Important conversation. Had a young man as a patient once who was convinced his lack of energy was due to having low testosterone and ordered pills off the internet to fix it. Turns out he had a rare blood disorder. Too many people, especially young men nowadays are going online and trying to self medicate and treat nonspecific symptoms for issues they don’t have a formal diagnosis for.
Yeah, people are saying that a lot of physicians are convinced everything is psychosomatic (which does happen sometimes) when it’s really endocrine, but the flip side is people being convinced everything should be treated by HRT when it may well be something else entirely. As a psychologist, I see a similar issue with people deciding that any psychological problems they have must be autism/ADHD and thus not really seeking (or rejecting) a good diagnostic assessment that could lead to better treatment.
If you believe the internet, there's an epidemic of lazy doctors, and the chief sign of laziness is when they refuse to order a test or a treatment.
But anyone who works as a clinician knows that it's exactly the opposite - the lazy clinicians are the ones who routinely order non-indicated tests and medications. Ordering a battery of tests takes three or four mouse clicks, and it sidesteps any difficult discussions with patients along the lines of "I'm sorry, but we've done all the guideline recommended tests and nothing has come up. I don't have an explanation for your symptoms. This is why I don't feel that ordering tests X, Y, and Z are medically indicated."
Why have that discussion when you can order 30 tests across five panels, wait for one to come back 1% out of parameters, and then ride in as the hero to tell the patient that you've found a diagnosis with a potential treatment. It's often a crock diagnosis, poorly if at all supported by the scientific literature. But for patients who are desperate to find a solution, it sounds like music.
Firefighter here, many departments around me are offering testosterone testing with our annual physical exams because low T can contribute to fatigue and depression, and both sleep deprivation and mental health issues are an occupational hazard to us (the "fatigue panel" my department offers also tests your TSH and vitamin D levels). However, this is done by a physician, and the one friend I have whose T levels came back low has to have them re-tested by his PCP before anything will be prescribed to him (I'm a woman and haven't had my bloodwork done yet ftr).
I feel like this headline is misleading. Actual low T is not a spurious pseudo-disease, the issue is that venture capital hucksters are fiddling with evidence-based acceptable T ranges to make a quick buck. Note how most of the people described in the article decided to start T based on some Internet bullshit and maybe 1 guy actually talked to his doctor.
This is a terrible take on this, I have worked with over 10,000 men in the last 5 years and while "capital hucksters" are a problem for many reasons, they aren't "fiddling with evidence based acceptable T ranges"
You know very little about TRT, or the men it has (or hasn't helped).
Most people cannot speak to their doctor about this, as the doctors don't understand it. Doctors will tell you themselves, it isn't something they really learn about in medical school.
Judging by your profile I think you may be a little biased :) I suppose more accurately, the issue the author is trying to name is (no offense) the cottage industry around TRT, not the actual health issue of low T, which is very much real – and which the headline undermines.
I have no experience with the NHS but I would be very surprised to hear an American endocrinologist profess to have never learned about HRT or its indications.
My profile has nothing to do with anything, there is one statement you made that matters which I already quoted, and the part about 1 guy actually talking to his doctor.
Many of these doctors at TRT clinics in the UK, are NHS GP's that have gone outside of the NHS and learnt (because they wanted to/job opportunities) about TRT themselves, as they didn't learn it in medical school, their words.
I am quoted, in the article as I was interviewed for it, pointing out that I speak to many men who try get help on the NHS and they can't, even when their levels are really low.
Now, not everyone is the same. We've helped people at clinics with levels of 14nmol/L which these "endocrinologists" say is preposterous, and it has saved their life, changed things massively for them.
We also have had people who have levels as low as 8 nmol/L and they don't feel too bad. This black and white thinking is absolutely ridiculous.
It's about time that the NHS realises it is not equipped for this and seeks help outside and works with private companies rather than against.
If you think a normal person can access a Urologist, at the first point of call, when the NHS you have to go through GP, then get referred to Endocrinologists.
I interviewed a consultant urologist for my business, he wasn't aware of private trt, at all.
Hmmmm..So are you arguing that UK docs don’t know about HRT therefore your business is needed? I’m not understanding your take on this. I am a licensed health care professional and can speak to what’s occurring in the US. I agree with light_sweet_crude about the cottage industries around HRT. We see this here in the States as well as in other areas of health (rebranded as wellness) like med spas and supplements/ “natural” products for women in peri/menopause. Lots of money to be made by unlicensed non- health care professionals with potential disastrous results
In the UK obtaining TRT via the NHS is near impossible for lots of very symptomatic men, so yes, private care is required.
You are right, you don't understand my take because you don't understand our healthcare system and you're talking about "unlicensed non-healthcare professionals" for some reason.
The reddit hive mind is strong in this thread, however.
I've used testosterone myself for 13 years, watched it transform peoples lives, help them with their depression and bring them back from literal hell, their families lives improve as a knock on effect, fix their relationships.
