Everyone is on testosterone

Summary

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Episode Overview

Title: Everyone is on Testosterone
Podcast: Today, Explained (Vox)
Date: October 31, 2025
Hosts: Noel King, Sean Rameswaram
Guests: Susan Dominus (New York Times Magazine), Rebecca Jackson (The Economist)

Theme:
This episode explores the surging use of testosterone therapy across America—its benefits, dangers, cultural significance, and business side. Both men and women are increasingly seeking out testosterone, with its promise of renewed vitality, energy, and libido. The episode delves into medical, personal, social, and even political facets surrounding this hormonal trend.

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Key Discussion Points & Insights

1. Testosterone: Who Wants It and Why?

• Testosterone is for everyone: Though naturally higher in men, women are increasingly seeking testosterone therapy.
  • [00:11] Susan Dominus: “You know what I’m talking about. Testosterone.”
• Prescription trends:
  • 11 million prescriptions written in the U.S. last year (up from 7.3 million five years prior).
  • Not just via doctors—med spas, wellness centers, and influencers are pushing testosterone.

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2. Women & Testosterone Therapy

• Testosterone in women's bodies:

  • Both sexes produce it, but men have roughly 10x more.
  • Declines with age; in women by 60, about half as much as in early adulthood.
  • Women can experience low libido, mood shifts, and energy dips as levels drop.
    • [03:37] Susan Dominus: “Men have literally 10 times the amount… it declines gradually in men… in women, who have much less, it diminishes even more dramatically.”

• Reported benefits:

  • Modest dose (approximating a healthy 30-something woman): mild increase in libido, better mood, some more energy.
  • Higher, non-recommended doses: increased sex drive, occasional irritability/rage, unwanted hair growth, acne.
    • [05:41] Susan Dominus: "It's not that you have this crazy high sex drive. It's just that I can lay in bed normal."
    • [06:23] Rebecca Jackson: "I once got dosed with a man's amount of testosterone on accident... I start looking at my boss and my coworkers..."
  • Risks: irreversible effects like hair loss, facial hair, acne.
    • [06:55] Rebecca Jackson: “So you’ve got hair on your face… My biggest complaint with taking testosterone is the appearance of zits that I used to never get…”

• Unregulated space:

  • No FDA approval for women, insurance doesn’t cover it, and "wellness" providers charge high prices.
  • [07:21] Susan Dominus: "...it's not even FDA approved for women in any dose... so insurance definitely does not cover any of this for women."

• Hard sell & profit:

  • Clinics incentivize nurses, push hotel getaways with a “hard sell.”
  • [08:13] Susan Dominus: “A job listing offering nurses $100 per shot of testosterone they gave women... so the nurse is highly incentivized to provide it.”

• Personal story:

  • Business owner, mom of four, lost 40% of her hair but gained energy and earned a PhD—she’d do it again.
    • [13:07] Susan Dominus: “It is true that she lost her hair... But that initial burst of energy gave her the inspiration... she then took on getting a PhD…”

Notable Quote

• [04:57] Susan Dominus: “There's really two very different [experiences]... a standard dose... those women report a minimal but meaningful restoration of their libido... [at higher doses]... unpredictable but fairly dramatic results.”

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3. Testosterone and Gender Politics

• Overlap with transgender health:
  • High-dose prescribing to women (sometimes conservative or religious) parallels gender-affirming hormone care.
  • Cultural irony: conservative communities using high-dose testosterone, sometimes approaching doses for gender transition, yet not connecting their use to gender-affirming care debates.
    • [11:25] Susan Dominus: “It actually is a hormone that has typically been associated with... masculinity. So it just to me kicks up all kinds of interesting questions.”

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4. Men & the “Testosterone Boom”

• Rising demand:

  • Not just older men; young men (20s and 30s) are flocking to clinics.
    • [18:53] Rebecca Jackson: "The people who are taking testosterone fastest now are not guys in their seventies, but men in their twenties and thirties."
  • Massive expansion of clinics like Game Day Men’s Health: 50 locations in April, now over 375 in 14 months.
    • [18:15] Rebecca Jackson: “When they opened in April of last year... since they opened another 325 testosterone clinics...”

