It is ironic that just as HRT for menopausal women seems to be coming to an end (because of the recent announcement of significant health risks associated with these medications1), some drug companies and some physicians are pushing the use of testosterone products for “male menopause.”
Disappointed, frightened and perturbed women are dumping their pills and patches, and many of them are also dumping on the medical profession. In my own practice, most of the women who have been taking HRT have just one question for me: “Should I quit cold turkey, or should I stop gradually?” Fortunately, I feel no need for any mea culpas — I have largely resisted the siren songs describing the putative benefits of female HRT. But now I am hearing the same story for male HRT.
We physicians must now be wary of claims that testosterone products can improve libido, energy, mood, stamina, strength, lipid ratios and heart disease2 — the same benefits that have been claimed for estrogen replacement in women. We are told that approximately a million Canadian men over age 60 are at risk of problems in these domains,2 but the “cure” may be worse than the “disease” — a number of rather scary adverse drug reactions for one such testosterone product are to be found in tiny print in the prescribing information.3
It's bad enough when ads on television and in the print media bombard men with examples of lethargic middle-aged men made youthful and potent again. When we physicians get on the bandwagon, our unwary patients are put at additional risk of being given these testosterone products. As suggested by David Sackett,1 physicians are strongly influenced by favours from drug companies. We still get much of our information at luxuriously catered meetings where we listen respectfully to prominent endocrinologists and urologists, who are often spokespersons for these same drug companies.
Luckily, 85% of eligible women rejected HRT for all these years. Will as many men resist such temptation?