Latest / The Morning Edition / Better sex life, mood and muscles, but there are risks to our testosterone obsession

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Better sex life, mood and muscles, but there are risks to our testosterone obsession · The Morning Edition

• 0:04
  S1: It's the latest health buzzword proposed as a magic cure
• 0:07
  S1: for everything from dementia to a low libido. But is
• 0:11
  S1: it safe or even advisable to take supplementary testosterone? I'm
• 0:17
  S1: Samantha Selinger Morris, and you're listening to Morning Edition from
• 0:20
  S1: The Age and The Sydney Morning Herald. Today, explainer reporter
• 0:24
  S1: Madeleine Heffernan on what the experts want us to know
• 0:28
  S1: and what this latest cultural obsession says about us right now.
• 0:33
  S1: It's August the 4th. Welcome, Madeleine, to the podcast.
• 0:40
  S2: Thanks for having me.
• 0:41
  S1: Okay. I'm so excited to speak to you this morning
• 0:44
  S1: because testosterone has become an absolute cultural phenomenon. So I
• 0:49
  S1: guess just tell us why are so many people buzzing
• 0:51
  S1: about it now?
• 0:52
  S2: Well, I think there are lots of reasons. One is
• 0:55
  S2: that men and women use it. So it's a huge market.
• 1:00
  S2: It's obviously big in the US. We have a secretary
• 1:03
  S2: of health who says he uses it for anti-aging.
• 1:06
  S1: This, of course, is Robert F Kennedy Jr.
• 1:08
  S2: Yes, we have a Secretary of War who has just
• 1:11
  S2: introduced that they will test the levels of military members
• 1:15
  S2: for both men and women 30 and over. And they've
• 1:17
  S2: actually as well in the US, introduced testosterone ways to
• 1:22
  S2: boost your testosterone in their nutrition guidelines over there as well.
• 1:26
  S2: So it's huge in the US. It's really big in
• 1:28
  S2: the UK because of, I guess, the idea that women
• 1:32
  S2: going through menopause and perimenopause need a lot of support.
• 1:35
  S2: And does testosterone provide that? And here in Australia, we
• 1:38
  S2: have a really interesting history with testosterone, because we were
• 1:42
  S2: the first country to ever regulate and approve the use
• 1:45
  S2: of testosterone just for women.
• 1:47
  S1: Okay. That is so interesting. And I guess broadly, before
• 1:50
  S1: we get into all of the claims, because there are
• 1:52
  S1: many about what testosterone can do to men or women,
• 1:56
  S1: I just wanted to ask you, is there a cultural
• 1:58
  S1: or political drive or impetus perhaps behind this trend? Like,
• 2:02
  S1: why do we think this is happening now?
• 2:04
  S2: So interesting. All the kind of cultural stuff behind it.
• 2:09
  S2: I think the internet is obviously playing a huge part
• 2:12
  S2: in this. If you're online and pretty much all of
• 2:14
  S2: us are, you're probably seeing a lot of testosterone content.
• 2:17
  S2: If you're a young man or even an older man,
• 2:19
  S2: there's a lot to do with strength and vitality and
• 2:22
  S2: what it is to be a man, I suppose.
• 2:25
  S3: Five signs that you have low testosterone.
• 2:27
  S4: If you do not know your testosterone level, it is
• 2:29
  S4: critical to know this as a man. If you want
• 2:31
  S4: some help getting some blood work done. Comment the word
• 2:33
  S4: TRT down in the comments below, and I'll send you
• 2:36
  S4: the information on how to do just that.
• 2:37
  S5: If any of this sounds like you, I'm here to help.
• 2:39
  S5: I created a free step by step training to help
• 2:42
  S5: you boost your testosterone levels naturally and get your lean, fit,
• 2:45
  S5: and energetic body back.
• 2:48
  S2: And for women, I guess we've grown up with perhaps
• 2:52
  S2: mothers who went through menopause in a quiet way, and
• 2:56
  S2: that's not happening anymore. So there's a lot of discussion
• 2:58
  S2: about how can I get through this sort of tricky period,
• 3:01
  S2: and why do I have to pay so much for
• 3:04
  S2: medication when men don't have to pay very much for testosterone,
• 3:08
  S2: which is subsidised by the PBS? So that's a big
• 3:11
  S2: part of the discussion as well.
