Are you man enough?

October 28, 2013

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Jonathan Sackier
Jonathan Sackier

  • Surgeon, Clinical Professor 
  • 30 years of healthcare experience 
  • Author of the “Fly Well” column in AOPA PILOT 
  • Flying since 15 years old, owns a Columbia 400 

In England where I grew up, there was an advertising campaign for a brand of petroleum whose mascot was a jungle cat. The slogan to encourage you to get revved up with its fuel was, "Have you got a tiger in your tank?" If the ads bombarding men are anything to go by, that is exactly the question they are asking. The tiger I am referring to is testosterone, which some abbreviate to just plain "T." Only they don't ask you if you want milk and sugar with that.

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Our bodies have complex check-and-balance systems where hormones, chemical messengers, are released to effect certain changes. When hormone levels drop, a stimulus causes more to be released, and conversely other messages might reduce the amount of a given hormone. Testosterone is just one of these hormones and although identified as being the "male" hormone, it is also found in women just as estrogens are found in men. 

The characteristics we view as masculine—energy, muscle development, body hair, libido—are certainly impacted as we age and testosterone levels drop, but to blindly fill up on supplements is potentially not beneficial and may even be harmful. Other things can impede how manly we are: poor diet, lack of exercise, and stress, for instance. In fact, sexual performance issues are most likely due to emotional overlays rather than limited testosterone levels. Although it is very straightforward to visit a doctor, have testosterone levels measured, and embark on replacement therapy, if easily addressable items like the food you eat, the workout you do not do, and the work pressures piling up are not dealt with, the drug may not help. 

Also bear in mind that adding testosterone has some potentially negative effects. It can lead to reduced sperm levels, thereby impacting fertility; once started it may need to be continued as the natural feedback loop will be "overpowered," and finally may increase the likelihood of developing or aggravating prostate cancer. Although there are no hard data on this latter topic, most doctors feel uneasy adding what the body might view as the perfect fertilizer for this particular weed; certainly one should not take testosterone supplements if prostate cancer has already reared its ugly head or if you have a strong family history. 

The facts suggest that there are definitely some men who will benefit from testosterone supplements and by all means, they should be properly treated. There are also plenty of men who do not need it and are consuming millions of dollars’ worth of unnecessary medications, possibly with hidden dangers. 

So be a real man: Get the facts, talk to your doctor, and keep tigers where they belong—in the wild. 

Dr. Jonathan Sackier is a surgeon, aircraft owner, and AOPA Pilot Protection Services expert.

Jonathan Sackier