• Influencer marketing:

  • Podcasters and online personalities (e.g., Joe Rogan, Dax Shepard) promote testosterone’s benefits:
    • [20:10] Joe Rogan (quoted): “It makes your body work way better…”
    • [20:32] Dax Shepard (quoted): “I spent my whole life as a medium boy, and now I’m a big boy, and I like it.”
  • TikTok, podcasts, social media drive demand—“gym bros” are key targets.

• Dangers & drawbacks:

  • Short-term: “roid rage” (aggression), insomnia, blood pressure, hair loss.
  • Long-term: Infertility—sometimes only partially reversible.
    • [21:11] Rebecca Jackson: “If it's not taken with a cocktail of other hormones... it can actually make you infertile...”
  • Clinics may inject first dose within the hour—mixed medical oversight.
    • [23:48] Rebecca Jackson: “Some of these clinics will also inject you with your first dose of testosterone within an hour of coming in.”

• Stigma & secrecy:

  • Many men are hesitant to talk about their use.
    • [24:00] Rebecca Jackson: "I tried... people were very cagey about it... I got the impression that, you know, probably a lot of people that I know are doing this but didn’t want to talk about it."

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5. Business & Societal Trends

• Testosterone clinics everywhere:
  • Growing like fast-food franchises, targeting urban and suburban communities.
  • [25:16] Rebecca Jackson: “I think we're already there. I'm inundated... these clinics are everywhere.”
• Endless industry:
  • Like Ozempic, ongoing use is required for continued effects, ensuring recurring revenue.
  • [25:16] Rebecca Jackson: “Also like Ozempic, it’s an industry that is not going anywhere... the cash here is kind of just endless.”

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Notable Quotes & Memorable Moments

• “When that testosterone kicks in, I’m bringing sexy back.”
  — Susan Dominus [06:34]
• “I think perhaps most alarmingly, some of these clinics will also inject you with your first dose of testosterone within an hour of coming in.”
  — Rebecca Jackson [23:48]
• “Even when there are negative side effects, it’s very hard to give it up. This reminds me to some degree of Ozempic.”
  — Noel King [24:41]

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Important Timestamps

• [02:23] – Prescription stats reveal testosterone’s explosive growth in the US.
• [03:33] – Breakdown of testosterone’s effects, production, and what declines do to women.
• [05:00]–[07:13] – Women’s personal experiences, from benefits to physical and emotional side effects.
• [09:20] – Why the FDA hasn’t approved T therapy for women—cancer risk fears, lack of long-term data.
• [11:25] – Complex cultural politics of women on high-dose testosterone.
• [13:07] – Story of the woman who lost her hair but gained new drive and ambition.
• [17:08] – Testosterone’s popularity spike among young men; urology stories and industry expansion.
• [20:10]–[20:37] – Influencer and celebrity impacts; direct quotes from Joe Rogan, Dax Shepard.
• [21:11] – Medical risks including infertility.
• [23:48] – The business model; first-dose injections, aggressive marketing.
• [25:16] – Clinics are everywhere; testosterone is the new Ozempic—no end in sight.

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Conclusions

• Demand for testosterone—from women and especially young men—is being driven as much by influencers and aggressive marketing as by medical need.
• The lack of FDA oversight for women and profit incentives has created a largely unregulated gray market.
• Both benefits and risks are often dramatic and life-altering, creating a population that struggles to quit even when side effects or medical complications arise.
• The trend reflects deeper societal anxieties about aging, vitality, and gender—and has business parallels to recent weight-loss drug fads.
• Testosterone is quietly and rapidly changing how millions of Americans relate to their bodies, each other, and to the concept of gender itself.

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For Listeners:

This episode highlights a booming industry, the medical and cultural fascination with testosterone, and the complicated balance of hopes, risks, and realities that come with biohacking our bodies. Whether you’re curious about the science, the business, or the personal stories, this episode gives you a vivid sense of why “everyone is on testosterone”—and what that means for the rest of us.

Transcript

[Noel King]

We all have it. Men want more.

[Rebecca Jackson]

Yeah, they do.

[Noel King]

Women also want more.

[Susan Dominus]

Oh, yeah.

[Noel King]

You know what I'm talking about. Testosterone.

[Rebecca Jackson]

Testosterone.

[Susan Dominus]

Oh, yeah. Oh, yeah. Testosterone. Oh, yeah.

[Noel King]

Big T Today on Today Explained. The hormone of which ladies and germs cannot get enough. Everyone's on T. Should they be?

[Rebecca Jackson]

Stay turned.