• 3:14
  S1: And just to give this some context, I mean, just
• 3:16
  S1: how many people are actually now taking supplementary testosterone? Like,
• 3:19
  S1: is this a niche prescription or has it become mainstream?
• 3:23
  S2: I wouldn't say it's mainstream yet, although this is probably
• 3:27
  S2: a case where the discussion is more vocal than the
• 3:30
  S2: actual usage. Having said that, a lot of men in
• 3:34
  S2: particular take it and we might not know about it
• 3:36
  S2: because they source it unofficially. We know in Australia about
• 3:40
  S2: 2000 women take Androfeme, which is the female specific testosterone,
• 3:46
  S2: and then men. There are 14 testosterone products on the PBS.
• 3:51
  S2: The numbers are actually not that high, but they have
• 3:54
  S2: been on the increase because we're an ageing population, and
• 3:57
  S2: testosterone levels do decline with age.
• 3:59
  S1: Okay, so let's get into, I guess, what claims we're
• 4:02
  S1: hearing either from medical professionals or for people just spruiking
• 4:06
  S1: it online as to what testosterone can actually do for people.
• 4:10
  S1: Like what are we hearing?
• 4:12
  S2: Well, in some parts of the world, testosterone has become
• 4:15
  S2: a kind of shorthand for masculinity. So the claims around
• 4:19
  S2: it are basically to do with strength, sexual power, wellbeing, vitality.
• 4:26
  S2: There is some truth to all that as well, because
• 4:29
  S2: testosterone has been around for a long, long time. And
• 4:31
  S2: we know that it does actually increase muscle mass and
• 4:34
  S2: it does help with sexual performance. But I suppose it's
• 4:39
  S2: shifted from being seen as kind of an old man
• 4:41
  S2: product to a younger man's product. And the concern is
• 4:44
  S2: that testosterone is being touted towards men who don't need it,
• 4:48
  S2: who don't have a deficiency. They're young, they have very
• 4:51
  S2: healthy levels. But the idea is that you're feeling tired,
• 4:55
  S2: you've got low energy. Maybe your sex drive is a
• 4:57
  S2: bit off. Maybe you have a testosterone deficiency. So that
• 5:01
  S2: is the concern among the experts that we spoke to.
• 5:04
  S2: And for women, it's really being promoted as a cure
• 5:07
  S2: for everything from brain fog to low energy. All of
• 5:12
  S2: the stuff that kind of comes through perimenopause. But really,
• 5:16
  S2: the research only shows that it's helpful for one thing,
• 5:19
  S2: for women.
• 5:20
  S1: Okay, so let's get into this. I mean, what are
• 5:22
  S1: the experts actually saying? What claims do stack up? How
• 5:26
  S1: does testosterone help and in what ways for both men
• 5:29
  S1: and women? Like what does the science actually tell us?
• 5:32
  S2: Well, look, there's a lot of research going into this.
• 5:34
  S2: So it is a field that will continue to provide
• 5:36
  S2: new answers, I suppose. But at the moment, as it stands,
• 5:39
  S2: testosterone is only useful for post-menopausal women and improving their
• 5:45
  S2: sex drive. So how receptive they are to sex and
• 5:48
  S2: how much they enjoy it. But people say, well, it's
• 5:52
  S2: actually useful for a lot more than that. And for
• 5:54
  S2: men it is useful for muscle mass, it is useful
• 5:57
  S2: for libido. It's essential and very safe. Endocrinologists say, who
• 6:03
  S2: are hormone specialists, very safe for men and useful for men,
• 6:07
  S2: their sexual health and their general well-being. For men who
• 6:09
  S2: don't produce enough and they tend to be older, they
• 6:12
  S2: tend to have diabetes and they tend to be overweight.
• 6:15
  S1: And so then for men who have sufficient testosterone levels, naturally.
• 6:19
  S1: Is there any benefit for them taking supplementary testosterone?
