Testosterone has joined Viagra as one of the most popular prescriptions for men of a certain age who suffer from what has been described as the male menopause, according to a study published on Wednesday.
Tens of thousands of men in the US are being prescribed testosterone in the form of patches, gel and injections.
The report comes out as other studies suggest that one of the largest growth areas for plastic surgeons is among men of a similar age.
Plastic surgeons reported this week an increased demand from men wanting to deal with sagging chins, stomachs and buttocks and even some who want their calf muscles pumped up to give them a more youthful appearance.
The study on testosterone, by the Institute of Medicine, found that the demand for prescription treatment by middle-aged and older men whose hormone levels were near normal was rising rapidly. More than 1.75 million prescriptions for testosterone products were written last year, a 170 percent increase in three years.
There is little research available into the long-term effects of such treatment which would be seen as a male equivalent of hormone replacement therapy for women about which recent studies have raised concerns. Men who seek the testosterone complain of lowered libido and fatigue.
While the US Food and Drug Administration has approved the testosterone therapy for men who suffer from hypogonadism, a condition in which the body makes very little testosterone, it has not passed it for other uses. An estimated four to five million American men suffer from this condition, but few appear to be the new patients seeking the testosterone treatment.
The report concludes that there is insufficient data to reach firm conclusions on the benefits or potential dangers of the treatments.
Such lack of research is unlikely to affect the demand, if the story of Viagra is any comparison. Once Viagra's magical properties became known, millions of men sought it in prescription form or over the internet with little concern about what its long-term medical effects might be.
Once news of the testosterone treatment becomes better known the same seems likely to happen. The main concern is said to be that it could increase the risk of prostate cancer.
"Certainly there are people out there who say testosterone replacement therapy is just wonderful, and others who say it doesn't do any good at all," said Dr. Dan Blazer of Duke University Medical Center, who led the team that conducted the study. "What we're saying is we just don't know," he said.
The report also considers whether the male menopause, or andropause as some doctors call it, requires treatment at all.
A study into long-term effects is not due to start until 2005. In the meantime, the report cautions that it should only be given to men who have identifiable medical reasons for its use rather than as an aid to virility.
Dr. William Rosner, a testosterone specialist at the college of physicians and surgeons of Columbia University, said: "Andropause, I don't know what that is. I don't know who coined this word, but to my mind it's a disservice."
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