If you spend a significant amount of time away from the U.S., you’re likely to notice things about the country more sharply when you return. Now, it seems, on my return from a month-long trip I can’t enjoy an hour of cable news without being bludgeoned by recurring ads about “Low T” affecting middle-aged men. Invariably, the actors in such ads are featured on fake construction sites, lifting trolleys with heavy chains, often carrying the percentage their testosterone levels supposedly could reach if they tried one of a handful of products.
These are just the latest in a string of ad campaigns seeking massively to expand the medical condition of hypogonadism (insufficient testosterone production, including because of treatments such as chemotherapy) to encompass, basically, all of middle age and beyond, during which most men experience a drop in testosterone levels. To give you a sense of scale for hypogonadism, though, one 2002 article on “androgen deficiency” in Urologic Clinics of North America calculated that the condition “affects an estimated 1 in 200 men,” or 0.5 percent. Not enough to justify wildly expensive ad campaigns—unless, of course, the manufacturers in question also manage to target middle-aged men bothered by the natural effects of aging—which is to say, most of us.
To support that expanded goal, the latest ads signal more aggressively than ever that a man must “know his figures” and, to the approving eye of his partner, will do “what a man does” when that figure is low—namely, raise it. But the men targeted for such ads aren’t refinancing their mortgage or buying a new car—they’re also, one hopes, listening to the federally required voiceover to such ads, which warns them, with good reason, that such products significantly increase their risk of developing prostate cancer, already a serious health risk among U.S. men, as well as potentially rewarding them with greater hairloss, lower sperm count, nausea, greater risk of blood clots, and difficulty sleeping. And that’s not even to mention vulnerability to psychologically related factors such as road rage and erratic mood swings, themselves heightened by stress, financial worry, lengthy commutes, longer working hours, and so on.
Unfortunately, no ad campaign for raising testosterone can avoid the inconvenient biological truth that the effectiveness of the product lies in a zero-sum relation to the body’s natural production of the hormone. As Wikipedia reminds us, “The primary functions of the testes are to produce sperm (spermatogenesis) and to produce androgens, primarily testosterone.” Put simply, artificially raised levels of testosterone inevitably, and correspondingly, reduce the body’s production of the hormone, slowing testosterone growth in the testes. (To offer an analogy with serotonin, a similar medical conundrum faces large numbers of patients on SSRI antidepressants—especially those complaining of “poop-out” after several months of treatment. Flooding the brain with artificially raised levels of serotonin also, similarly, reduces the amount of serotonin the brain can produce on its own, a situation that can be hazardous when drug treatment ends and natural levels of the brain messenger are lower even than before treatment.)
To be clear, I understand why men would want to raise their libidos, to enjoy and maintain a regular sex life. But as I’ve posted elsewhere, about other advanced cultures treating health and medical issues quite differently than we do, there are significant gains to be had from some careful comparisons, especially when supposedly quick-fix pharmaceuticals can do a lot more harm than good—to ourselves, our families, and our population.
In Peru, Brazil, and Colombia, you won’t find nightly ad campaigns for men with “Low T,” but you will find men of all ages talking and joking openly about the pleasures they have with a wealth of natural aphrodisiacs available in those countries (and now ours, thanks to the Internet), from acai, algarrobina, and catuaba, to berries, figs, ginger, guarana, maca, and pomegranate juice (also rich in antioxidants), to—less exotically—egg white, garlic, olive oil, pineapple, pine nuts, scallops, and, well, countless more delicious foods, especially those containing trace elements of zinc. That's even ignoring the well-known benefits to the libido of exercise. The salsa from a traditional Peruvian ceviche is locally dubbed leche de tigre, or “tiger’s milk,” because of its potency, but even humble oatmeal, soy, and root vegetables play their part.
My point? Don’t for a moment imagine that treatment options are limited to products that greatly increase your risk of getting prostate cancer and a litany of other nasty side effects. Listen to the medical hazards detailed at great length in the ads themselves, and ask yourself and your doctor if it’s really worth putting yourself at such risk—especially when nature offers so many inexpensive, healthful, and broadly delicious alternatives.