• 6:23
  S2: Mhm. That's a tricky one, because the way we measure
• 6:25
  S2: testosterone differs throughout the world. So different countries have different
• 6:30
  S2: measures of what is clinically low testosterone. But generally speaking,
• 6:35
  S2: testosterone is a drug that has a very high placebo effect.
• 6:38
  S2: So the fact that people are taking it and they
• 6:41
  S2: tend to say that they're receiving a lot of benefits
• 6:43
  S2: from it. So that's one major issue with the drug,
• 6:46
  S2: I suppose. And the second thing is that there are
• 6:49
  S2: actually a lot of side effects from it too, whether
• 6:51
  S2: it's acne or it's its irritability, its hair loss, and
• 6:56
  S2: then ranging to the more serious side effects. If you're
• 6:58
  S2: a young man and you're taking it and you don't
• 7:00
  S2: need it. Some of the effects can be permanent, including
• 7:04
  S2: low or no fertility. So that's why all the doctors,
• 7:08
  S2: all the medical experts that we spoke to, said that
• 7:10
  S2: it's really essential for men in particular, that if they're
• 7:13
  S2: concerned about their testosterone, that they need to be tested
• 7:16
  S2: and have their usage followed by a professional, otherwise they
• 7:19
  S2: risk perhaps infertility down the track.
• 7:22
  S1: Well, I wanted to ask you about the potential dangers
• 7:25
  S1: in both men and women taking testosterone, because some of
• 7:28
  S1: them are, I mean, are quite severe. You mentioned some
• 7:31
  S1: of them there, but in men you've written that evidence
• 7:33
  S1: shows that if you take too much, men can suffer
• 7:36
  S1: testicular shrinkage, breast development, reduced sperm production or infertility. And
• 7:41
  S1: in women, a permanently deepened voice. Changes in menstruation. Uncomfortable
• 7:45
  S1: clitoral enlargement can also make women irritable and hot headed,
• 7:49
  S1: and both men and women can suffer hair loss, irritability
• 7:52
  S1: and acne. So I guess my question for you is,
• 7:55
  S1: do you think that people is there a wide understanding,
• 7:58
  S1: I guess, do you think about the dangers of this,
• 8:00
  S1: you know, hormone that is being touted as something of
• 8:03
  S1: a cure all for all kinds of conditions?
• 8:06
  S2: Perhaps not. And the reason that there are so many
• 8:09
  S2: of these side effects sort of coming through is because
• 8:12
  S2: not in Australia, because we have a women's product regulated here,
• 8:15
  S2: but in other markets, including in the US, women are
• 8:18
  S2: taking the male product, which means they're taking too much.
• 8:22
  S2: And that's why we're seeing these horrendous side effects. There
• 8:25
  S2: are side effects anyway. I mean they're safe, but there
• 8:27
  S2: are side effects from taking the women's product. But when
• 8:30
  S2: you take the men's product and you take too much,
• 8:32
  S2: that's when these horrible side effects come. And I guess
• 8:37
  S2: the reason why we're seeing so many side effects in
• 8:39
  S2: men as well is because many are taking it outside
• 8:42
  S2: of medical supervision and bought from unofficial sources, you know,
• 8:47
  S2: apps or contacts through gyms or whatever it is. And
• 8:51
  S2: they don't know what they're taking. They don't know what
• 8:53
  S2: levels they're taking. So that's why we're seeing these stories
• 8:56
  S2: of sort of horrendous side effects.
• 9:07
  S1: After the break.
• 9:09
  S2: These women have regained their sex drive in a big
• 9:12
  S2: way and are really enjoying their sex lives, probably for
• 9:14
  S2: the first time in a long time.
• 9:28
  S1: Okay. And I wanted to ask you about something on
• 9:30
  S1: that point because you had something fascinating in your piece,
• 9:32
  S1: which is that one Sydneysider Belinda told you that some
• 9:35
  S1: of her friends have figured out what they called a
• 9:37
  S1: hack to get their GP to prescribe them with testosterone
• 9:42
  S1: for off label reasons. So you've already gone into the
• 9:45
  S1: science behind it, which is that there's one medical reason
• 9:47
  S1: for which testosterone supplements are approved for women, and that
• 9:50
  S1: is specifically for postmenopausal women who are distressed about having
• 9:53
  S1: a low libido. So tell us what these women were
• 9:56
  S1: wanting testosterone for, and how are they actually managing to
• 9:59
  S1: get it for conditions for which this medicine is not approved?
