Testosterone replacement therapy (TRT) prescriptions are rapidly increasing globally. Prescriptions in the U.S.A. alone have increased from 7.3 million in 2019 to more than 11 million in 2024. The general public isalso searching for information, with Youtube, Facebook and TikTok playing a role. A video from The Joe Rogan Experience, featuring Dr Andrew Hubermanand discussing testosterone optimisation, has over 5.5 million views. This highlights how TRT is no longer solely thought of as a medical intervention.
Male hypogonadism is a condition in which the body does not produce enough of a hormone called testosterone. This may be associated with reproductive features (incomplete pubertal development, decreased erections, decreased libido) and non-reproductive features (loss of motivation, low mood, irritability). A diagnosis requires the symptoms and the biochemical evidence of testosterone deficiency. Only those with symptoms require TRT.
The most widely used options for TRT are transdermal gels and intramuscular injections. Effective treatment has been shown to:
- maintain secondary sexual characteristics
- increase libido
- increase muscle strength
- increase fat-free mass
- increase bone density.
However, adverse effects include acne, prostate enlargement, stimulation of the growth of breast cancer, sleep apnoea, and heart failure. TRT should be avoided in those with breast cancer, prostate cancer or an increased risk of prostate cancer.
TRT is becoming increasingly mainstream, with fitness influencers such as Shans.Bruh, Bradley Martin, and Togi openly discussing their regimens and highlighting their muscle growth. Research has shown that the growth of anabolic-androgenic steroid use by non-athletes has increased, alongside a parallel increasing prevalence of concerns about body image among young males. This trend is fueled by the social emphasis on having a lean and muscular body physique. As a result, there has been a surge in online and for-profit men’s health clinics offering telehealth services, making testosterone more accessible than ever.
This leads to the potential for those with normal testosterone to be exposed to unnecessary adverse effects. The doses tested in clinical trials are physiological doses of 100 mg of testosterone per week, while anabolic-androgenic steroid users may use up to 1,000 to 5,000 mg per week.1 The long-term effects of these high doses are still poorly understood. As a result, expert panels are advocating for prospective longitudinal studies to better assess the long-term outcomes and risks associated with TRT use in this setting.1
The need for clear, accurate and easily accessible information about TRT is essential to prevent misinformation and to help individuals make informed health decisions. Content promoted by social media influencers may be oversimplistic and may not represent the broader medical picture and risks involved. Effective medical writing can play a role here through the translation of complex science into accessible and relatable information. This allows individuals to evaluate their options and avoid making decisions based solely on hype and anecdotal content.
TRT is an example of how traditional methods of patient education are changing. Patients no longer rely solely on doctors or web searches for information; instead, they are increasingly turning to social media groups, influencers and targeted online content. These methods have incredible reach and engagement, but also a risk of spreading oversimplified information and misinformation. This shift presents an opportunity for medical professionals and communicators to engage in these spaces to contribute accurate and evidence-based information to help support informed decision-making.
With TRT conversations moving beyond the clinic to social media platforms, the way people access health information is rapidly changing. There is a critical need for clear and accurate communication to help people make informed choices. Elion specialises in transforming complex medical topics into engaging, evidence-based content to inform, educate and empower.
Want to communicate complex therapies such as TRT clearly and accurately? Get in touch with Elion to see how we can help.
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