[Susan Dominus]

Let's bring that bass back. Oh, yeah.

[Rebecca Jackson]

Bring it through.

[Susan Dominus]

Give him a big T. Finish.

[Noel King]

Every story you love, every invention that moves you, Every idea you wished was yours. All began as nothing, Just a blank page with a blinking cursor asking a simple question. What do you see? Great ideas. Start on Mac. Find out more on apple.com Mac support for today Explained comes from Nuremberg, a film from Sony Pictures Classics. It's the aftermath of World War II. The world is confronting the horrors of the Holocaust. And U.S. army psychiatrist Lt. Col. Douglas Kelly is evaluating Herman Guring, oh, Hitler's second in command. Meanwhile, chief prosecutor Robert Jackson leads the Allies, informing an unprecedented international tribunal for. For the trial of the century. As Dr. Kelly delves deeper into Guring's psyche, a tense psychological duel unfolds. Starring who? Starring Russell Crowe, Rami Malik, Leo Woodall and Michael Shannon. Only in theaters November 7th.

[Rebecca Jackson]

So the number one thing I think that doctors don't prescribe, which is a shame, is Today Explained.

[Noel King]

Medical professionals, your doctors, your nurses wrote 11 million prescriptions for testosterone in the US last year. That was up from 7.3 million five years earlier. But a lot of people are also getting T sometimes in troubling doses.

[Susan Dominus]

I had to take mine down because I was like. It was like I was humping everything. Yeah, you'll just hump and hump and.

[Noel King]

Hump away from nutritionists, med spas, wellness centers. Susan Dominus, a staff writer at the New York Times Magazine, recently wrote about the women taking T. In recent months.

[Susan Dominus]

I've just been seeing the topic come up much more among influencers. Ladies, low libido, brain fog, depression, anxiety, low testosterone.

[Noel King]

Do you notice a difference with it?

[Rebecca Jackson]

I do.

[Noel King]

Me too.

[Susan Dominus]

Libido is.

[Rebecca Jackson]

Yeah, I know.

[Susan Dominus]

And I have more.

[Noel King]

I found it again. I found my libido.

[Rebecca Jackson]

Right.

[Susan Dominus]

My friend started talking to me about their experiences with it. And I heard some kind of incredible stories about what happened to women when they went on unusually high doses of it. You know, that idea that a hormone could have such a hold not just on how you felt physically, but how you felt emotionally and in relationship to other people, that was a really intriguing idea to me.

[Noel King]

What is this hormone? What does testosterone do exactly? And who has it?

[Susan Dominus]

So both Men and women have testosterone. Men have literally 10 times the amount of this hormone that women do. And it is something that declines gradually in men over time. But in women, who of course have much less of it to begin with, it actually diminishes over time even more dramatically, so that by the time they are around 60, they have about half of the amount of testosterone circulating through their body that they had in their, let's say, early 20s. And it's produced by both the ovaries and the adrenal glands in women, but it is only produced by the adrenal glands by that point in women's lives.

[Noel King]

As women have less testosterone over time, what starts to happen? What changes?

[Susan Dominus]

Well, we're not exactly sure, to be honest. You know, it's one of these situations in which we know what happens when you replenish their testosterone, which is that if you restore women to the levels of testosterone that they had in their 30s, when they are actually, let's say, in their 50s, there's a lot of research that suggests that it restores some of their libido and other things such as mood or energy.

[Noel King]

And in your article, you very hilariously described what happens when women start taking testosterone. It was inspiring. Tell us what you learned.

[Susan Dominus]

So there's, I mean, there's really two very different.

[Rebecca Jackson]

Right.

[Susan Dominus]

In the United States, when women take what is considered, I'm just gonna use this, you know, colloquially a standard dose of testosterone, one that's been approved by various illustrious medical societies, at least in short term use. You know, this is the amount that restores women in their 50s or 60s, back to where they were in their late 30s, to that level of testosterone. Those women report a minimal but meaningful, you know, restoration of their libido.

[Rebecca Jackson]

I started to feel like I was attributable attracted to my husband again in a different way that I haven't felt in quite some time. Think of this. Think of not going to bed hoping.

