Dr. Gerald Chodak is advising men who are considering going on testosterone replacement therapy to be aware of the known side effects and the unknown side effects with the drugs. Dr. Chodak published his warning on Medscape, a web resource for physicians and health professionals.
Testosterone treatments, such as AndroGel, Axiron and Testim, are FDA-approved to treat men with a condition in which an injury or disease prevents them from producing enough testosterone. This can result in symptoms such as low sex drive, muscle loss, weight gain, and fatigue.
However, pharmaceutical companies that sell testosterone treatments have launched aggressive marketing campaigns in recent years with advertisements that address men directly, asking if they are experiencing symptoms of so-called “Low T” and suggesting they talk with their doctors about testosterone therapy.
“The problems with the advertisements is that they are marketing testosterone replacement to men who may not have low testosterone levels,” Dr. Chodak said. “In 2013, one study found that about one quarter of the prescriptions were given to men who never had their testosterone levels measured. Thus, the idea of trying to reset the clock, improve men’s overall function, their ability to exercise, and their sexual function has been a marketing ploy that is not based on good evidence or support.”
As a result, prescriptions for testosterone products have skyrocketed in recent years.
Testosterone replacement therapy sounded like a fountain of youth until recent studies linked the medication to cardiovascular risks. One study found that men using testosterone supplements were at an increased risk for cardiovascular death, stroke and heart attack. Another study found that men younger than age 65 who have a history of coronary artery disease were at an increased risk, and men older than age 65 have an increased risk even if they do not have heart disease. The second study also found that men were at an increased risk of strokes and heart attacks within the first 90 stays of starting testosterone drugs.
What’s more concerning is there is little evidence to show that men who use the supplements actually benefit from the drugs.
An advisory panel for the FDA reviewed the drugs and recommended that further studies be done to determine the cardiovascular risks with testosterone drugs. The panel also suggested stronger wording on the drug’s label to stop overprescribing of the testosterone products.
“The long-term safety of these drugs is not well determined, particularly in men who may have any underlying cardiovascular disease,” Dr. Chodak warned.