• 10:03
  S2: I spoke to Doctor Corinna Severin, who's a women's health
• 10:07
  S2: general practitioner in Melbourne and Sydney. Patients are coming to
• 10:11
  S2: her and they want testosterone for everything from muscle strength
• 10:15
  S2: to mood, brain fog, cognition, general vitality, wellbeing, dementia, she says.
• 10:21
  S2: You name it. Someone will have said testosterone is the
• 10:23
  S2: magical cure for that. And she says that patients will
• 10:27
  S2: be very, very insistent that that's what they want. She's
• 10:31
  S2: not the only one. A lot of women are going
• 10:33
  S2: into their doctor's clinic and saying, I want testosterone. And
• 10:36
  S2: doctors have different ways of dealing with that request. Look,
• 10:40
  S2: a lot of women say they're really tired and they
• 10:43
  S2: want energy, and they believe that testosterone will give it
• 10:46
  S2: to them, but they know that that is not an
• 10:49
  S2: approved reason for getting it. So they go to their
• 10:51
  S2: GP and say, look, I have a low libido. I
• 10:53
  S2: used to have a great sex drive and now I don't.
• 10:55
  S2: And it's really affecting my relationship. It's really affecting my mood.
• 10:59
  S2: And then the GP will ask you a series of
• 11:01
  S2: questions and generally prescribe it, even if that woman is
• 11:06
  S2: getting testosterone for a different reason. Now that's called off
• 11:09
  S2: label prescription, and it's probably quite common for testosterone. Now,
• 11:14
  S2: the reason that the women are doing that is because
• 11:16
  S2: they've heard word of mouth and anecdotally, that testosterone is
• 11:19
  S2: really helpful for reasons beyond low libido. That is distressing.
• 11:23
  S2: But a lot of doctors that we spoke to had
• 11:25
  S2: mixed feelings about that, because they say that the research
• 11:28
  S2: doesn't show that it's helpful for energy. And if there
• 11:30
  S2: is any kind of boost, it's perhaps from placebo.
• 11:34
  S1: Right. Okay. And so I'm just curious because we're speaking
• 11:37
  S1: about this now, but you've written a multi-thousand word explainer
• 11:41
  S1: on this. It's a very deep dive. I'm dying to know.
• 11:43
  S1: What were you most surprised to discover about Testosterone use.
• 11:48
  S2: I loved writing, it was it was fascinating. I think
• 11:51
  S2: the most interesting thing was how testosterone might be used
• 11:54
  S2: in the future. I find that really fascinating. We know
• 11:57
  S2: there's sort of unmet demand already for vitality and well-being
• 12:01
  S2: and sex drive, but then we also know that there's
• 12:04
  S2: a lot of studies going on right now about the
• 12:08
  S2: idea of using testosterone to offset some of the lean
• 12:11
  S2: muscle mass that gets lost when people take ozempic and
• 12:14
  S2: weight loss drugs. So Michael Buckley, who's the CEO of Lawley,
• 12:19
  S2: which makes testosterone here in Australia, he believes in the
• 12:22
  S2: future after studies and regulators tick it off, he believes
• 12:26
  S2: in the future that we will be using testosterone when
• 12:29
  S2: we take ozempic, which means we lose the fat, but
• 12:32
  S2: we don't lose all the muscle. I think that's really fascinating.
• 12:35
  S2: That will be a huge market, obviously, if it comes
• 12:37
  S2: to pass. The other idea that's really strong, particularly among
• 12:41
  S2: women who are huge fans of testosterone, is the idea
• 12:44
  S2: of adding Testosterone to hormonal treatment therapy in the future.
• 12:49
  S2: That's the idea of testosterone being the missing hormone, I suppose.
• 12:53
  S2: So at the moment, you'll take your estrogen, your progestin,
• 12:56
  S2: and then perhaps in the future, you'll take testosterone as
• 12:59
  S2: well to help you manage that kind of difficult period.