[Susan Dominus]

That your husband doesn't touch you. It's not that you have this crazy high sex drive. It's just that I can lay in bed normal. However, there's an entirely different cohort of women who are getting prescribed what are known as pellets, or they're taking a lot more of the cream than their doctors would advise. And these women are getting into their systems several times the level of testosterone that they ever would have had in their bodies, even as very, you know, young women in their 20s. And those women are having unpredictable but fairly dramatic results. Some women report, you know, really intense, almost Uncomfortable sex drives.

[Rebecca Jackson]

I once got dosed with a man's.

[Susan Dominus]

Amount of testosterone on accident.

[Rebecca Jackson]

And I start looking at my boss and my coworkers and I'm like, oh.

[Susan Dominus]

My God, why do I want to.

[Rebecca Jackson]

Why do I want to do things with my coworkers? Like, this is making no sense.

[Susan Dominus]

When that testosterone kicks in, I'm bringing sexy back. Yeah, Some women report irritability or even rage. Some women report side effects like having chunks of hair fall out, hair growth on their faces or elsewhere on their bodies where they're not used to having hair grow.

[Rebecca Jackson]

So you've got hair on your face.

[Susan Dominus]

And you want to know if it can be reversed.

[Rebecca Jackson]

My biggest complaint with taking testosterone is the appearance of zits that I used to never get and now I get.

[Susan Dominus]

Them all the time. And also a lot of women on those high doses, I mean, it's kind of like a steroid, right? Like they report having tremendous boosts of energy.

[Noel King]

You know, I've seen this on my own Instagram. Contact this company and they'll run a test for you. But insurance doesn't cover testosterone, right?

[Susan Dominus]

Oh, it's not even FDA approved for women in any dose. So basically a bunch of illustrious medical societies, you know, got together and issued a consensus statement in 2019 and they said, look, we know, I know it's not approved by the FDA for women, but we're gonna go out on a limb here and say that the safety data looks pretty good, at least in the short term, at least for postmenopausal women, who are the women who've been studied the most for this. But it's not approved by the FDA even at that level. And so insurance definitely does not cover any of this for women. I think there are a lot of people who stand to make a lot of money off of these high doses of testosterone because, you know, insurance doesn't get involved. They can charge women a lot of money sometimes they get, they certainly don't get addict to it, but they have a hard time, you know, walking away from it. And it, you know, they, they, it can cost upwards of easily upwards of $1,000 at a time to take these pretty high dose testosterone pellets, for example. It's not the only way women get high testosterone. I saw a job listing on one kind of aesthetic spa that was offering nurses $100 per shot of testosterone that they gave women in their spa. And you know, then I heard stories from other that they were basically directed before they even left the spa, like, make sure you get your testosterone shot you know, so the nurse is highly incentivized to provide it. Women are sort of being told, take our word for it, you're going to love it. Like, go book a, you know, a hotel for you and your husband this weekend. You're going to be so busy, you know, so there's a very hard sell. They are sort of posing as medical practitioners. Some of them are, some of them are ob gyns or urologists who, you know, are trained, but the financial incentives are high. And, and, and sometimes women love it, and sometimes they discover midway through, let's say a pellet which can take three months to dissolve, that they're miserable, but there's nothing you can do about it once it's been inserted, you know, underneath the skin of your buttock.

[Noel King]

Why hasn't the FDA approved this as a treatment for women?

[Susan Dominus]

Well, the last time that a drug company got it together and actually did some trials of a testosterone patch, it was Procter and Gamble that did show that women were having, you know, incrementally more satisfying sexual experiences. Their libidos were restored. But that was right after another study came out in 2002 that caused a big menopausal hormone therapy scare. And so basically, as I understand it, the people on the panel were concerned about cancer risks, you know, breast cancer specifically. And there was even a couple of excess cases in a fairly small sample size, and they just didn't have enough long term data is what they said to endorse it and give it FDA approval. Now a lot of feminist followers of medical history, you know, have said, well, that was not required for testosterone to be approved for men. There was no long term data for men required. All that the drug companies had to prove back then was that it restored men to the level of testosterone that, you know, would make them virile and youthful and strong again. To which other people would then say, right, but they don't get breast cancer and women do. So, you know, that's the concern with women.

[Noel King]

Perhaps not surprisingly, some of the conversation around this has turned political. You wrote about the parallels between women, often conservative women who are taking testosterone, and gender affirming care for transgender people. Tell me a little bit about what you explored here.

[Susan Dominus]

You know, I just thought it was interesting. One of the most influential testosterone influencers is this lovely person named Marcella Hill.

