Testosterone levels in men have declined more than 25% over the last two decades. And most people — men and women alike — have no idea why, what it means, or what to do about it.

In this episode, Leslie sits down with Shalin Shah, CEO of Marius Pharmaceuticals and one of the leading voices in the testosterone therapy space, to have the conversation that a lot of doctors still aren't having. Leslie brings her own experience — she's been on topical testosterone as part of her HRT protocol — and together they go deep on why T levels are dropping, how to know if yours are low, and what the treatment landscape actually looks like in 2026.

They cover the difference between total and free testosterone and why the number your doctor shows you may be almost meaningless. They talk about the FDA panel that convened in December 2025, what was asked of regulators, and why the outcome could change how millions of people access care. They discuss why testosterone got classified as a controlled substance in 1990, the faulty studies that put cardiovascular and prostate cancer warnings on labels for decades, and what the landmark 2023 Traverse Study finally put to rest.

They also talk about women — because testosterone is a female hormone too, and the gap between how men and women access treatment is still significant.

If you've been curious about this subject — whether for yourself, your partner, your father, or your sons — this is the conversation to start with.

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00:00:00 Introduction & Leslie's Personal Story

00:02:18 The State of Testosterone Today

00:05:57 What's Causing the Decline

00:08:00 Symptoms of Low T & Why You Should Get Tested

00:10:10 Why Your Doctor Probably Isn't Testing You

00:12:24 What's a Normal Testosterone Level?

00:16:20 Testosterone and Women

00:20:00 Leslie's HRT Journey & Treatment Options

00:25:20 Natural Ways to Boost Your Levels

00:30:03 The FDA Panel — What Was Discussed

00:33:20 The Prostate Cancer Study — 3 People, 80 Years of Policy

00:36:30 What Needs to Change & What's Next

00:40:34 Outro

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Why Testosterone Levels Are at an All-Time Low with Shalin Shah