Throughout the United States, men are constantly targeted for some variation of testosterone. There are prescriptions, supplement pills and even testosterone replacement therapy, also known as TRT, which is becoming one of the most widely prescribed medications in the U.S. today. However, there are many controversies over the benefits, risks and “appropriate use” of TRT.

The pharmaceutical company AbbVie created a testosterone replacement therapy, called AndroGel, which is found to lead to some improvements in libido and sexual function in men over age 65. However, there is limited evidence provided that it works for other symptoms advertised. The National Institutes of Health ran recent trials for testosterone treatment in older men, and it was actually showing inconsistent results.

The FDA even made drug companies add a warning to the drug labels for the potential increased risk of heart attack and stroke in men over age 65, as TRT may cause serious side effects. Potential side effects for men under 45 include increased risk of infertility, although, clinical trials and data analyses are further studying these issues.

Drug manufactures including Eli Lilly and AbbVie are currently facing thousands of lawsuits from men, regarding side effects caused by TRT. The FDA recalled Eli Lilly’s testosterone pill last year, due to safety concerns.

CNBC reports, despite the warnings and lawsuits, the TRT market is expected to reach $3.8 billion by 2022, which is increased from $2 billion in 2012. Global Industry Analysts believes the market will boom due to the increase in aging male population, which may lead to hypogonadism, the medical term for the condition in which the testicles don’t make enough testosterone.

The increase is “obviously driven by the bottom line and an enormous opportunity to make money,” said Lawrence Ross, a urologist and professor at the University of Illinois at Chicago, who co-authored the study using data from the CDC. “There’s no question that the intense direct-to-consumer marketing sparks interest in young men who then ask their doctors about the drug,” Ross said.

The TRT industry holds a “tremendous amount of conflicts of interests,” said Thomas Perls, a professor of Medicine at Boston University. Perls describes TRT as “disease mongering,” or “redefining a disease so that it greatly enlarges the potential population that would be interested in the drug, with the addition of mass marketing,” he said.

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