• 13:01
  S1: But that is, again, that would just be to help
• 13:03
  S1: women's libido. Because my understanding from your piece is that
• 13:07
  S1: any benefits other than for libido are actually unproven.
• 13:11
  S2: Well, that's true, although that might change in the future. Look,
• 13:14
  S2: there is research looking at whether testosterone is helpful to
• 13:17
  S2: women in other ways as well, and whether testosterone will
• 13:21
  S2: be helpful for women and their libido earlier in life
• 13:24
  S2: before menopause. So that might change. But at the moment, yes,
• 13:29
  S2: that's all we know. At the moment, it's only helpful
• 13:31
  S2: for women and their libido post menopause.
• 13:34
  S1: And also I should sort of flag as well. I
• 13:35
  S1: thought this was quite fascinating that Sydney sexual health physician
• 13:38
  S1: that you spoke to this is Doctor Terry Farren. She
• 13:41
  S1: said that about half of her female patients who take
• 13:43
  S1: testosterone discontinue it after a trial. So does that mean
• 13:47
  S1: that even though it is proven to help boost post-menopausal
• 13:52
  S1: women's low libido, that actually it doesn't do that for everybody?
• 13:56
  S2: Yes, is the answer. However, I would say in terms
• 13:59
  S2: of libido, it does help, but not all that much.
• 14:01
  S2: So it's not like you've got no sex drive and
• 14:04
  S2: then you have a huge sex drive. Maybe you've got
• 14:05
  S2: a little bit of a sex drive. Maybe you say
• 14:07
  S2: yes next time. So I suppose it's a quite a
• 14:09
  S2: subtle change.
• 14:11
  S1: Okay. And I wanted to ask you a question because
• 14:13
  S1: we mentioned just before that for most women, it sounds
• 14:16
  S1: like the positive impact they get from taking testosterone is
• 14:18
  S1: relatively mild, perhaps in comparison with men who are low
• 14:22
  S1: in testosterone, and they're taking it. But you did quote
• 14:25
  S1: one writer in your explainer. This is Susan Dominus, who
• 14:28
  S1: spoke about women pursuing dramatic highs. So can you just like,
• 14:32
  S1: just tell us a little bit about what she was
• 14:34
  S1: talking about there?
• 14:36
  S2: Yes. So these women have regained their sex drive in
• 14:40
  S2: a big way and are really enjoying their sex lives,
• 14:43
  S2: probably for the first time in a long time. And
• 14:46
  S2: so the sex drive has gone through the roof. And
• 14:49
  S2: I guess they're feeling amazing because they're having orgasms and
• 14:53
  S2: they're having a lot of sex in Australia, it's probably
• 14:55
  S2: not so pronounced because we have the women's products, so
• 14:58
  S2: we're getting women appropriate doses, which means maybe the sex
• 15:01
  S2: drive is a bit lower on testosterone. But in the US,
• 15:05
  S2: multiple orgasms, multiple side effects.
• 15:08
  S1: Wow. And that's because again, they are taking the men's
• 15:10
  S1: testosterone as opposed to the women specific testosterone medication.
• 15:15
  S2: That's right. Having said that, in Australia, I spoke to
• 15:18
  S2: one GP who said that a lot of women go
• 15:21
  S2: through menopause. Their sex drive has sort of dried up.
• 15:25
  S2: They start taking testosterone and it's great. You know, it
• 15:28
  S2: is great for some women. It's wonderful. It's great for
• 15:31
  S2: their relationship that they've got their sex drive back and
• 15:35
  S2: they feel like it's a bit of reward for, you know,
• 15:37
  S2: all the hormonal changes that have gone through over the
• 15:40
  S2: past ten years. And now they feel like they can
• 15:42
  S2: kind of enjoy their bodies and their sex lives again.
• 15:45
  S1: Wow. That helps us understand really what's reasonable for women
• 15:50
  S1: to perhaps expect that they might get if they take
• 15:53
  S1: testosterone and if they actually need it. What about men?
• 15:56
  S1: What's the upshot? Who is it actually advisable for?
• 16:01
  S2: Well, about 1 in 200 men have clinically low testosterone.