You have no idea what you're talking about and that's what makes this so awful.
I want to get a comment in before the Reddit hivemind converges on the narrative that "low T" is a fad disease.
Bluntly, after my own experiences with GPs in the UK, I do not trust most doctors on hormonal or endocrine problems. Not only because of my own health experiences but in my family too, and this includes women: doctors do not take seriously when you report problems with energy, metabolism or mood.
(And if you are twitching to dismiss this as a Mens Entitlement problem, try asking the older women in your family how seriously they're taken by doctors)
This has included quite mechanical ailments too. I once had to battle my GP to get my foot looked at due to chronic pain - despite their insistence I just needed to lay it up, it turned out I had a cuboid fracture. Likewise to get physio afterwards: despite explaining to my doctor I was a thirty five year old man who could no longer walk more than a hundred meters, the GP basically shrugged it off as "one of those things, just rest it".
So I have absolutely no trust whatsoever in doctors who say, that patients self-reports of weight loss, higher energy, better immunity on T replacement are just some placebo effect.
If people want hormones, let them. Inform them of the risks, allow consent, and stop policing peoples choices. These articles have the same tone as those "concerned" about menopausal women choosing HRT - stop it.
For sure there are serious issues with the medical establishment (I speak from personal experience of hormonal and autoimmune issues. Bad combo.), but also just at a base level I don’t trust these for profit medical companies to provide adequate care or accurate information. If you think about a generic patient getting the test results that the author of this article was getting, and they decided to go on TRT, they might be choosing it, but they wouldn’t be choosing it in an informed way after having been given test results saying that their levels which are in fact within the normal range are concerning. It reminds me of vitamin companies – vitamin deficiencies are a serious issue but companies that sell vitamins are also motivated to say you need more than you really do, and that their method of getting your levels up is the best way when it may or may not be.
Signed, another woman who had her symptoms dismissed for several years by my pcp as 'hormonal', 'all in my head', and that I was 'not handling stress well.... go see a therapist'. Well, he was right about it being all in my head.... I very nearly died from my (first) brain tumour; I had emergency surgery two weeks before my wedding. I was subsequently diagnosed with a rare genetic cancer disease. You'd think having proof of a dangerous disease would mean that doctors took me seriously. They insisted I had gall bladder issues, but it turned out to be pancreatic cancer. I was fucking bedridden for years, and I KNEW something was wrong. I KNEW I had neuroendocrine anomalies but still had to beg doctors to believe me enough to order the proper tests. A little over a year ago I had surgery to remove thyroid and parathyroid cancer. But it's not just my cancer stuff; I recently started HRT after years of asking for it. It's been a little over four months and my quality of life has already improved a hundredfold.
I've seen many excellent doctors and surgeons, but I have to advocate heavily for myself (and all my daughters have the disease as well, so I advocate for them, too :( ). All the fucking time I have to research symptoms and understand multiple rare types of tumours and say things in just the right way to be taken seriously. I probably would've phoned it in--my disease is painful and exhausting and it is relentless--but I wanted to be an example to my daughters that you can find great joy in life even in the midst of great suffering. I actively taught them to advocate for themselves, to ask questions, to listen to their gut feelings and intuition. And technologies and research continue to improve outcomes for many of our cancers/disease. Just in the last ten year I've been so impressed with the treatments developed and the various successes. It gives me hope that my girls' future will have less suffering than what I have, and my dad had, endured.
The main “concern” I’ve seen has been on that one NYT article, and the main issue I saw that people had was bemusement that the NYT took a break from its rigorous trans-panic editorial calendar to write a cheeky article about how much testosterone treatment is helping women.
Also when people say they went on testosterone and started feeling better. That doesn't mean it was the right choice. Any bodybuilder will tell you that going on testosterone will make you feel great, at least in the short term. Better mood, boosts confidence, etc. And these are people who definitely don't need it, but are just taking it recreationally.
The whole "Drug makes me feel good -> i should be on drug" logic ignores that doctors go through years and decades of education because it's not that simple. There are other things to take into account, things that actually require an education.
Plenty of drugs make people just feel better. Give energy, reduce pain, better mood. But handing out these pills to anyone who asks is not the solution. And I actually do think it's peoples own choice, but there's just a concerning amount of people who think they have it all figured out because they took some drug that no doctor said they needed and now they feel great.
I saw it myself with someone who couldn't sleep that well, doctors didn't want to prescribe any medication, so they got it themselves. Worked great, put them right to sleep. Didn't work out so great in the long run, as these things tend not to.
A lot of people genuinely kind of believe that life altering drugs exist (for people with no diagnosed disorder or disease) that do not have any real downsides or side effects. Like you can just improve a healthy human with drugs and why shouldn't you?
>If people want hormones, let them. Inform them of the risks, allow consent, and stop policing peoples choices. These articles have the same tone as those "concerned" about menopausal women choosing HRT - stop it.
