The use of the anabolic steroid testosterone as the primary component of hormone replacement therapy (HRT) for men had been gradually increasing throughout the 2000s. Men suffering from testosterone deficiency and reduced libido were asking their doctors if testosterone was right for them and doctors were saying yes.
The popularity of testosterone replacement therapy seems to have peaked in 2014. The number of testosterone prescriptions has declined ever since then. Abraham Morgantaler, a leading medical expert in hormone replacement, thinks the decline has less to do with the therapeutic effectiveness of testosterone and more to do with the media coverage of it.
The promise of hormone replacement therapy (HRT) for improving the health of middle-aged and older men has been largely derailed by “medical hysteria” according to Morgantaler. In a recent article published in the medical journal “Nature Reviews: Urology”, Morgantaler says that the news media has “hijacked” legitimate medical opinion with unwarranted concerns of cardiovascular risk.
“A recent study has shown a decline in testosterone prescriptions since media reports of potential increased cardiovascular risk in 2014,” wrote Morgantaler. “The phenomenon of medical hysteria accounts for this reduced prescribing, as numerous subsequent studies provide substantial evidence of reduced cardiovascular risk and other important benefits with testosterone therapy for men with testosterone deficiency.”
Morgantaler’s review of the literature on the topic seems to indicate that testosterone therapy does not cause any adverse cardiovascular side effects when prescribed at therapeutic levels consistent with HRT. To the contrary, testosterone only provides cardiovascular benefits. So anyone who avoids TRT because they think it is bad for the heart is doing so out of “medical hysteria”. Morgantaler defines medical hysteria as the phenomenon where “medical opinion can be hijacked by media stories that distort science by only emphasizing studies that deemed newsworthy”.
Patients who would otherwise benefit from TRT read news stories that sensationalize the supposed dangers of testosterone and they either decline doctor-recommended TRT or they ask for alternatives to TRT.
Sometimes even the doctors are influenced by the medical hysteria. A major problem in medical practice is the lack of time that physicians have to read and review the actual empirical research in medical journals. Many doctors regrettably receive the latest news about medical treatments from the news media because they simply don’t have enough time to read journal articles.
The unfortunate result of all of this is that patients who could otherwise benefit from testosterone prescriptions are not receiving the best possible medical care.
Morgentaler, A. (August 30, 2018). Testosterone therapy and medical hysteria. Retrieved from nature.com/articles/s41585-018-0081-2