[Rebecca Jackson]

To go from being dead inside not wanting anyone to touch you to wanting to, to have sex at all, having it in your brain at all, is a massive difference in how you show up to life.

[Susan Dominus]

Who was A member of the Church of Latter Day Saints, and she was still in the church when she started taking really, really high doses of testosterone.

[Rebecca Jackson]

Want to know what a middle aged woman that feels good has in common with a bodybuilder? Testosterone.

[Susan Dominus]

According to her, there are these aesthetic and wellness spas offering pellets and high doses of testosterone all, you know, Utah, which is largely a Mormon community. You know, I pointed out to her, you know, you were taking so much testosterone that you were approaching the levels that people who are transitioning take. And she said, you know, I never really sat and thought about what I even think about that. It was. She'd never really made the connection. And so it is just interesting because people who are taking testosterone in high doses, which is to say at levels that are two or three times higher than women ever naturally have. And that's to say many, many women across the political spectrum are also on, frankly, in a way, you could say a transitioning spectrum or a gender affirming care spectrum. I think that they feel in a way that testosterone is helping them do gender affirming care in making them feel more sexual and therefore more wifely maybe. And maybe a lot of them talk about how it tones their arms and they feel like they look great, you know, but it actually is a hormone that has typically been associated with, you know, with masculinity. So it just to me kicks up all kinds of interesting questions.

[Noel King]

There is a woman you wrote about who I will have a hard time forgetting. She's in her late 40s, she's a business owner, she's a mom, she gets on a high dose of tea and she feels amazing. Her sex drive improves, but then she loses her hair. So she scales back her dose. Her hair still has not come back. And you asked her, would you do it again? And she said yes. What do you make of this?

[Susan Dominus]

I think she feels that when she had that initial burst of energy, it is true that she lost her hair, not all of her hair, she lost about 40% of her hair. But that initial burst of energy gave her the inspiration. Even though she, I think, has four kids and was literally helping her husband run three jobs. She then took on getting a PhD and she is so thrilled that she's on her way to becoming a doctor because she works very, very hard and it's tough for her to get respect from the many men in her field. And she feels like having a PhD will really help her cause she's really proud of herself. And for her, I thought it would have been like the sex that made it because it really completely changed her sex life with her husband. They had had very routine rote sex for years and years. It was not a big part of her life and that really changed on high dose testosterone. But I think she just felt like she could deal with the hair, you know. But nothing would have gotten her enrolled in that PhD and nothing else would have really changed her marriage quite as dramatically as it did.

[Noel King]

Susan Dominus is a staff writer for the New York Times Magazine. Coming up, the young men who are taking testosterone and why Every story you love, every invention that moves you, every idea you wished was yours, all began as nothing. Just a blank page with a blinking.

[Susan Dominus]

Cursor asking a simple question.

[Noel King]

What do you see? Great ideas Start on Mac. Find out more on apple.com Mac this.

[Susan Dominus]

Week on Net Worth and Chill, we're joined by Marina Larude, the powerhouse, founder and CCO of Larude, the luxury footwear brand that's redefining accessible luxury. From conceiving the idea during an RV road trip with her husband to winning the FNAA 2024 Brand of the Year award, Marina's journey from Teen Vogue fashion director to building her own empire is nothing short of inspiring. Marina gets candid about the money mindset shift from executive to entrepr, how she's scaling internationally while maintaining her values, and what it really takes to compete with footwear giants. When you're bootstrapping your way to the top, get ready for an unfiltered conversation about wealth building, taking calculated risks, and turning your corporate expertise into entrepreneurial gold. Listen wherever you get your podcasts or watch on YouTube.com YourRichBFF.

[Noel King]

OpenAI wants to.

[Rebecca Jackson]

Be worth a trillion dollars, Nvidia is.

[Noel King]

Already worth $5 trillion and Google just.

[Susan Dominus]

Made 100 billion DOL in one quarter. What do all those things have in common?

[Noel King]

They all talk about AI a lot.

[Susan Dominus]

And no one, including I suspect them, knows exactly what we're all supposed to do with AI to make it worth all that money.

[Rebecca Jackson]

This week on the Vergecast we talk about which AI products might turn into something.

[Susan Dominus]

Plus smart glasses with screens, Apple shortcuts, all the new stuff in Photoshop and more on the Vertcast. Wherever you get podcasts, if you want your body to perform well, I think.