This is not reality. Physicians are liable for the bad outcomes from these choices, even if they recommend against it. They are legally and morally obligated to only prescribe it in cases where the benefit is outweighed by the risk, which is frequently not the case.
I agree here. The hoops I have jumped through we someone with only half a thyroid. Ideal and a in range are two different things with the endocrine world. While as a woman I don't have the same experience as men with testosterone, I do know that patients are constantly dismissed for symptoms that are treatable. It wouldn't shock me if research eventually shows that midlife has edocrine changes for everyone eventually.
Edit: getting a second opinion this week as completely out of range adrenal tests were ignored because I'm a mid 40s woman. Jokes on that guy because I'm on the combined pill which I told him and it invalidates a LOT of the hormone tests he did
Right. I think two things can be true: a lot of the faddish ads on TV like "Nugenix" feel bullshitty and unhelpful. I also think that being frank about hormone changes is important. I suppose there's just a mixture here that is about what "masculinity" is and what's performative, but I'm not sure that making men feel bad for pursuing options is the right approach.
I'm nonbinary - I do not take hormones (if anything, as I get further into perimenopause, I think I'd be taking hormones they expect women to take at that phase) BUT I have had some affirming care and I wholly support gender affirming care for all. If that's a man getting something for low T, getting a hair transplant, whatever - or a woman getting breast implants and a chin lift - so be it.
I am dealing with a medical situation right now that involves going from doctor to doctor to say "hey, I am in *constant pain*, what is going on here? I know the labwork shows nothing, the ultrasounds you're running don't show it, but this is happening" and it's fucking maddening to not have people listen to me. It's fucking maddening when I talk about being nonbinary and some people act like I'm actually mentally ill.
Someone in the article mentions it, but people are looking for ways to make them feel normal, baseline again after a struggle. This is just about feeling right in your body. I'd like to see better discussion about that before "too many men think they have low T!" keeps circulating and starts feeling like a moral panic.
Anecdotally, I have three friends on TRT that describe it as life changing and I’m inclined to believe them because my wife started HRT 18 months ago and the difference it has made in her quality of life is literally amazing.
Ultimately these are very much decisions you should make with your doctor, not based on what a journalist thinks.
You responded to an article about low levels of evidence for trt in men by comparing it to hrt in your wife and I'm just pointing out it's a totally different situation in terms of the specific point the article is making
I responded by providing anecdotes from three people I trust that say it’s changed their life and said I’ve also seen the same effect in my wife with HRT. I stand by the fact that people I know that have taken testosterone replacement all claim that it’s life changing.
The biggest things I’ve noticed are mood and energy. My wife is a naturally very funny, outgoing, and ambitious person. You could see those things just kind of dwindling in her late 30s as she was more stressed, tired, and just kind of unhappy and cranky a lot.
Her doctor recommended HRT and she initially was hesitant but finally decided to give it a try when a friend told her how much it had helped her. Within like 2-3 months it was like she was completely back to herself…funnier than hell, working out all the time again, going out with her girlfriends, buying new clothes, leaning in at work, always in a really good mood with our kids, super fun to be around, etc. This sounds so cliche, but she’s living her life to the fullest again.
i'm a cis dude, but i despise the hypocrisy around it being OK for cis men and women to have gender-affirming care but it's suddenly oh so super controversial for trans people to receive hormones. it's just two-faced and malicious!
I don't disagree with you, but doesn't this article somewhat undermine your point? It's doing moral policing over men's self-reporting of better health outcomes on T replacement.
It is a milder form of the articles from 10 years ago that expressed "scientific concern" about menopausal women choosing HRT, emphasising the risk of breast cancer, and dismissing the autonomy of patients.
Women have to fight against uninformed doctors to get menopause hormones. It fucking sucks to be offered nothing after giving them a well-documented list of your meno symptoms. “Just eat right and do yoga, oh, let’s do a Pap smear since you’re here.”
Agreed. It’s also interesting that when hormonal disorders are common, they’re just disorders that affect cisgender people, but when they’re rare or unusual they’re seen as making you intersex.
Intersex is actually a term for several conditions that cause sexual difference and there’s not necessarily consensus on which ones count, which is why you’ll see estimates for the total intersex population vary wildly (for instance, counting PCOS changes the numbers substantially).
“Gender affirming care” is a euphemism to encompass treatments for gender dysphoria. Cisgender people are not treating gender dysphoria, by definition.
When people try to argue that things like hair transplants for men or mar-a-lago face surgery for women are “gender affirming care”, they are intentionally misinterpreting the meaning of the euphemism.
Indirectly, this argument suggests that GAC is “the same as” purely cosmetic procedures, instead of being a matter of identify.
People that are opposed to “gender affirming care” typically are opposed to the way GAC addresses gender dysphoria, rather than some argument like “all hormonal medicine is morally wrong” or “all cosmetic procedures are morally wrong”.
