Although women undergo a sudden decline in the female sex hormone estrogen during menopause, most men experience a gradual tapering off in testosterone production that begins in their forties and continues at about 1 percent a year. That decline, sometimes referred to as "andropause," is the subject of medical debate, with some researchers saying it is predictable and normal and others saying it is associated with diseases and conditions that can be kept at bay by taking additional testosterone.
The FDA has approved testosterone only for hypogonadism, a steep decline in hormone production triggered by surgery or disease that harms the testes or pituitary gland. But the IOM panel concluded that a significant majority of the more than 1.75 million testosterone prescriptions in 2002 were for men who did not have the condition. Once the FDA has approved a drug for one condition, doctors can legally prescribe it for any medical purpose. Such "off- label" uses are widespread -- and sometimes controversial.
The sharp increase in testosterone use since 1999 coincided with the FDA's approval of new and easier ways to administer the drug. Testosterone used to be given only by monthly injections, but men can now get it as a patch or a gel. Because of the way testosterone acts in the body, it is not given in pill form in the United States.
The FDA has approved testosterone only for hypogonadism, a steep decline in hormone production triggered by surgery or disease that harms the testes or pituitary gland. But the IOM panel concluded that a significant majority of the more than 1.75 million testosterone prescriptions in 2002 were for men who did not have the condition. Once the FDA has approved a drug for one condition, doctors can legally prescribe it for any medical purpose. Such "off- label" uses are widespread -- and sometimes controversial.
The sharp increase in testosterone use since 1999 coincided with the FDA's approval of new and easier ways to administer the drug. Testosterone used to be given only by monthly injections, but men can now get it as a patch or a gel. Because of the way testosterone acts in the body, it is not given in pill form in the United States.
