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| Dr. Shezad Malik Law Firm

As a Texas Medical Doctor and a Dallas Dangerous Drug attorney, I am concerned by the onslaught of tv advertisements that specifically target older men. The ads ask the questions with a concerned male voice over, “Have you noticed a recent deterioration of your ability to play sports?” “Do you have a decrease in sex drive?” “Do you have a lack of energy?”

If so, the ads warn, you should “talk to your doctor about whether you have low testosterone” — “Low T,” is the new buzz word.

According to media experts in 2012, drug makers in the United States spent $3.47 billion on advertising directly to consumers. Abbott Laboratories spent $80 million advertising AndroGel last year. Sales of prescription testosterone gels that are absorbed through the skin generated over $2 billion in American sales last year.

The FDA approved testosterone treatment for people suffering from testosterone hormonal deficiencies caused by medical problems like endocrine tumors or the disruptive effects of chemotherapy, a medical condition called hypogonadism. Now the prescription gels are being sold as lifestyle products, to raise falling levels of the male sex hormone as men age.

Testosterone Treatment Benefit?

“The market for testosterone gels evolved because there is an appetite among men and because there is advertising,” said Dr. Joel Finkelstein, an associate professor at Harvard Medical School who is studying male hormone changes with aging. “The problem is that no one has proved that it works and we don’t know the risks.”

The gels are of questionable medical benefit for many of the millions of men who now take them, doctors say, and their side effects may well prove dangerous.

“These medicines come with a risk of coronary artery disease,” according to Dr. Topol, a cardiologist expert.

Low T No Such Disease

Many experts say that pharmaceutical advertising promotes excessive and inappropriate drug use by convincing patients that they are ill or have a more serious condition and they need medicine to treat it. While television viewers are pummeled with advertising warning men they may have “low T,” Dr. Finkelstein said, “There is no such disease.”

Patients of any age may benefit from testosterone replacement if their levels are severely low because of serious medical problems, experts say. But testosterone normally declines as men age — just as estrogen does in women.

The F.D.A. has approved the gels “for use in men who either no longer produce the male sex hormone testosterone or produce it in very low amounts.” But that directive is ambiguous.

Unanswered Questions About Testosterone

Should testosterone be replaced in older men, and will it safely redress frequent ordinary symptoms of male aging, like decreased muscle mass and libido? And what constitutes a very low amount? Dr. Finkelstein said, “Until there are big long-term studies to address the issues of testosterone replacement, we’re not ready to make recommendations on that.”

Sex Drive in Men Related to Estrogen

New research shows a different hormone may play a role in less sex drive and more fat as men age. Estrogen, the female hormone, is needed by men, too, and a new study gives the first clear evidence that too little of it can cause certain “male menopause” symptoms.

“A lot of things we think are due to testosterone deficiency are actually related to the estrogen deficiency that accompanies it,” said Dr. Joel Finkelstein. He led the U.S.-government funded study, which published recently in the New England Journal of Medicine.

Men’s bodies convert some testosterone into estrogen, and levels of both decline with age. Until now, there was no way to tell which hormone was responsible for complaints of diminished libido, strength and energy. While strength and libido do decrease with falling testosterone levels, that effect may not be significant until testosterone levels are very low, Dr. Finkelstein said. Low testosterone is rarely the main cause of erectile dysfunction. No one has really defined what is a “normal” or “physiological” testosterone level. And yet, physicians often order tests for “low T.”


  1. Gravatar for Jay

    Interesting perspective because it comes from a medical and legal professional because I am sure it is only a matter of time that middle aged men who have been conned and have suffered side effects might sue.

    As a middle aged male myself, after I noticed signs of natural decline in libido and energy level, after doing extensive research, I found that I needed to be more aggressive with my workout and make some dietary changes. It has helped me a lot. And I believe this is a better choice because I can do it the rest of my life and get other health benefits of diet and exercise.

    1. Shezad Malik MD JD

      Regular exercise, a healthy diet and keeping your weight down, is the surest and healthiest way of naturally boosting testosterone levels. Best part no side effects.

  2. Gravatar for mikeshell

    Some men go through a phase called andropause, caused my low testosterone. I did.It's a real problem for men, one that they might be ashamed of. But there is no need, I suffered for some time before I got the help I needed. is one site that helped me out a lot. Good Luck guys there is hope.

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