Why so many men are obsessed with testosterone

Despite the anecdotal nature of the study, it had a seismic impact on medical practice. Most doctors stopped prescribing testosterone because the risk of prostate cancer was too high. This ban remained in effect for the rest of the 20th century. For about 60 years, “testosterone was administered almost nowhere in the world,” says Dr. Abe Morgentaler, a urologist at Harvard Medical School. When he was in medical school in the 1980s, Morgentaler told me, “I was taught that a healthy man given testosterone today would come back with aggressive prostate cancer in a month.”

However, Morgentaler was curious about the hormone’s potential. During his studies, he found that the mating dances of castrated lizards were restored when they were given testosterone. When he practiced as a urologist, more and more men came to him complaining of sexual problems. It took a decade for Viagra to be introduced, and doctors had little to offer. “I thought: Maybe boys are like my lizards,” says Morgentaler. He began prescribing testosterone to a small group of patients, warning them that it could increase their risk of prostate cancer. Desperate, most of the men carried on anyway.

To his surprise, many of his patients reported that not only were they now having a lot of sex, but that other aspects of their lives had improved. “They said, ‘My wife likes me again,'” he recalls. “Another says, ‘I wake up in the morning, swing my legs over the side of the bed and feel optimistic about the day. I haven’t felt this way in 15 years.'” As Morgentaler spoke at conferences over the next decade about his patients’ positive results, including preliminary data suggesting that the incidence of prostate cancer was not increasing, more and more doctors followed his lead.

But shortly after Morgentaler began treating his patients, a new obstacle arose. Doping scandals rocked the world of sports, and athletes trying to set records and win Olympic medals were caught taking testosterone and other anabolic steroids in doses much higher than what Morgentaler administered to his patients. In 1990, Congress passed a law adding steroids, including testosterone, to the Drug Enforcement Administration’s list of controlled substances. This made the hormone illegal without a prescription and introduced new restrictions for doctors.

After some studies published in the early 2010s suggested that TRT was linked to a potential increase in heart attacks and strokes, the FDA issued a warning for testosterone products. As part of the warning, the agency called on drugmakers to fund the largest randomized, placebo-controlled trial examining the risks and benefits of TRT