The Rising Trend of Testosterone Replacement Therapies

Posted by Dr. Michael White, Published on February 20th, 2025
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Recent TV commercials have highlighted the life-changing aspects of testosterone replacement therapies such as Androgel and Axiron, which treat low testosterone in men, also known as hypogonadism. While this treatment has long been established, the approach has seen a transformative shift in recent years, moving from doctor-administered injections to topical gels for home use.

Historical advancements in Testosterone Treatments
The Food and Drug Administration (FDA) approved the first topical gel, Androgel, in 2001. A year later, Testim joined the list of FDA-approved treatments, followed by Axiron in 2010. As an alternate option, the first FDA-approved testosterone skin patch was introduced in 1995, with a newer, lower dose daily version of the Androderm patch coming out in October 2011.

The Allure of Testosterone Treatments in Younger Men
Increasingly, men in their 30s and 40s experiencing fatigue, loss of libido, and less than optimal sexual function are resorting to Low T medication. Numerous men view this as a solution to what they perceive as a deficiency, believing that replenishing what's missing will restore normalcy.

The Downside of Testosterone Replacement Therapy
However, this trend is concerning Dr. Bryan Hecht, a reproductive endocrinologist and fertility specialist at University Hospitals Fertility Center West. According to Dr. Hecht, these therapies might be the cause of low or nonexistent sperm levels in an increasing number of men he consults. Despite testosterone improving libido and sexual function, it can suppress the body's ability to produce sperm in large doses. This is one of the numerous potential side effects that have led the FDA to issue a comprehensive list of possible side effects.

Expert Insights on Testosterone Therapies and Fertility
Dr. Hecht adds, “historically, the majority of men treated for low testosterone tended to be somewhat older. That's why I think the impact on fertility hasn't gotten a whole lot of emphasis." As a result, those considering fatherhood may need to reconsider their options before diving into low testosterone treatments, he advises.

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