Testosterone has been the subject of controversy lately, mainly because people keep trying to sue pharmaceutical companies for allegedly dangerous side effects of testosterone replacement therapy (TRT).

The Mayo Clinic recently published a new review of the existing medical literature and found no evidence of a link between TRT and cardiovascular risk. In fact, the review found evidence that the opposite is true: studies show that higher testosterone levels could actually contribute to a reduction in the risk factors associated with these conditions.

Still, discouraged by the rumors and hordes of baseless lawsuits, many doctors are becoming increasingly reluctant to prescribe TRT for patients suffering from low testosterone levels in their bodies (Low-T).

So why is there so much controversy surrounding TRT? Why do many physicians shy away from prescribing a proven treatment that can improve the lives of so many men?

First, let’s get our facts straight. Testosterone plays a very important part in our bodies and is involved in the processes for building muscle and bone mass, sperm and red blood cell production, sex drive and many other key bodily functions. Men suffering from low testosterone levels often find themselves gaining weight, chronically tired, disinterested, depressed and unable to have a normal sex life.

Low-T is a medical condition primarily caused by underproduction of testosterone by the testes, which are controlled by the pituitary gland and the hypothalamus. Typically, a man’s testosterone levels begin to decrease naturally past the age of 30 by around 1 percent a year.

About 40 percent of men over the age of 45 suffer from Low-T. The condition can be significantly sped up by smoking, stress, unhealthy diet, diabetes, obesity and a number of other factors.

Testosterone has long been a well-known treatment of this condition, however, in recent years the prevalence of TRT prescriptions has skyrocketed. Sensing the increased demand, drug companies quickly developed and began to aggressively market various testosterone-infused gels and creams that make it easy for people to take TRT into their own hands. Physicians lacking experience in prescribing testosterone, and a multitude of lawyers seizing every opportunity to cash in on their incompetence have been a major factor behind the controversy.

In the Mayo Clinic review, Harvard Medical School Professor Dr. Abraham Morgentaler and his team looked at all the studies conducted since1940. In the end, they only found four studies that connected an increased cardiovascular risk with testosterone prescriptions. Two of those four studies had serious methodological problems, which should give medical professionals pause. On the other hand, the review found dozens of studies demonstrating a link between Low-T and cardiovascular and mortality risks.

So what does this mean? Despite very public and very scary criticisms, there is absolutely no science behind claims that TRT increases the risk of heart disease or stroke.

Still, TRT is a medical treatment, and it needs to be given under the supervision of a highly qualified expert. Patients who suffer from the symptoms of Low-T should demand that their medical professional conducts a comprehensive evaluation and examination, and that they receive an individually tailored treatment plan that includes careful, regular monitoring.

This is a great deal of work for doctors, who could just as easily write a prescription for a testosterone gel and send patients on their way. That said, as medical professionals, we have a responsibility to “first, do no harm.” To me, this means that we have to treat Low-T like the real medical condition that it is.


Dr. Christopher Asandra, M.D., is an experienced physician, innovative entrepreneur and passionate caregiver who has dedicated his medical practice to improving the lives of men across the country. As the Founder and Chief Medical Officer of NuMale Medical Centers, Dr. Asandra has helped thousands of men suffering from E.D., low testosterone and other sexual dysfunctions rediscover and revive their confidence, energy and relationships.