Trump Officials Want to Make Testosterone Drugs Easier to Get. Is That a Good Idea?

Officials working for President Donald Trump want to make it easier for men to get a prescription for testosterone. Testosterone is a hormone that affects sex drive, mood, energy, and other parts of health. The push is backed by Health Secretary Robert F. Kennedy Jr. and other top government leaders. It is part of a debate that has been going on for decades about whether giving men extra testosterone is safe and helpful.

Defense Secretary Pete Hegseth announced on Tuesday that the military would start checking soldiers for low testosterone levels. He said offering the hormone to troops could help them perform at their 'absolute best.' Many popular online influencers and podcasters also support testosterone, saying it can boost muscle strength and energy. However, scientists say the idea that testosterone fixes everything is not backed up by solid research.

Medical experts say that about ten years of new studies have shown testosterone can help men's sexual health. Those same studies helped calm earlier worries that the hormone might be bad for the heart. 'Many providers have been trained for years that these were real issues, and they were scared to get a testosterone reading from a patient or offer them testosterone therapy,' said Dr. Justin Dubin, a urologist at Baptist Health Miami Cancer Institute. A urologist is a doctor who specializes in the urinary system and related health problems.

Last year, the Food and Drug Administration, known as the FDA, removed a strong warning label about possible heart risks linked to testosterone pills, gels, injections, and patches. The FDA made this decision after new data showed those risks were not as serious as once feared. Last month, the agency also proposed rewriting the instructions for doctors, which could allow testosterone to be used for age-related problems like low sex drive and erectile dysfunction. Right now, the label only allows the hormone for men with very low testosterone caused by a serious medical condition or injury.

Testosterone was first approved as a medicine in the 1950s to treat a condition called hypogonadism. Hypogonadism is when the body does not make enough testosterone because of a medical problem. Testosterone levels drop naturally as men age, and that can affect their mood, sex life, bone strength, and more. Researchers have argued for a long time about when it is appropriate to diagnose and treat men for these kinds of problems.

Dr. Shalender Bhasin of Harvard Medical School has led several major testosterone studies. He explained that the symptoms of low testosterone can look a lot like normal signs of aging in men, which makes it hard to know who really needs treatment. Bhasin helped write guidelines for the Endocrine Society, a group of hormone doctors, which say that men should have documented symptoms and two blood tests showing low hormone levels before getting a prescription. One recent study found that only 12% of men who received a testosterone prescription actually met those guidelines.

In the early 2010s, drug companies spent millions of dollars on TV ads for testosterone products. The ads promised relief from tiredness, weight gain, memory problems, and other issues. By 2013, testosterone drugs were selling more than two billion dollars' worth every year, even though they were not officially approved for most of those problems. In 2015, the FDA required drug companies to add a strong warning about possible heart risks and to clarify that their products were not approved for everyday complaints.

New research helped the FDA feel more comfortable making changes. A large study published in 2023 followed 5,000 men with a history of heart disease. Half used a testosterone gel every day, and the other half used a fake gel. After two years, there was no difference in heart attacks or strokes between the two groups.

Even though these are the biggest testosterone studies ever done, doctors say more research is still needed. The Endocrine Society has called for studies lasting 15 to 20 years to look at slow-developing risks, including prostate cancer. Prostate cancer remains a concern because some doctors worry that testosterone might help tumors grow faster. The FDA has proposed new language saying only men whose prostate cancer has spread to other parts of the body should avoid testosterone.

There are also some men who should clearly avoid testosterone therapy right now. Men who want to have children soon should not take it, because the hormone shuts down the body's natural process of making sperm. 'It can stop the signal from your brain to your testicles to make testosterone, and so you stop making sperm,' said Dr. Dubin. That can make it very hard or impossible for a man to father a child.

People should also be careful about products sold online that claim to boost testosterone naturally. These dietary supplements are not approved by the FDA and probably do not work. Actual FDA-approved testosterone medications come in several forms, including gels, pills, injections, patches, and implanted pellets. Many of these can be ordered through telehealth services, but a 2022 study found that most online prescribing companies did not ask basic safety questions or even check whether patients truly had low testosterone levels.