So it’s really only “hypocritical” if you intentionally misconstrue “gender affirming care” as something other than “treating gender dysphoria by trying to align a patient’s external appearance with their internal identity”.
It’s controversial partly because it is not good for the body, particularly when women take high levels of testosterone it cause vaginal and uterine atrophy that causes pain and may need surgical intervention. Chronic pain is debilitating.
I can't believe I'm saying this when I am very hostile to cure alls, wellness industry, and podcasters, and don't even ask me about RFK Jr. But the doctors quoted here are so clearly full of it.
The sertraline I've taken for most of my life has an "unknown" mechanism of action and you're certain it's impossible for these guys who seem relatively normal to stop feeling like shit because of normal levels you've arbitrarily decided? My grandfather was born before the synthesis of testosterone and doctors are arguing against that scammy company by just saying don't worry, we know everything.
Men's testoterone levels change with age just like women, it's not on the level of menopause but they have their own issues. It's not wrong for women to use hormones to relieve their suffering and help their bodies, and it's not wrong for men either.
If they feel fine and don't want it then that's great. If they don't feel fine and they want to try it, they should be allowed to do that.
My husband and I are both in our mid 40s, we both use testoterone injections and it is life changing. I was already on estrogen replacement for perimenopause but testoterone is what gave me my life back. My husband feels dramatically better too, he's lost his extra weight and he sleeps better at night, he's obviously less anxious. These are issues we complained to doctors about and there was no answer. We figured out we could fix it ourselves and so we did. If there's a better option then doctors need to tell people and prescribe it, otherwise we'll just handle it ourselves I guess.
The risks with men are slightly different. Long term testosterone use leads the body to reduce or stop testosterone production and it can be permanent. As a result you only want to be taking it if you have a DEFINITE deficiency, which not every man will have. Otherwise you could fuck up a healthy testosterone supply and end up on hrt unnecessarily for life.
However with women the oestrogen production has suddenly and significantly lowered at menopause in every woman so there isn’t the same concern of lowering an already healthy supply. Moreover, hrt doesn’t stop or reduce the rate at which your ovaries from producing oestrogen.
The concern in the article is particularly about the advertisement of hrt to YOUNG men. No one is advertising hrt to premenopausal women
Vanillacaramelalmond | 23 hours ago
Important conversation. Had a young man as a patient once who was convinced his lack of energy was due to having low testosterone and ordered pills off the internet to fix it. Turns out he had a rare blood disorder. Too many people, especially young men nowadays are going online and trying to self medicate and treat nonspecific symptoms for issues they don’t have a formal diagnosis for.
skyewardeyes | 18 hours ago
Yeah, people are saying that a lot of physicians are convinced everything is psychosomatic (which does happen sometimes) when it’s really endocrine, but the flip side is people being convinced everything should be treated by HRT when it may well be something else entirely. As a psychologist, I see a similar issue with people deciding that any psychological problems they have must be autism/ADHD and thus not really seeking (or rejecting) a good diagnostic assessment that could lead to better treatment.
Calavar | 6 hours ago
If you believe the internet, there's an epidemic of lazy doctors, and the chief sign of laziness is when they refuse to order a test or a treatment.
But anyone who works as a clinician knows that it's exactly the opposite - the lazy clinicians are the ones who routinely order non-indicated tests and medications. Ordering a battery of tests takes three or four mouse clicks, and it sidesteps any difficult discussions with patients along the lines of "I'm sorry, but we've done all the guideline recommended tests and nothing has come up. I don't have an explanation for your symptoms. This is why I don't feel that ordering tests X, Y, and Z are medically indicated."
Why have that discussion when you can order 30 tests across five panels, wait for one to come back 1% out of parameters, and then ride in as the hero to tell the patient that you've found a diagnosis with a potential treatment. It's often a crock diagnosis, poorly if at all supported by the scientific literature. But for patients who are desperate to find a solution, it sounds like music.
light_sweet_crude | 19 hours ago
Firefighter here, many departments around me are offering testosterone testing with our annual physical exams because low T can contribute to fatigue and depression, and both sleep deprivation and mental health issues are an occupational hazard to us (the "fatigue panel" my department offers also tests your TSH and vitamin D levels). However, this is done by a physician, and the one friend I have whose T levels came back low has to have them re-tested by his PCP before anything will be prescribed to him (I'm a woman and haven't had my bloodwork done yet ftr).
I feel like this headline is misleading. Actual low T is not a spurious pseudo-disease, the issue is that venture capital hucksters are fiddling with evidence-based acceptable T ranges to make a quick buck. Note how most of the people described in the article decided to start T based on some Internet bullshit and maybe 1 guy actually talked to his doctor.
ritchiedrama | 18 hours ago
This is a terrible take on this, I have worked with over 10,000 men in the last 5 years and while "capital hucksters" are a problem for many reasons, they aren't "fiddling with evidence based acceptable T ranges"
You know very little about TRT, or the men it has (or hasn't helped).
