For guys without hypogonadism, a wait-and-see approach may make the most sense. "We just don't have the data to prove that raising testosterone in men who already have normal levels confers any real benefit," says Dr. Robert Mordkin , a urologist in Arlington, Virginia. Furthermore, Mordkin adds, "Natural waxes and wanes of testosterone as we age may have some not yet entirely understood protective effects." In addition to making us better fathers, as the Northwestern study infers, declining testosterone "may lower our vulnerability to prostate cancer at a time in our lives when we're at the greatest risk for it." That said, if you have classic symptoms of hypogonadism – low libido, fatigue, erectile dysfunction – "it's probably reasonable to check your testosterone. And for those guys whose blood levels come under definitions of low testosterone, it's probably reasonable to try the therapy for a while. But that's very different from saying testosterone is the fountain of youth."
Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:
Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin and into the bloodstream. Testosterone-containing creams and gels that are applied daily to the skin are also available, but absorption is inefficient (roughly 10%, varying between individuals) and these treatments tend to be more expensive. Individuals who are especially physically active and/or bathe often may not be good candidates, since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself; children and women are highly sensitive to testosterone and can suffer unintended masculinization and health effects, even from small doses. Injection is the most common method used by individuals administering AAS for non-medical purposes.