• 16:06
  S2: So it's not a small number of men. And then
• 16:08
  S2: there's a further 1 in 600 men who have an
• 16:11
  S2: extra X chromosome. And they need it. So these people
• 16:14
  S2: need it and it's essential for them. It will help
• 16:18
  S2: them with their sex lives, help them with their muscle mass,
• 16:21
  S2: with their bones, with their energy. So I guess the
• 16:24
  S2: message of the people that I spoke to was, if
• 16:27
  S2: you have concerns, go to your GP, talk about it,
• 16:30
  S2: don't source it somewhere else and get tested. Get tested
• 16:34
  S2: multiple times. And there are lots of reasons why you
• 16:38
  S2: might have low energy. There are lots of reasons why
• 16:40
  S2: you might be fatigued or irritable. It's not necessarily to
• 16:44
  S2: do with testosterone, and testosterone does decline with age, but
• 16:47
  S2: it's not necessarily a problem. So even if your testosterone
• 16:51
  S2: levels are declining, if it doesn't bother you, you don't
• 16:55
  S2: need to medicalize it by getting treatment. Testosterone is only
• 17:00
  S2: needed if it is clinically low and it's bothering you.
• 17:03
  S2: If the symptoms are bothering you and it comes up
• 17:06
  S2: in the tests that you're clinically low. Yes, take it.
• 17:08
  S2: But if it's not bothering you, it's not a problem.
• 17:10
  S2: There's no need to worry and be fretting about your
• 17:12
  S2: testosterone levels.
• 17:14
  S1: And I do have one follow up question, because I
• 17:17
  S1: get the sense from our discussion that it can be
• 17:19
  S1: quite helpful for some women, but it's not necessarily a
• 17:23
  S1: massive boost in particular for sexual function or sex drive.
• 17:27
  S1: But when it comes to the men, you had one
• 17:29
  S1: health researcher. This is Benjamin Benante at the University of Queensland,
• 17:34
  S1: and he has analyzed testosterone use amongst men. And he
• 17:39
  S1: said that it's like day and night when they get
• 17:42
  S1: that function back. And I think he was talking about
• 17:44
  S1: a boosted libido and the easing of low mood. So
• 17:48
  S1: am I correct to have gleaned that perhaps for men,
• 17:51
  S1: it can be a much greater impact than when women
• 17:54
  S1: use it, supplementary wise?
• 17:56
  S2: I think that's right, Samantha. I think all the studies
• 17:59
  S2: for women have shown that it's quite slight, but for
• 18:02
  S2: men it can make a huge difference. It is the
• 18:04
  S2: primary sex hormone. So that makes sense. That's not to
• 18:07
  S2: say that every man uses it. But if you are
• 18:09
  S2: clinically low. Yes. Getting it to that normal, healthy level
• 18:12
  S2: can really improve quality of life. Having said that, there
• 18:15
  S2: are ways of improving testosterone levels without taking the hormone,
• 18:19
  S2: and that involves weight loss and sleep and stress management.
• 18:24
  S2: So one of the endocrinologists that I spoke to, Carolyn Allen,
• 18:27
  S2: she talks about the fact that for women, menopause is non-negotiable.
• 18:32
  S2: It happens. And all these hormonal changes come with that.
• 18:35
  S2: But for men, they actually have a lot of agency
• 18:37
  S2: in terms of how they manage their hormones. So if
• 18:41
  S2: they have a healthy diet, if they sleep well, if
• 18:43
  S2: they manage their stress, their hormones are a lot smoother
• 18:47
  S2: and they can control them better than women can. So
• 18:50
  S2: that's great news for men. I think it's really empowering
• 18:53
  S2: for them.
• 18:57
  S1: That's incredible. Well, thank you so much, Madeline, for your time.
• 19:02
  S2: Thank you so much for having me.
• 19:17
  S1: Today's episode was produced by Josh towers. Our executive producer
• 19:21
  S1: is Tammy Mills, and our podcasts are overseen by Lisa
• 19:25
  S1: Muxworthy and Tom McKendrick. If you like our show, follow
• 19:29
  S1: the Morning Edition and leave a review for us on
• 19:31
  S1: Apple or Spotify. Thanks for listening.