Testosterone Replacement Therapy: Separating Fact from Fiction

When I wrote this a dozen years ago, I said, “There has been a lot of hype about testosterone the last few years. I say hype because the claims have run way ahead of the science.”

Science has mostly caught up, so I’ve modified accordingly.

There are those who claim testosterone replacement is the next best thing to the fountain of youth. You gain muscle, you lose weight, your sex drive and function return to how things were when you were twenty. You sleep better, depressed vanishes, you have more energy, you think more clearly, and you’re able to leap tall buildings in a single bound. At best, these are exaggerations of effects seen in some men.

A superhero with the letter "T" on his chest.

It is looking like there are no simple “dose related” effects for testosterone, meaning you can’t get more of what testosterone does just by having more testosterone in your system. Above a certain level, adding more does nothing good, and can do harm. Studies show that in men with testosterone in the normal range, actual levels had nothing to do with sex drive, or sexual frequency. And if low T is killing your erections, it’s so low you have no interest in sex.

One big problem is we don’t have a handle on what “normal” levels means. Look at two men with the same levels of testosterone and one is showing signs of low testosterone, while the other is not. The first might benefit from testosterone supplementing, the second will not.

At this point, in 2024, it looks like the benefits outweigh the risks for most men. This is where your doctor come in. You can get a testosterone prescription online without giving much information. Please don’t do that. It’s quick and there is no embarrassment, but you’re bypassing the safety of dealing with a doctor who knows your unique health situation.

What about women? Testosterone has been suggested as a cure all for low sex drive in women, and especially in post-menopausal women. Thing is, a well done study found that higher levels of testosterone in women resulted in them having an increased desire to masturbate, but not to have sex with a partner. No one has done a study to see if giving women testosterone increases their desire to masturbate, but it seems likely this is the case. Hardly the result most men want! Recent research has found low levels of testosterone to be fairly safe for women, but I still can’t find solid evidence it results in more or better sex.

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9 responses to “Testosterone Replacement Therapy: Separating Fact from Fiction”

  1. Love Letters says:

    What’s the motivation behind this post? Not sure you’ve got either personal experience or medical expertise to either recommend or dissuade someone trying testosterone in response to a personal issue. I look to your blog to help me become a more generous husband, and improve my marriage as a result. Just not sure what action I supposed to take here? Just to research testosterone before using it?

  2. Love Letters – I am motivated by recently seeing a number of research based articles that warn about possible harm to those who use testosterone. Given that I talk about sex here, I felt I had both a place and a responsibility to mention this.

    I have no personal experience with this. I’m not in the medical field, but I’m a very well read layman. I gave links to both popular media stories and research papers for those who want to read more.

    Bottom line I want to make sure men don’t jump blindly onto a bandwagon that could have very bad results.

  3. Taki says:

    Is it possible that women who after using Testosterone had an increased urged of masterbation was due to them not being used to be sexual active due to low libido, so it becomes overwhelming moving to have sex 2x a month to asking for it say 4x a week (m exagarating just to make a point)…just this one finding can be further investigated for another 4 or more years!!

    • Pa’dam says:

      It sounds like that they were just hiding the extra by satisfying their needs solo. To me, that is still sexually active, just not with a partner. Maybe they didn’t want to be “too easy.” Maybe they were under some sort of social pressure to not stand out from the “normal” crowd. Maybe it was opportunity driven in that they wanted more than their specific situation could provide. I suspect there is more here that might be very helpful in the future.

  4. Taki – The study was not on adding testosterone, but looking at the natural testosterone levels of women and asking about their frequency of partner sex and masturbation.

    Actually this is not the first time this has been found – a decade or more ago a study of teenage girls found the same thing – those with higher T levels were not more sexually active, but they did masturbate more.

    If a woman with high T were in a loving relationship, I’d think she would gladly aim that desire at her guy, but I don’t have studies to support that.

  5. Daniel says:

    So, when a woman starts the T flowing, she turns into a teenage boy. Heh…

  6. Eleutheros says:

    Part of the HCG weight loss my Precious One and I went through 2 years ago included bio-identical hormone balancing. Testosterone is a hormone that works it’s ‘magic’ in balance with other hormones, including the several types of testosterone. More is, indeed, not better. And synthetic hormones should be avoided completely.

    Balance seemed to be the key for unlocking testosterones benefits me and was verified through comments by those who hadn’t seen me in a while that I seemed to have more hair on my head and looked younger and healthier. My libido also increased as my precious one will testify.

    THIS is all I have to offer, my experiences, shared.

    Be good.

  7. Pa’dam says:

    I can’t help but wonder if the cardiovascular issues were due to years of living the kind of lifestyle that comes with lower T levels, then changing habits. What I mean is, decades of less activity in many ways might result in a buildup in arteries and such that goes unnoticed because the lifestyle hasn’t been hindered by it. Then with increased T, they begin to do more again and find that the buildup doesn’t permit enough blood to support it. Maybe the problem was already there but not serious enough to notice under the circumstances and the change in circumstances just revealed it.

    In that same “vein,” I wonder if a continuing, gradual increase in T might result in their body naturally breaking the buildup loose, preferably dissolving it, and flushing it out of their system much the way healthier eating habits and more exercise might do. The result would be better health and lower risk of heart trouble and stroke in the long run though it might be a rough process for a while, especially if they rush it.

    You might ask, why not just eat healthier and exercise more. That’s a good option and viable if you have the motivation and discipline to do it. Low T can hamstring that plan. If this was doing what it sounds like it was, increased T might just jumpstart the process. Gradual increase until a better state of health/fitness is achieved followed by a gradual weaning off with a good exercise and diet plan to keep you going. Of it might mean that some would need the increase to maintain. That would take time and care to learn.

    I’m curious what more they have learned on this in the intervening years.

  8. Pa’dam says:

    Oh and, while I desperately want my wife to want increased activity WITH me, I would be happy to see her begin masturbating. It would force her to take a better look at the convoluted butchering of Scripture underpinning her current belief on the subject. Such an honest and necessarily honest assessment SHOULD change much in our home for the better. We are pretty stubborn and hard headed, though, the both of us. It might take a while for her to come around. That might be another rough process but we’ll worth it in the end if it worked out right

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