Perhaps a reason why scepticism exists around testosterone therapy is that testosterone deficiency syndrome cuts across several specialities. Endocrinologists are not trained in sexual medicine and do not read urology or sexual medicine journals; and urologists do not read endocrine journals; and cardiologists read only cardiology journals. Patients present with bothersome symptoms that they want treated. They do not want a philosophical dissertation on ageing or theology, they want their health and their relationship back. We do not tell patients that blindness, deafness, dementia and loss of teeth are “just part of ageing” and we would treat hypothyroidism at age 100 years without a moment’s thought that this is an endocrine condition associated with ageing.
I have personally treated more than 1,000 men with symptomatic testosterone deficiency, following them for longer than ten years and I have published my results. I can categorically say that (in conjunction with PDE5Is) I have never prescribed any other medicine that has such an impact on the life of my patients, their partners and even their families.
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