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Testosterone ‘Optimization’ Boom Puts Men’s Fertility and Care Systems at Risk

New consumer clinics are selling quick tests and therapy as a lifestyle upgrade that can lead to unnecessary treatment and suppressed sperm production.

Overview

  • Private providers often rely on single, finger-prick or non-fasting tests despite guidelines calling for two separate morning venous samples to confirm deficiency.
  • Men with normal hormone levels are increasingly starting therapy, even though raising testosterone above roughly 12 nmol/L is unlikely to boost sexual function, energy or mood.
  • Exogenous testosterone suppresses the body’s fertility signals, reducing sperm production and risking long-term infertility, particularly after several years of use.
  • When properly prescribed for confirmed hypogonadism, therapy can improve mood, libido, strength and bone health, with potential metabolic benefits in some patients.
  • Earlier prostate cancer fears have largely been dispelled, but studies report small increases in atrial fibrillation and blood clot risk, and endocrinology clinics are seeing a rising burden of follow-up and side-effect management.