Testosterone Not the Whole Story in Male Menopause (cont.)

Testosterone supplements have potential side effects, including acne and prostate enlargement. But maybe the biggest worry is that the long-range health effects are unknown.

"If a man asks me if this will raise his risk of heart disease 10 years from now, all I can say is, 'I don't know,'" Amory said. "We're flying a bit blind on this."

He and Finkelstein both pointed to the story of hormone replacement in women as a cautionary tale. Doctors once widely prescribed estrogen and progesterone to women as a way to ward off heart disease -- until a large U.S. trial found that older women given the hormones actually faced increased risks of blood clots, heart attack, stroke and breast cancer.

"We haven't had an analogous study in men yet," Amory said.

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SOURCES: Joel Finkelstein, M.D., associate director, Bone Density Center, Massachusetts General Hospital, Boston; John Amory, M.D., M.P.H., professor, medicine, University of Washington, Seattle; Sept. 12, 2013, New England Journal of Medicine