Most people cannot speak to their doctor about this, as the doctors don't understand it. Doctors will tell you themselves, it isn't something they really learn about in medical school.
light_sweet_crude | 18 hours ago
Judging by your profile I think you may be a little biased :) I suppose more accurately, the issue the author is trying to name is (no offense) the cottage industry around TRT, not the actual health issue of low T, which is very much real – and which the headline undermines.
I have no experience with the NHS but I would be very surprised to hear an American endocrinologist profess to have never learned about HRT or its indications.
ritchiedrama | 17 hours ago
My profile has nothing to do with anything, there is one statement you made that matters which I already quoted, and the part about 1 guy actually talking to his doctor.
Many of these doctors at TRT clinics in the UK, are NHS GP's that have gone outside of the NHS and learnt (because they wanted to/job opportunities) about TRT themselves, as they didn't learn it in medical school, their words.
I am quoted, in the article as I was interviewed for it, pointing out that I speak to many men who try get help on the NHS and they can't, even when their levels are really low.
Now, not everyone is the same. We've helped people at clinics with levels of 14nmol/L which these "endocrinologists" say is preposterous, and it has saved their life, changed things massively for them.
We also have had people who have levels as low as 8 nmol/L and they don't feel too bad. This black and white thinking is absolutely ridiculous.
It's about time that the NHS realises it is not equipped for this and seeks help outside and works with private companies rather than against.
Shumba-Love | 17 hours ago
Dr. Larry Lipshulz urologist at Baylor College of Medicine would like a word. He’s a researcher and clinician in men’s reproductive health.
ritchiedrama | 17 hours ago
If you think a normal person can access a Urologist, at the first point of call, when the NHS you have to go through GP, then get referred to Endocrinologists.
I interviewed a consultant urologist for my business, he wasn't aware of private trt, at all.
Shumba-Love | 16 hours ago
Hmmmm..So are you arguing that UK docs don’t know about HRT therefore your business is needed? I’m not understanding your take on this. I am a licensed health care professional and can speak to what’s occurring in the US. I agree with light_sweet_crude about the cottage industries around HRT. We see this here in the States as well as in other areas of health (rebranded as wellness) like med spas and supplements/ “natural” products for women in peri/menopause. Lots of money to be made by unlicensed non- health care professionals with potential disastrous results
ritchiedrama | 15 hours ago
In the UK obtaining TRT via the NHS is near impossible for lots of very symptomatic men, so yes, private care is required.
You are right, you don't understand my take because you don't understand our healthcare system and you're talking about "unlicensed non-healthcare professionals" for some reason.
The reddit hive mind is strong in this thread, however.
kazuwacky | 14 hours ago
You have money in the game you're selling.
Be honest about it or stop acting like you don't.
ritchiedrama | 14 hours ago
You don't even understand the topic at hand..
It doesn't matter whether I have money "in the game" or not, you can't just dispute something that is factual lol.
kazuwacky | 13 hours ago
I understand you get paid for youg lads messing with their endocrine system if they stop needing a prescription (maybe even then).
I'm not gonna stop you grifting but I'm going to do what I can to point it out.
ritchiedrama | 13 hours ago
I've used testosterone myself for 13 years, watched it transform peoples lives, help them with their depression and bring them back from literal hell, their families lives improve as a knock on effect, fix their relationships.
You have no idea what you're talking about and that's what makes this so awful.
yojimbo_beta | a day ago
I want to get a comment in before the Reddit hivemind converges on the narrative that "low T" is a fad disease.
Bluntly, after my own experiences with GPs in the UK, I do not trust most doctors on hormonal or endocrine problems. Not only because of my own health experiences but in my family too, and this includes women: doctors do not take seriously when you report problems with energy, metabolism or mood.
(And if you are twitching to dismiss this as a Mens Entitlement problem, try asking the older women in your family how seriously they're taken by doctors)
This has included quite mechanical ailments too. I once had to battle my GP to get my foot looked at due to chronic pain - despite their insistence I just needed to lay it up, it turned out I had a cuboid fracture. Likewise to get physio afterwards: despite explaining to my doctor I was a thirty five year old man who could no longer walk more than a hundred meters, the GP basically shrugged it off as "one of those things, just rest it".
So I have absolutely no trust whatsoever in doctors who say, that patients self-reports of weight loss, higher energy, better immunity on T replacement are just some placebo effect.
If people want hormones, let them. Inform them of the risks, allow consent, and stop policing peoples choices. These articles have the same tone as those "concerned" about menopausal women choosing HRT - stop it.
