Steroids shouldn't only be the preserve of bodybuilders (Photo by Cameron Spencer/Getty Images)
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For decades, we’ve been living in a world of steroid smoke and mirrors. On one side, we have athletes and bodybuilders taking heroic doses of these substances in secret, often guided by “broscience” and internet forums rather than medical professionals. On the other, we have lawmakers and anti-doping agencies waging a quixotic war against performance enhancers, bellowing that such drugs are “positively un-American” and treating testosterone and growth hormones as if they’re as dangerous as heroin. Meanwhile, caught in the middle are millions of ordinary people who might benefit from hormone optimisation but are too afraid or ashamed to seek help. This situation is untenable, and it’s time we cleared the air.
Let’s start with a simple fact: testosterone levels in men have been declining for decades. A man aged 60 in 2002 had about 85% of the testosterone level of a man the same age in 1987. Even more alarmingly, we’re seeing a 20% deficit in testosterone levels in adolescent and young adult males. This isn’t just a matter of feeling less manly — it’s associated with a host of health problems, from obesity to diabetes. After all, as well as regulating libido, testosterone is crucial for building bone and muscle mass, distributing fat, and producing red blood cells.
For many men aged between 45 and 50, testosterone replacement therapy (TRT) could provide significant health benefits. When properly monitored by a physician, TRT can improve mood, increase muscle mass, reduce body fat, enhance libido, and even help with cognitive function. And yet, instead of treating this as a normal part of ageing care, we’ve stigmatised it, driving people to seek dangerous alternatives or suffer in silence.
This reluctance is rooted in misconceptions about the risks of testosterone therapy. Yes, like any medical treatment, it has potential side effects, such as increased blood pressure, cholesterol, and stroke risk. But these more remote dangers are often exaggerated, while the immediate and obvious benefits are downplayed.
I speak from personal experience. In March 2022, at age 40, I tore my left pectoral muscle. Coming on the heels of two decades of “clean” lifting, this injury led me to explore testosterone replacement therapy under the supervision of a physician. My regimen consists of weekly doses of self-injected testosterone cypionate, with regular blood work to monitor my health. The results have been significant: my testosterone levels have increased from 600 to around 1,000 nanograms per decilitre, with no increases in bad cholesterol or other negative side effects related to liver or kidney function. This hasn’t made me into any sort of superhuman — and I’m still nowhere near as ripped as I was in my late twenties — but during this period, I squatted 600 pounds and deadlifted 700 pounds for the first time in two decades of strength training.
Of course, for every story like mine, there are others that are far from successful. Indeed, just as with every case of stigma, the misleading debate around steroids has created an environment ripe for charlatans and unsafe practices. Just consider the case of Brian “Liver King” Johnson, who built a fitness empire on the claim that his muscular physique was the result of eating raw organ meats and following “ancestral” practices. When it was revealed that he was actually spending thousands of dollars a month on steroids, many were shocked. But should we have been? From “natural” bodybuilders who are anything but to supplement companies peddling magic pills and boilerplate “customised” workouts, the entire ecosystem is built on a foundation of lies. It’s a classic case of prohibition creating more problems than it solves.
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SubscribeInteresting but personally I feel uneasy about all this fiddling with our bodies (but then again I am against the search for immortality).
And the main question (briefly mentioned at the end of the article only) should be: Why are men’s testosterone levels dropping? Quite possibly it is a self perpetuating cycle from lack of activity/action.
I doubt your final conjecture is the reason, but I agree with you that it is urgent that we discover the real reason for it.
Although I have no particular issue with this essay, I would much rather the focus of it was in line with you second paragraph.
The testosterone level in men peaks at age 20 and then declines, so I’m not sure what he’s talking about. At his age , at 40, a level of 600 ng/dL was about right. The average is is 679 NB/dL. Healthy men have a range of 450-600. So, to currently have a level of 1000 is abnormal. As a side note, I am currently in menopause. Two doctors have refused to give me estrogen. They thought the risks were too high. They don’t hand out estrogen like candy. Also, 70- year-old women are post-menopausal. They no longer get estrogen because the risks are too high, and they no longer have hot flashes, etc.
My wife is finding the same condition tough going but will not touch oestrogen. She eats healthily, does yoga, cycles to work. She’s a fine example, well, except for her disappointingly low consumption of beer.
