What it is
Regulatory status: prescription medication (Schedule III controlled substance in the US; androgen / anabolic steroid)
Mechanism evidence: human
At a glance
What it is, why people use it, the evidence, and what to know before trying it.
Why people use it
- **Hypogonadism symptom relief** (established indication: restore androgen-dependent physiology in men with confirmed deficiency).
- **Energy / vitality / fatigue improvement.**
- **Mood / depressive-symptom improvement.**
- **Libido / sexual desire and sexual activity.**
- **Erectile function.**
- **Body composition** (↑ lean / fat-free mass; ↓ fat mass) and **strength / physical function.**
- **Bone** (↑ BMD / estimated strength; ↓ fractures).
- **Cardiovascular benefit or neutrality** (hard MACE outcomes).
- **Prostate safety** (no increase in prostate cancer / LUTS; PSA monitoring).
- **Correction of anemia** (hemoglobin).
Evidence at a glance
For men with **confirmed hypogonadism** (symptoms plus unequivocally low morning T), TRT is an established prescription therapy: sexual desire/activity improve modestly (TTrials, TRAVERSE sexual), hemoglobin and anemia correct (TTrials, TRAVERSE anemia), lean mass rises and fat mass falls (multiple meta-analyses), and volumetric BMD rises (TTrials Bone). **TRAVERSE** — 5246 men, gel, ~33 months follow-up — showed MACE **noninferiority** (7.0% vs 7.3%; HR 0.96, 95% CI 0.78–1.17), which supported FDA’s **2025** removal of the CV boxed-warning *language* while **keeping** the age-related Limitation of Use and adding BP warnings; AF, PE, and AKI were still higher on drug. Fertility suppression is **expected and strong** (WHO/Liu). Fracture prevention is **not** established (TRAVERSE more clinical fractures). Cognition is **null**. **“Optimization” of mid-normal T** has **no** hard-outcome mandate and conflicts with FDA/EMA/Endocrine Society framing.