AllegedlyLiterate | 23 hours ago
For sure there are serious issues with the medical establishment (I speak from personal experience of hormonal and autoimmune issues. Bad combo.), but also just at a base level I don’t trust these for profit medical companies to provide adequate care or accurate information. If you think about a generic patient getting the test results that the author of this article was getting, and they decided to go on TRT, they might be choosing it, but they wouldn’t be choosing it in an informed way after having been given test results saying that their levels which are in fact within the normal range are concerning. It reminds me of vitamin companies – vitamin deficiencies are a serious issue but companies that sell vitamins are also motivated to say you need more than you really do, and that their method of getting your levels up is the best way when it may or may not be.
ritchiedrama | 23 hours ago
The issue is what is being defined as normal levels and by who.
The nhs range is broad, and not fit for purpose when it comes to testosterone, often also not testing free testosterone.
If it was up to the nhs, thousands of men would be suffering with low testosterone and on anti depressants
Awkwardlyhugged | a day ago
You are correct.
Signed, a woman who had her spinal fracture and perimenopause dismissed as fatness and depression.
Thanks doc!
SnooBananas7856 | 23 hours ago
Definitely correct.
Signed, another woman who had her symptoms dismissed for several years by my pcp as 'hormonal', 'all in my head', and that I was 'not handling stress well.... go see a therapist'. Well, he was right about it being all in my head.... I very nearly died from my (first) brain tumour; I had emergency surgery two weeks before my wedding. I was subsequently diagnosed with a rare genetic cancer disease. You'd think having proof of a dangerous disease would mean that doctors took me seriously. They insisted I had gall bladder issues, but it turned out to be pancreatic cancer. I was fucking bedridden for years, and I KNEW something was wrong. I KNEW I had neuroendocrine anomalies but still had to beg doctors to believe me enough to order the proper tests. A little over a year ago I had surgery to remove thyroid and parathyroid cancer. But it's not just my cancer stuff; I recently started HRT after years of asking for it. It's been a little over four months and my quality of life has already improved a hundredfold.
I've seen many excellent doctors and surgeons, but I have to advocate heavily for myself (and all my daughters have the disease as well, so I advocate for them, too :( ). All the fucking time I have to research symptoms and understand multiple rare types of tumours and say things in just the right way to be taken seriously. I probably would've phoned it in--my disease is painful and exhausting and it is relentless--but I wanted to be an example to my daughters that you can find great joy in life even in the midst of great suffering. I actively taught them to advocate for themselves, to ask questions, to listen to their gut feelings and intuition. And technologies and research continue to improve outcomes for many of our cancers/disease. Just in the last ten year I've been so impressed with the treatments developed and the various successes. It gives me hope that my girls' future will have less suffering than what I have, and my dad had, endured.
smellslikebadussy | 22 hours ago
The main “concern” I’ve seen has been on that one NYT article, and the main issue I saw that people had was bemusement that the NYT took a break from its rigorous trans-panic editorial calendar to write a cheeky article about how much testosterone treatment is helping women.
kazuwacky | 14 hours ago
What an alarming post.
If you mess with you endocrine system, that's it. You're on hormones for life now.
Honestly concerned by the number of young men I have informed of this fact. Posts like this really reinforce my lived experience.
JohnCavil | an hour ago
Also when people say they went on testosterone and started feeling better. That doesn't mean it was the right choice. Any bodybuilder will tell you that going on testosterone will make you feel great, at least in the short term. Better mood, boosts confidence, etc. And these are people who definitely don't need it, but are just taking it recreationally.
The whole "Drug makes me feel good -> i should be on drug" logic ignores that doctors go through years and decades of education because it's not that simple. There are other things to take into account, things that actually require an education.
Plenty of drugs make people just feel better. Give energy, reduce pain, better mood. But handing out these pills to anyone who asks is not the solution. And I actually do think it's peoples own choice, but there's just a concerning amount of people who think they have it all figured out because they took some drug that no doctor said they needed and now they feel great.
I saw it myself with someone who couldn't sleep that well, doctors didn't want to prescribe any medication, so they got it themselves. Worked great, put them right to sleep. Didn't work out so great in the long run, as these things tend not to.
A lot of people genuinely kind of believe that life altering drugs exist (for people with no diagnosed disorder or disease) that do not have any real downsides or side effects. Like you can just improve a healthy human with drugs and why shouldn't you?
Smee76 | 22 hours ago
>If people want hormones, let them. Inform them of the risks, allow consent, and stop policing peoples choices. These articles have the same tone as those "concerned" about menopausal women choosing HRT - stop it.
This is not reality. Physicians are liable for the bad outcomes from these choices, even if they recommend against it. They are legally and morally obligated to only prescribe it in cases where the benefit is outweighed by the risk, which is frequently not the case.
BeagleButler | 22 hours ago
I agree here. The hoops I have jumped through we someone with only half a thyroid. Ideal and a in range are two different things with the endocrine world. While as a woman I don't have the same experience as men with testosterone, I do know that patients are constantly dismissed for symptoms that are treatable. It wouldn't shock me if research eventually shows that midlife has edocrine changes for everyone eventually.
