CLEVELAND, Ohio -- If you pay attention to television commercials, you may be seeing ads touting the life-changing properties of Axiron, a testosterone-replacement therapy that is applied under the arm like deodorant, and Androgel, a clear gel that comes in a pump.
Treatment for low testosterone in men -- the condition is also called hypogonadism -- has been around for decades. But in recent years, the therapy has shifted from injections in the doctor's office to topical gels that can be used at home.
Androgel, the first topical gel, was approved by the Food and Drug Administration in 2001. Testim followed in 2002, then Axiron came along in 2010. The first testosterone skin patch was approved in 1995. A new lower-dose version of the Androderm patch, which is changed daily, was approved in October 2011.
More younger men -- men in their 30s and 40s -- who are bothered by fatigue, loss of libido and less-than-virile sexual function are turning to medication to treat "Low T." Some of them view the condition as some sort of deficiency. Take more of what's missing and everything will be OK.
And that concerns Dr. Bryan Hecht.
A reproductive endocrinologist and fertility specialist at University Hospitals Fertility Center West on Crocker Road, across from Crocker Park, Hecht works with couples who have fertility challenges.
The majority of the men he sees do not have low or nonexistent levels of sperm.
But for those who do, Hecht says, testosterone-replacement therapy is to blame more and more.
Testosterone improves libido and sexual function. But in large doses, it also can suppress the body's ability to produce sperm. That's just one of the many side effects that in recent years have prompted the Food and Drug Administration to spell out all of the possible side effects.
"Historically, the majority of men [treated for low testosterone] tended to be somewhat older," Hecht said. "That's why I think the impact on fertility hasn't gotten a whole lot of emphasis."
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