” if we normalised the idea that hormones are just another tool for optimising health and well-being” Sex hormones are extremally potent drugs, with a whole-body systematic effects. I presume this isn’t what the author intended, but this line slightly sounds like he think they should be popped like multivitamins
I think there is merit to the core argument about men supplementing testosterone to cope with age-related and environment-induced declines. What you are essentially trying to do there is bring male testosterone back to a ideal level, and I think in general medicine is too passive when it comes to aging-related issues. Aging is ‘normal’ so we shouldn’t intervene, but if ‘normal’ is decades of chronic illness, that’s a terrible normal. That said, I’m not a doctor, and this should be guided by empirical research into optimising outcomes.
That being said, extending that to transgender issues is flawed. Females naturally have a tenth (15-70 ng/dL) the testosterone levels as males, and the different exposure starts from utero. You’re not returning females to a normal baseline, you’re warping a female body in dramatic and still only partially understood ways. We know that vaginal atrophy and incontinence are common, and in the case of atrophy, extremally painful side effects. There are also concerning indications about cardiovascular health.
It’s perfectly possible that oestrogen in males and testosterone in females do not have analogous levels of risk. The fact they are treated differently may in fact be justified. From what I’ve seen, testosterone seems to be more concerning. And regardless, introducing highly abnormal sex-hormone levels to adult human bodies is not the same as treating age-related decline.
What’s very odd, I think, is that men’s testosterone levels have been falling at the same time as a rise in the silly complaints about the invented problem of toxic masculinity.
How can this be?
Feminization of males from a young age which has become very popular.
Plus the increasing amounts of estrogen in the water supply (which doesn’t only affect men but is wreaking havoc on fish and amphibians).
For older men exogenous testosterone can really aid with quality of life. But I would worry that decriminalisation would encourage healthy young men to take it. To most people 40 years ago Arnold looked somewhat freakish. Now the pumped, bodybuilder look is the general aspiration and can lead to healthy young guys taking absurd doses of steroids to achieve it, rather than for genuine medical reasons.
I wouldn’t describe the “pumped, bodybuilder look” as a general aspiration, except amongst a particular cohort of (more often than not) thick young men. To read this article from Bateman eulogising the use of testosterone as a lifestyle choice is to tell me all i need to know about his worth as a thinker/writer.
The use of testosterone to help maintain age-related functionality is a different matter, and should be regarded as on a par with the female use of HRT. Whatever damage prolonged use of hormones might lead to in younger age groups no longer applies.
Olivers testosterone level before treatment was actually pretty good for a middle aged male and certainly did not require medical intervention. Given that exogenous testosterone levels are not subject to diurnal rhythm his new level is supra-physiological. Time will tell of course if that will have an impact on health markers, these things can creep up on the body.
I suspect vanity was the overriding factor in his case and not medical need.
Oliver is also pushing T as a back-door way of gaining acceptance for the broader spectrum of performance enhancers, which further bolsters your last sentence.
PSA ?
The irony of this pudgy, moonfaced guy writing about testosterone is not lost on the reader.
It’s a bit of an overreach to equate testosterone supplementation with what people know as steroids. Test is at least a naturally-occurring hormone, unlike the rest of the cocktails that some choose to take.
As some others have noted, this conveniently skirts the underlying issue – lowered T levels. What is going on with that? Could it possibly be that our growing appetite for pharmacological aids to deal with one condition impacts something else? Maybe the human body should not be treated like a petri dish.
Blurs the distinction between hormones (testosterone) and steroids. Apples and oranges.
Also steroids are a very wide field – steroid creams used to be prescribed for eczema but I don’t think that’s what Bateman has in mind…
But doesn’t testosterone promote the growth of prostate cancer? Check with your physician before attempting anything like this.
The most obvious cause of the reduction in male testosterone production is the massive decrease in manual labour in the western male population.
Other than a few men who nobody is interested in listening to, nobody cares Oliver, nobody cares.
Quite irresponsible of a “journalist” to use his platform to give medical advice that he is unqualified to render. All categories of steroid hormones (androgens, estrogens, progestins, glucocorticoids, and mineralocorticoids) have well-established adverse side-effects that are not entirely mitigated even when used under close medical supervision. His personal testimonial as a testosterone user is tantamount to an opioid addict rhapsodising on the benefits of heroin.
I think snake oil is better
I’ve just had a shipment. Can I interest you in a gallon?
🙂
I’m of the mind that if you are essentially healthy and free of pain you should avoid medical intervention.
Enjoy your food, have fun, don’t stint on chocolate (or beer). Don’t have hormones.