Edit: getting a second opinion this week as completely out of range adrenal tests were ignored because I'm a mid 40s woman. Jokes on that guy because I'm on the combined pill which I told him and it invalidates a LOT of the hormone tests he did
tallemaja | 16 hours ago
Right. I think two things can be true: a lot of the faddish ads on TV like "Nugenix" feel bullshitty and unhelpful. I also think that being frank about hormone changes is important. I suppose there's just a mixture here that is about what "masculinity" is and what's performative, but I'm not sure that making men feel bad for pursuing options is the right approach.
I'm nonbinary - I do not take hormones (if anything, as I get further into perimenopause, I think I'd be taking hormones they expect women to take at that phase) BUT I have had some affirming care and I wholly support gender affirming care for all. If that's a man getting something for low T, getting a hair transplant, whatever - or a woman getting breast implants and a chin lift - so be it.
I am dealing with a medical situation right now that involves going from doctor to doctor to say "hey, I am in *constant pain*, what is going on here? I know the labwork shows nothing, the ultrasounds you're running don't show it, but this is happening" and it's fucking maddening to not have people listen to me. It's fucking maddening when I talk about being nonbinary and some people act like I'm actually mentally ill.
Someone in the article mentions it, but people are looking for ways to make them feel normal, baseline again after a struggle. This is just about feeling right in your body. I'd like to see better discussion about that before "too many men think they have low T!" keeps circulating and starts feeling like a moral panic.
bws2a | 22 hours ago
This. Spot on.
BrogenKlippen | a day ago
Anecdotally, I have three friends on TRT that describe it as life changing and I’m inclined to believe them because my wife started HRT 18 months ago and the difference it has made in her quality of life is literally amazing.
Ultimately these are very much decisions you should make with your doctor, not based on what a journalist thinks.
thecream_oftheCROP | 22 hours ago
Women often need HRT for treating peri/post menopausal symptoms. It's not the same for men
listenyall | 22 hours ago
The level of evidence for hrt in women is incredibly high, I don't think these are comparable at all
BrogenKlippen | 21 hours ago
Let’s just let people make their own health decisions with their providers
listenyall | 21 hours ago
You responded to an article about low levels of evidence for trt in men by comparing it to hrt in your wife and I'm just pointing out it's a totally different situation in terms of the specific point the article is making
BrogenKlippen | 20 hours ago
I responded by providing anecdotes from three people I trust that say it’s changed their life and said I’ve also seen the same effect in my wife with HRT. I stand by the fact that people I know that have taken testosterone replacement all claim that it’s life changing.
latswipe | 19 hours ago
let's not discuss things because trends are an illusion and facts are facts
jb_in_jpn | 23 hours ago
What are the changes you've noticed respectively, if you don't mind me asking
BrogenKlippen | 23 hours ago
The biggest things I’ve noticed are mood and energy. My wife is a naturally very funny, outgoing, and ambitious person. You could see those things just kind of dwindling in her late 30s as she was more stressed, tired, and just kind of unhappy and cranky a lot.
Her doctor recommended HRT and she initially was hesitant but finally decided to give it a try when a friend told her how much it had helped her. Within like 2-3 months it was like she was completely back to herself…funnier than hell, working out all the time again, going out with her girlfriends, buying new clothes, leaning in at work, always in a really good mood with our kids, super fun to be around, etc. This sounds so cliche, but she’s living her life to the fullest again.
limedifficult | 21 hours ago
I’m 40 and I’ve been debating HRT. This sounds so much like me that I think you’ve just pushed me into making that doctor appointment!
Smee76 | 22 hours ago
She went on estrogen? You aren't clear about what she's actually on.
BrogenKlippen | 22 hours ago
I think it’s estrogen and progesterone.
SnooKiwis2161 | 21 hours ago
Likely that combo, women also benefit from appropriate doses of testosterone - lots of discussions on it in the menopause subreddit
It's good to hear she got support, many doctors are still insisting women should suffer without
ohfrackthis | 20 hours ago
HRT for women is PET-> progesterone + estrogen + testosterone.
[OP] Dreaming_Blackbirds | a day ago
i'm a cis dude, but i despise the hypocrisy around it being OK for cis men and women to have gender-affirming care but it's suddenly oh so super controversial for trans people to receive hormones. it's just two-faced and malicious!
yojimbo_beta | a day ago
I don't disagree with you, but doesn't this article somewhat undermine your point? It's doing moral policing over men's self-reporting of better health outcomes on T replacement.
It is a milder form of the articles from 10 years ago that expressed "scientific concern" about menopausal women choosing HRT, emphasising the risk of breast cancer, and dismissing the autonomy of patients.
Bright_Ices | a day ago
I didn’t see them saying they agree with the article.
