Key facts
- Trump administration officials are pushing to make it easier for men to obtain testosterone prescriptions.
- The move is supported by Health Secretary Robert F. Kennedy Jr. and Defense Secretary Pete Hegseth.
- The FDA has proposed new language to allow testosterone use for age-related symptoms like low libido.
- Recent studies indicate testosterone therapy can improve sexual health and have minimal heart risks.
- Experts warn that testosterone use can impact fertility and requires careful consideration for men with prostate cancer history.
- Online promotions for testosterone-boosting supplements are discouraged due to lack of FDA approval.
Officials aligned with President Donald Trump are seeking to ease the process for men to obtain prescriptions for testosterone, a move that comes amid evolving scientific understanding and a long-standing debate about the hormone's benefits and risks. Health Secretary Robert F. Kennedy Jr. and other top officials support this shift, which also aligns with advice from some online influencers. Defense Secretary Pete Hegseth stated the military will begin screening troops for low testosterone to optimize performance.
While the notion of testosterone as a universal elixir for strength is not scientifically supported, recent research has bolstered its benefits for sexual health and allayed some concerns about cardiac impact. Dr. Justin Dubin, a urologist, noted that updated data has reduced provider apprehension regarding prescribing the hormone. The Food and Drug Administration (FDA) has already removed a prominent safety warning about heart risks associated with testosterone pills and has proposed rewriting prescribing instructions to permit its use for age-related symptoms like low libido and erectile dysfunction, which currently is not its primary approved use.
Experts who prescribe testosterone highlight that many men seek it for symptoms significantly affecting their quality of life, not just for severe medical conditions. The history of testosterone prescription has evolved since its initial approval in the 1950s for hypogonadism. Testosterone levels naturally decline with age, impacting sexual function, mood, and bone density, leading to ongoing debate about diagnosis and treatment. Dr. Shalender Bhasin of Harvard Medical School points out that overlapping symptoms with aging can lead to misdiagnosis and controversy.
Bhasin suggests that increased willingness to prescribe testosterone reflects a greater acknowledgment of men's sexual health issues, similar to the impact of Viagra. Current Endocrine Society guidelines, which Bhasin helped author, recommend discussing testosterone with men exhibiting symptoms and having two confirmed low hormone blood test results. However, a recent study indicated only 12% of men receiving prescriptions met these criteria, suggesting a potential for overprescribing that led to previous restrictions.
In the early 2010s, extensive advertising promoted testosterone for various symptoms, leading to significant sales despite a lack of FDA approval for many uses. In 2015, the FDA mandated clearer labeling that drugs were not approved for routine issues and added a boxed warning about potential heart risks. However, an FDA-mandated study published in 2023 involving 5,000 men with heart disease found no increased risk of heart attack or stroke between those receiving testosterone gel and a placebo. Further NIH studies on nearly 800 older men showed improvements in erectile dysfunction and libido, with minor effects on mood, but little impact on fatigue or memory.
Despite these findings, Bhasin emphasizes the need for more long-term research on safety and efficacy, with the Endocrine Society recommending 15-20 year studies, particularly concerning prostate cancer. Experts agree that men planning to have children should avoid testosterone therapy as it can suppress sperm production. Caution is also advised for men with prostate cancer or at risk, though proposed FDA language suggests only men with metastatic prostate cancer should avoid it. The article also warns against unapproved online testosterone-boosting supplements, noting that many telehealth services lack proper screening and testing protocols.