[Rebecca Jackson]

You should get today explained. My name is Rebecca Jackson. I cover the south for the Economist and I write mostly about politics, a little bit about culture and economics, and I like to think of the states that I cover as like the former Confederacy, from Texas down to Florida all the way up to Virginia.

[Noel King]

All right, so in the first half of the show, we talked about how a lot of women are going on testosterone, and for many of them, it's working. For some of them, there are side effects. You wrote a piece about how men are doing the same thing. Where did the idea come from?

[Rebecca Jackson]

You know, some of the best stories just come from conversations with friends, and this was an example of that. I have a friend who's a med student, and he was doing a urology rotation, and he told me one day that there were all of these young guys coming in asking for testosterone. And I thought that was super interesting and decided to sort of look into it a bit more and found out that Pfizer had actually reported a shortage of testosterone this year because of rising demand. So I started talking to doctors and people in the pharmaceutical industry and found out that this is actually a huge trend.

[Noel King]

How big a trend is it? Do we know how many men are doing this?

[Rebecca Jackson]

So it's really hard to gauge how many people are doing it, because some people are getting at doctor's offices, others are getting it from a gym. Yeah. One of. One of the things that sort of helped me quantify the rise was I went to visit a testosterone clinic. There are now these. All of these. These healthcare clinics popping up that are devoted to testosterone. I went to Game Day Men's Health clinic in the Buckhead neighborhood of Atlanta.

[Susan Dominus]

It takes only 10 minutes to measure your testosterone levels. Then we'll create a plan to optimize your health. Kind of anything you need as you get older as a guy and you look in the mirror and that light switch gets turned off, we help you turn it back on.

[Rebecca Jackson]

And they opened in April of last year, and they were the company's 50th franchise. But in the 14 months since they opened another 325 testosterone clinics, Game Day clinics opened up across the country.

[Noel King]

That is massive. And that's just one clinic. That's just Game Day.

[Susan Dominus]

Yeah.

[Rebecca Jackson]

So Game Day is one of the most popular, but there are tons of these types of clinics. Actually, when I went to Game Day, I walked out, and across the street, there was another testosterone clinic competing with them.

[Noel King]

Huh.

[Rebecca Jackson]

Okay.

[Noel King]

So your friend, who is a medical student, told you the surprise was it was young men who were coming in.

[Rebecca Jackson]

Yeah. So I think one important thing to remember here is that lots of health crazes do stem from real medical problems, and testosterone is no exception. So as men age, their testosterone levels tend to drop. That's natural and normal. But for some People, it can dip into an abnormal range, and that causes problems. It can make you, for example, have low sex drive, low energy, weight gain, have trouble putting on muscle mass. And like many medical problems, this is exacerbated by things like obesity and drug use, which has become more common in America. And so over time, this has become a bigger issue. And doctors have found that they can treat low testosterone and many of the symptoms that come along with it with these injections. But I think the troubling thing here, and the trend that I'm most interested in, is that the people who are taking to testosterone fastest now are not guys in their seventies, but they're actually men in their twenties and thirties.

[Noel King]

Who is telling men in their twenties and thirteties about testosterone? Where are they getting the info from?

[Rebecca Jackson]

Yes, as you can probably imagine, this is not all doctors. The people who are hawking this stuff are podcaster and influencers. So Joe Rogan, who has the biggest audience in America, says that testosterone has made him feel younger.

[Susan Dominus]

It makes your body work way better. You can avoid a host of ailments and conditions that are related to your body breaking down due to age.

[Rebecca Jackson]

And you can look to other celebrities, like Dax Shepard, an actor and podcaster. He told a reporter a couple years ago in an interview that because of testosterone, because he's been on testosterone replacement therapy.

[Susan Dominus]

I spent my whole life as a.

[Noel King]

Medium boy, and now I'm a big boy, and I like it.

[Rebecca Jackson]

So there are all these influencers, especially on TikTok, that are basically telling, like, young gym bros that they'll see more gains at the gym, they can have better sex. They'll have more appeal with women if they get on testosterone, even if their doctor doesn't actually think that they need to.

[Susan Dominus]

First off, fellas, you are a warrior. It's embedded in our DNA. How are you gonna be a warrior if your testosterone levels are low?

[Rebecca Jackson]

CRT is not going to directly affect the growth of your johnson, but it will help you out out in three ways.

