Just at the time when carefully designed studies of female hormone replacement therapy for postmenopausal women are revealing risks that many experts did not anticipate, other doctors are promoting hormone replacement for older men in the form of a gel that’s rubbed into the skin.
LIKE MANY MEN approaching middle age, Jim Metts was losing some of his sex drive, energy and memory. “I just didn’t feel as youthful as I should at 48,” he said. At first he didn’t discuss it much. “This was a private thing between my wife and myself,” he said.
But then Metts heard about testosterone replacement therapy. He found Dr. Robert Tan who often prescribes it.
“Probably one in three men above 60 are what we call hypogonadal, or low on testosterone. And a lot of these men are not diagnosed yet,” said Tan of the University of Texas Health Science Center in Houston.
Tan measured Mett’s testosterone level, diagnosed him as deficient and prescribed testosterone gel. Metts said he immediately recovered virility, strength and memory.
“I feel like I’m in my 30s again,” he said. So is testosterone an elixir of youth for millions of men? Scientists have know for decades that testosterone, a well-studied male hormone, increases muscle mass and can make men more aggressive. But until recently it was available only as an injection or an uncomfortable patch.
But the new gel, a prescription product that comes in ketchup-like packets which cost about $250 a month, has led to a lot of marketing to both doctors and the public.
Many experts are skeptical.
“It is a little simplistic to think that giving a single hormone could really be the panacea for aging,” said Dr. Frances Hayes of Massachusetts General Hospital.
And there is fear of side effects — the hormone can increase blood clotting and risk for heart attack, cause men’s breast to swell and make prostate cancer grow faster.
“If there’s a cancer that’s already existing and it’s hidden, the concern is it will grow more quickly if you give testosterone — like feeding it food,” said Dr. Abraham Morgentaler of Men’s Health Boston.
And experts point out there have been no big long-term studies of testosterone replacement. And many believe if the studies were done — as they were with female hormones — they could reveal far bigger risks than anyone knows.