A Doctor Weighs in on Testosterone Replacement Therapy

While various treatments for andropause (the male equivalent of menopause) are gaining popularity, testosterone replacement therapy is the only option tailored specifically to each patient’s needs by their doctor, making it the safest and most effective option.

While general awareness and understanding of testosterone replacement therapy has improved in recent years, many people still have questions. Is testosterone replacement therapy safe? What are the side effects of testosterone replacement therapy? How is testosterone replacement therapy different from over-the-counter drugs and supplements?

Mary Samplaski, MD, a urologist and andrologist with USC Urology, part of Keck Medicine of USC, answers these questions and more.

How do you know if you have low testosterone?

Testosterone commonly starts to dip in a man’s late 40s or early 50s, and the most common symptoms include:

• Low energy.
• Impaired libido (decreased sexual desire) and performance issues.
• Exercise intolerance.

Of course, other conditions can cause these symptoms, so it’s a good idea to call a doctor if they develop.

Why not just take an over-the-counter remedy?

Over-the-counter testosterone remedies commonly advertised on TV are mainly vitamin and herbal supplements.

“I actually believe in the global benefits of certain supplements, but there have been few, if any, studies showing that these supplements actually increase a person’s testosterone level,” Dr. Samplaski says.

And in the United States, not all supplements are regulated.

On the other hand, testosterone replacement therapy prescribed by a doctor is “very, very tightly regulated” due to the impact it can have on people’s bodies. This means patients can’t get testosterone replacement therapy without a prescription, but it also means that treatment is tailored specifically to each individual for maximum safety and effectiveness.

Does testosterone replacement therapy cause cancer?

Dr. Samplaski says that while public awareness and understanding have improved in recent years, there’s one harmful myth about testosterone replacement that refuses to die: that it causes cancer.

It does not.

How is testosterone replacement therapy administered?

Testosterone replacement therapy is most commonly given as a topical gel or an injection.

What if I’m too embarrassed to ask for it?

Direct-to-consumer advertising by testosterone pharmaceutical companies has resulted in more men requesting testosterone testing. This has resulted in men who would benefit from replacement seeking medical care.

Still, there are those who may feel shy or embarrassed about discussing their symptoms. Others may associate testosterone treatment therapy with negative stereotypes, but Dr. Samplaski says that getting treatment for low testosterone is just like getting treatment for any other medical issue.

“If you’re having symptoms,” she says, “there’s very little downside to getting checked, right?”

Besides, she adds, decreasing testosterone is a natural part of getting older — your doctor and their staff aren’t going to think you did anything wrong. It’s much more likely that they’ll just think you care about your quality of life.

For those who may feel shy or embarrassed talking about their symptoms, she says that many feel more comfortable having their appointment over telemedicine.

And according to Dr. Samplaski, her patients typically find the discussion more than worthwhile.

“Generally speaking, my testosterone replacement patients are my happiest because they just feel so much better,” she says. “For some, it can be life changing.”

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