[Noel King]

What's the catch here? What are some of the drawbacks for young men or dangers?

[Rebecca Jackson]

Yeah, so if you're not taking it to bulk up, if you actually have a deficiency and you're going through a doctor, then it could be a very good thing. The problem is, as you said, the guys who are taking tons of it and without actually needing it. So people used to think that testosterone was dangerous. People used to think that it could cause prostate cancer or heart attacks. That's proven to not be true. But there are some real issues, especially if you take it at bodybuilding doses. So for one thing, it can cause what's called roid rage, steroid rage, which is basically just guys getting unusually aggressive. And there's also been reporting of other side effects like insomnia, high blood pressure, and hair loss. But more concerningly, if it's not taken with a cocktail of other hormones, preventative ones, it can actually make you infertile. Some of the doctors I spoke to told me that they often have young men coming in who are horrified to find out that after taking the stuff that their friend gave them at the gym for. For a little while, they've seriously hurt their prospects of having children. One doctor in Houston told me that he can restore fertility to about 25% of their baseline, but he can't get a guy back to normal.

[Noel King]

The loss of fertility seems like a very serious problem for young men, especially at a time when we're all concerned about, you know, too few babies being born in the US you mentioned all these clinics, which makes me think there is a lot of money involved in the sale of testosterone right now. Tell me what you found about the business here.

[Rebecca Jackson]

Yeah, so one of the interesting things is that these businesses obviously serve a real purpose. There are men who really need testosterone replacement therapy, and they're benefiting from the fact that they can now just sort of walk to a men's health clinic that specializes in this stuff in their neighborhood. The problem comes partly in the marketing. You know, some of these clinics, I sat in a lot of the waiting rooms. Let me tell you, it's a bit awkward to be a young woman sitting in these waiting rooms trying to not make eye contact with the guys. But, you know, many of these places sort of market themselves as places where a gym bro would feel comfortable. Right? They've got these big black leather sofas, they've got a fridge full of cold drinks and a game on. So they try and basically make it a place that guys can feel comfortable, but also a place that sort of makes you feel like if you're not the alpha male that you want to be, we can help you with that. And they've got all these systems where you can refer a friend to get money off your next treatment. And I think perhaps most alarmingly, some of these clinics will also inject you with your first dose of testosterone within an hour of coming in.

[Noel King]

Huh. Did you have a chance to talk to any of the men in the waiting room even as you were avoiding their. Avoiding their eyes? Did you speak to anyone who said, like, hey, here's why I'm here. Here's what this is about for me.

[Rebecca Jackson]

You know, I gotta say, Noel, I tried, and it was mostly unsuccessful. The conversations were kind of awkward and stilted, and I didn't have much success. I went around, you know, very. This makes.

[Susan Dominus]

Makes.

[Rebecca Jackson]

Makes you win a lot of friends as a reporter. But I went around asking a lot of my guy friends if they were on this stuff. And people were very cagey about it. And I actually got the impression that, you know, probably a lot of people that I know are doing this but didn't want to talk about it.

[Noel King]

All right, so clearly taking testosterone has some pros and some cons. And what we've learned in this show is for the people who experience the pros, it's very hard to give it up.

[Susan Dominus]

Up.

[Noel King]

Even when there are negative side effects, it's very hard to give it up. This reminds me to some degree of Ozempic. It is a treatment that when people are on it and when it's working, they really, really, really love it. And it seems to me that there is a lot of money to be made here. Do you think that we are moving toward a world where there's a testosterone clinic on every corner? And where we're looking, as we saw with, you know, weight loss drugs, we're looking at shortages because so want to be taking t. Where do you think this is going?

[Rebecca Jackson]

I mean, to some extent, Noel, I think we're already there. I'm inundated. You know, I'm a woman and I'm inundated with testosterone ads all the time. These clinics are everywhere in the city that I live in, and there's clearly a ton of money in it. They're doing very well. I think, also like Ozempic, it's an industry that is not going anywhere like Ozempic. You need to continue taking testosterone if you want to see the results. And that means that the cash here is kind of just endless.

[Noel King]

Rebecca Jackson. She covers the south for Leading magazine. The economist Miles Bryan produced today's show. Aminah El Saadi edited Adrienne Lilly engineered with an assist from Patrick Boyd. Laura Bullard checked the facts. I'm Noel King.

[Rebecca Jackson]

It's today explained Sam.