Some bodybuilders, athletes and men simply seeking improved libidos have long used testosterone to boost their performance, but the new gel raises the possibility of greater misuse of the steroid.
Teenagers and young adult athletes with perfectly acceptable testosterone levels are among those most likely to seek the hormone's power-enhancing qualities and are among those most at risk.
Even temporary use of testosterone in boys and men without low levels of testosterone can cause psychological side effects, including mood swings, severe aggressiveness and impaired judgment, experts say. Testosterone use can impair fertility and, among teenagers, can stunt bone growth.
"I am always concerned when you talk about sex hormones, whether it's for women or men, that people will only fixate on the sensational benefit," says Robert E. Dudley, chief executive of Unimed Pharmaceuticals in Deerfield, Ill., the manufacturer of the new testosterone gel, AndroGel. "They may think, 'I'm going to look great and have a ravishing sexual appetite' and forget that these are powerful hormones. . . . I would hate to see an adolescent get hold of the product."
Testosterone is an anabolic steroid, a class of drugs that are illegal to distribute for nontherapeutic purposes in the United States. Steroids are also banned by the International Olympic Committee and most other sports organizations but are still thought to be widely used. Testosterone is one of about 20 popular anabolic steroids used for athletic purposes.
The National Institute on Drug Abuse estimates that more than 1 million adults have abused anabolic steroids. The most recent government study of teen drug use showed an alarming increase in anabolic-steroid use among middle-school youths from 1998 to 1999, with an estimated 2.7% of eighth-graders saying they used the drugs.
Parents should be warned that testosterone gel might become available over the Internet. Internet prescribing of prescription drugs is considered a dangerous practice and would be especially risky in this case, experts say.
"This is a serious medicine. It's not an elixir," says Dr. Ronald S. Swerdloff, a leading researcher of the hormone at Harbor-UCLA Medical Center. "It should not be administered to people without proper assessment of the medical need."