increase by 15 percent. In general, a man’s waist should be half his height.

Some diet changes may be useful for reasons other than just weight loss. If you drink too much booze, switch to water — alcohol lowers testosterone levels. Eating more cruciferous vegetables like broccoli and collard greens can also help, by blunting the effects of estrogen in a man’s body. At the end of the day, eating more of the right foods and fewer junk foods improves mood and energy — which may be the only fix many men need.

You can read the whole article online here.

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DID YOU SEE: New York Times on the “low-T” industry

The front page of the Sunday New York Times business section yesterday led with an important story called “Selling That New-Man Feeling.” The article details how the pharmaceutical industry, especially the company that manufactures Androgel, has made literally billions of dollars exploiting adult men’s insecurities about aging, masculinity, and sexual performance. Although many scientists find the claims made by companies promoting testosterone supplements to be unpersuasive, still the market plays to guys who get suckered into thinking “low-T” is a major health problem and that boosting their testosterone levels with commercial products will lead to the fountain of youth or at least better boners.

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I do believe there are some men whose health is affected adversely by sub-normal testosterone levels. But that population is quite small, not big enough to enrich pharmaceutical companies. The way testosterone supplements are being marketed now, with vague questionnaires that link “low-T” to symptoms every breathing human experiences, constitutes the worst kind of snake-oil salesmanship. I have friends who’ve gotten suckered into trying testosterone patches, gels, and injections. Some of them have experienced the illusory effect of feeling stronger, peppier, and more libidinous — to my mind, indistinguishable from the placebo effect — but most of them have encountered significant side effects: irritability and short-temperedness at best, prostate cancer at worst.
lowTGranted, any doctor who’s any good monitors prostate health closely when prescribing such supplements, but not every patient collaborates with their physicians’ best practices. But in my work as a sex therapist, I have been appalled to hear that men in their sixties and seventies have been prescribed testosterone supplements by their doctors. It seems to me unconscionable to mislead middle-aged and elderly men into thinking they can maintain the same level of sexual performance they experienced when they were 25. Men can lead active, healthy, sexually fulfilling lives well into later life, but the key factors are diet, exercise, stress reduction, and emotional balance, not to mention a concerted effort to accept aging with grace and resourcefulness — all of which require patience and commitment, for which pills and gels are no substitute.

But don’t take my opinions and observations as the last word. Judge for yourself. Read the article here and tell me what you think. Another very smart article on this subject appeared in the Times two years ago, talking about how the use of steroids and hormone supplements by athletes has spread to the general population — see Steve Kettman’s “Are We Not Man Enough?”