It’s a fact nowadays that the medical community is not fond of the main androgen.
Both endocrinologists and urologists are trying to avoid prescribing testosterone during its deficiencies.
They are literally terrified and try to provide alternative treatments.
For instance, aromatase inhibitors (AIs) or SERMs or even hCG to kick HPTA, even though total testosterone (TT) is way below the limits (TT<300ng).
This protocol might work for a brief period of time, however it’s highly unlikely to stay within eugonadal levels under stressful conditions.
While urologists are suggesting the use of PDE5 inhibitors like tadalafil and sildenafil, for instance.
That, of course, just provides a blood flow to the penis and doesn’t fix hormonal levels.
There was a case where I had a conflict with colleagues as to whether testosterone replacement therapy (TRT) was obligatory in middle-aged patients with levels of an 80-year-old man.
They are not treated and later develop obesity and insulin resistance, eventually leading to type 2 diabetes and the metabolic syndrome.
Along with depression, fatigue, and erectile dysfunction, of course.
So, my guess is that they could be frightened because of the following reasons:
1) The bad reputation that testosterone has spread among the bodybuilding community and sports in general.
They wrongly consider it as an anabolic. However, testosterone is the main androgen with anabolic properties.
2) As my friend Rick Collins, Esq., the legal boss of the fitness industry explains, testosterone is demonized by all because of its stigma in sports and it’s linked to cheating (not fair play).
Of course, this is a very generalized and old-fashioned perception that negatively influences society.
3) Perhaps the medical world knows the potency of testosterone and how effective medication can be.
It heals hypogonadism, fatigue, depression, dyslipidemia, erectile dysfunction, lack of libido, type 2 diabetes, osteopenia and even arthritis.
Hence, Big Pharma and doctors could claim that testosterone is the wonder drug that may easily ruin the incomes of many medications including SSRIs, semaglutide, EPO, metformin, tadalafil, and statins.
Moreover, a patient who undergoes TRT is turning into an “A male,” and physicians are losing him as a patient.
4) The social standards of the 21st century.
Men are more likely to be less masculine and more feminine with lower testosterone levels.
The lowest ranges in the last decades have dropped from 400 => 200 and in order to be considered as hypogonadal, you must reach pathetic levels of testosterone.
5) Fear and prejudice coming out of ignorance and lack of knowledge.
It’s a fact that most endocrinologists are dealing with thyroid issues and diabetes, and being testosterone deficient isn’t among their priorities.
It’s a taboo subject instead, the same for urologists who wrongly associate testosterone with prostate cancer.
I’m hoping that men will lighten up and be awakened one day.
As a medical doctor, I wish all men with TT<500 could use TRT.
Men become fragile as they age because of this and low T equals slow death.