Is testosterone replacement therapy safe? Take a look at …

Millions of American men use a prescription testosterone gel, patch, or injection to boost levels of the manly hormone. The ongoing marketing blitz promises that treating "low T" this way can make men feel more alert, energetic, mentally sharp, and sexually functional. However, legitimate safety concerns linger, as explained in the February 2014 issue of the Harvard Men's Health Watch.

"Because of the marketing, men have been flooded with information about the potential benefit of fixing low testosterone, but not with the potential costs," says Dr. Carl Pallais, an endocrinologist and assistant professor of medicine at Harvard Medical School. "Men should be much more mindful of the possible long-term complications."

Some studies have found that men taking testosterone have more cardiovascular problems, like heart attacks, strokes, and deaths from heart disease. Some physicians also have a lingering concern that testosterone therapy could stimulate the growth of prostate cancer cells. Yet the evidence is mixed, with some studies showing a lower cardiac risk with testosterone therapy and no apparent effect on prostate cancer.

In such uncertain times, men should take a cautious approach, Dr. Pallais says.

"I can't tell you for certain that taking testosterone raises the risk of heart problems and prostate cancer, or that it doesn't," Dr. Pallais says. "We need a large study with multiple thousands of men followed for many years to figure it out."

Until then, here are some tips for taking a cautious approach to testosterone therapy:

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