Trump officials want to make testosterone drugs easier to prescribe. Is
that a good idea?
[July 17, 2026]
By MATTHEW PERRONE
WASHINGTON (AP) — Officials under President Donald Trump want to make it
easier for men to get a prescription for testosterone, the latest shift
in a decades-long debate over the benefits and risks of replacing the
hormone that affects sex drive, mood and other health factors.
The move, backed by Health Secretary Robert F. Kennedy Jr. and other top
officials, aligns with the advice of many online influencers and
podcasters, including men’s health gurus who tout the hormone as a way
to boost muscle and energy. On Tuesday, Defense Secretary Pete Hegseth
said the military would begin screening for low testosterone and
offering the hormone as a way to help troops operate at their “absolute
best.”
The notion of testosterone as an all-purpose elixir for strength and
vitality is not supported by the science. But medical experts say a
decade of new research has bolstered the case for testosterone's
benefits for sexual health while allaying concerns about its impact on
the heart.
“Many providers have been trained for years that these were real issues,
and they were scared to get a testosterone reading from a patient or
offer them testosterone therapy,” said Dr. Justin Dubin, a urologist at
Baptist Health Miami Cancer Institute.
Last year, the Food and Drug Administration removed a bold safety
warning about possible heart risks with testosterone pills, gels,
injections and patches, based on recent data that showed no increase in
those problems.
Last month, the agency proposed rewriting prescribing instructions to
clear the way for using testosterone against age-related symptoms, such
as low libido and erectile dysfunction. Currently the label emphasizes
that the hormone is only approved for abnormally low testosterone levels
caused by serious medical conditions or injury.
But experts who prescribe the drug say those patients are a small
segment of people seeking help.
“The majority of people we see in our office are regular men complaining
of these common symptoms because they're dramatically affecting their
quality of life,” said Dr. Helen Bernie, a urologist and director of
sexual health at Indiana University.
Testosterone use has evolved over decades
Testosterone was first approved in the 1950s to treat hypogonadism, a
condition defined by low testosterone levels caused by medical problems
affecting the testes or other organs.
Testosterone declines naturally with age and can effect sexual function,
mood, bone density and other measures. The question of how to diagnose
and treat men with those issues has long been debated by researchers.
“These symptoms overlap with symptoms of human aging in men, so there’s
a high risk of misdiagnosis and that’s led to the controversy” said Dr.
Shalender Bhasin, of Harvard Medical School, who has co-authored several
recent testosterone studies and guidelines.
Bhasin says increased willingness to prescribe testosterone reflects
growing acceptance of the seriousness of men's sexual health problems,
beginning with the introduction of Viagra for erectile dysfunction in
the 1990s.
Bhasin helped write the Endocrine Society’s current guidelines for
testosterone, which recommend discussing testosterone with men who have
documented symptoms and two blood test results confirming low hormone
levels. One recent study by Michigan researchers found that just 12% of
men getting a prescription met that criteria.
Prescriptions previously soared, despite little evidence
The potential for overprescribing testosterone is real and helped lead
to current restrictions.
In the early 2010s, drugmakers spent millions on TV ads for gels,
patches and other products promising relief from “low T,” including a
laundry list of symptoms like fatigue, muscle loss, brain fog and weight
gain.
By 2013, the drugs were generating more than $2 billion in sales
annually, despite lacking FDA approval for most of the issues described.
Doctors remain free to prescribe drugs off-label, or for unapproved
uses, and many men today continue taking testosterone because they
believe it improves energy, mood and appearance.
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A vial of testosterone cypionate in Columbus, Ohio, on Jan. 18,
2024. (AP Photo/Carolyn Kaster, File)
 In 2015, the FDA hit drugmakers with
a double whammy: They had to clarify that their drugs weren’t
approved for routine problems and also add a boxed warning about
possible heart risks.
FDA scrutiny led to new research
The FDA now says updated data warrants relaxing the restrictions.
An FDA-mandated study published in 2023 followed 5,000 men with a
history of heart disease, with half receiving daily testosterone gel
and the other half getting a sham drug. After two years there was no
difference in heart attack, stroke and related problems between the
two groups.
A series of studies by the National Institutes of Health also
clarified the benefits of the hormone. Results from nearly 800 older
men showed testosterone therapy improved erectile dysfunction,
libido and other sexual measures and had a small effect on mood.
There was little or no improvement in other measures like fatigue,
memory or overall well-being.
The recent testosterone studies are the largest ever conducted, but
Bhasin — who helped lead both efforts — says more research is needed
on longer-term effects.
“I think FDA’s label changes are very welcome and they are bringing
us a big step forward," said Bhasin, who also co-authored the
Endocrine Society's guidelines. "But I think there’s a lot more to
be done to better define the safety and efficacy.”
In recent comments submitted to the FDA, the Endocrine Society
recommended studies of 15 to 20 years to assess conditions that
evolve slowly, including prostate cancer, which remains a concern
when prescribing testosterone.
Some men should not get testosterone
Experts agree that men who are hoping to have children in the near
future shouldn’t take the hormone. Getting testosterone from a pill
or gel shuts off the body’s natural process for making the hormone.
“It can stop the signal from your brain to your testicles to make
testosterone, and so you stop making sperm,” Dubin said. “That can
compromise fertility.”
Most guidelines also recommend careful consideration for men who
have had prostate cancer or are at risk of the disease, given
lingering questions about whether hormone therapy hastens tumor
growth. But guidelines may soon change.
The FDA has proposed new language that would only suggest that men
whose prostate cancer has spread to other parts of the body should
avoid testosterone.
Be wary of online promotions
Dietary supplements promoted online to boost testosterone should be
avoided because they aren't FDA approved and probably don’t work.
FDA-approved testosterone drugs come in a variety of forms. Gels and
pills generally need to be used daily. Injections, patches and
implantable pellets can last for weeks or several months.
Many of these medications are available through telehealth services,
though accessing them that way can have risks.
A 2022 paper by Dubin found that only 1 in 7 online prescribing
companies asked basic screening questions, including whether men
planned to have children. And most of the companies did not have a
testing threshold for whether patients actually had low
testosterone.
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