KellyJin17 | 23 hours ago
Generally speaking if you post something, it’s a show of support.
Fresh_Ad3599 | 23 hours ago
Generally speaking, no it is not.
Gladyskravitz99 | 19 hours ago
I often post stories for discussion or just to see others' thoughts on them
Bright_Ices | 16 hours ago
Thanks for supporting my comment!
TeamHope4 | 14 hours ago
Women have to fight against uninformed doctors to get menopause hormones. It fucking sucks to be offered nothing after giving them a well-documented list of your meno symptoms. “Just eat right and do yoga, oh, let’s do a Pap smear since you’re here.”
[OP] Dreaming_Blackbirds | 8 hours ago
good point. too many men doctors. also there's data that black patients in the US are rarely believed by white doctors. so there are lots of biases.
macchic63 | 8 hours ago
I wish it were only the male doctors… ask me how I know.
AllegedlyLiterate | a day ago
Agreed. It’s also interesting that when hormonal disorders are common, they’re just disorders that affect cisgender people, but when they’re rare or unusual they’re seen as making you intersex.
Stillsharon | a day ago
“Intersex” is a disorder of sexual development that can affect how hormones are produced in the body and the levels at which they occur though.
AllegedlyLiterate | a day ago
Intersex is actually a term for several conditions that cause sexual difference and there’s not necessarily consensus on which ones count, which is why you’ll see estimates for the total intersex population vary wildly (for instance, counting PCOS changes the numbers substantially).
kazuwacky | 13 hours ago
Not true, biology is never binary. It's always a scale of change.
Nature laughs at our tidy boxes.
LysergioXandex | 9 hours ago
I think that’s a bad comparison.
“Gender affirming care” is a euphemism to encompass treatments for gender dysphoria. Cisgender people are not treating gender dysphoria, by definition.
When people try to argue that things like hair transplants for men or mar-a-lago face surgery for women are “gender affirming care”, they are intentionally misinterpreting the meaning of the euphemism.
Indirectly, this argument suggests that GAC is “the same as” purely cosmetic procedures, instead of being a matter of identify.
People that are opposed to “gender affirming care” typically are opposed to the way GAC addresses gender dysphoria, rather than some argument like “all hormonal medicine is morally wrong” or “all cosmetic procedures are morally wrong”.
So it’s really only “hypocritical” if you intentionally misconstrue “gender affirming care” as something other than “treating gender dysphoria by trying to align a patient’s external appearance with their internal identity”.
Stillsharon | a day ago
It’s controversial partly because it is not good for the body, particularly when women take high levels of testosterone it cause vaginal and uterine atrophy that causes pain and may need surgical intervention. Chronic pain is debilitating.
InvisibleEar | 19 hours ago
I can't believe I'm saying this when I am very hostile to cure alls, wellness industry, and podcasters, and don't even ask me about RFK Jr. But the doctors quoted here are so clearly full of it.
The sertraline I've taken for most of my life has an "unknown" mechanism of action and you're certain it's impossible for these guys who seem relatively normal to stop feeling like shit because of normal levels you've arbitrarily decided? My grandfather was born before the synthesis of testosterone and doctors are arguing against that scammy company by just saying don't worry, we know everything.
pinkbootstrap | 19 hours ago
I'm really reluctant to agree with this having hormone issues myself as a woman. I think doctors just love to dismiss hormone problems in general.
ManateeNipples | 23 hours ago
Men's testoterone levels change with age just like women, it's not on the level of menopause but they have their own issues. It's not wrong for women to use hormones to relieve their suffering and help their bodies, and it's not wrong for men either.
If they feel fine and don't want it then that's great. If they don't feel fine and they want to try it, they should be allowed to do that.
My husband and I are both in our mid 40s, we both use testoterone injections and it is life changing. I was already on estrogen replacement for perimenopause but testoterone is what gave me my life back. My husband feels dramatically better too, he's lost his extra weight and he sleeps better at night, he's obviously less anxious. These are issues we complained to doctors about and there was no answer. We figured out we could fix it ourselves and so we did. If there's a better option then doctors need to tell people and prescribe it, otherwise we'll just handle it ourselves I guess.
Nfjz26 | 10 hours ago
The risks with men are slightly different. Long term testosterone use leads the body to reduce or stop testosterone production and it can be permanent. As a result you only want to be taking it if you have a DEFINITE deficiency, which not every man will have. Otherwise you could fuck up a healthy testosterone supply and end up on hrt unnecessarily for life.
However with women the oestrogen production has suddenly and significantly lowered at menopause in every woman so there isn’t the same concern of lowering an already healthy supply. Moreover, hrt doesn’t stop or reduce the rate at which your ovaries from producing oestrogen.
The concern in the article is particularly about the advertisement of hrt to YOUNG men. No one is advertising hrt to premenopausal women
latswipe | 19 hours ago
dig far enough back, and you're gonna find the American obsession with eugenics.