The number of androgen prescriptions in Connecticut — testosterone by far the most common among them — has increased by 63% over the past three years, according to data from the Department of Consumer Protection’s Prescription Monitoring Program.  Androgens are a small group of hormon es that regulate male physiological characteristics. People of both sexes naturally produce testosterone but can elevate levels through testosterone replacement therapy. As a steroid with a moderate potential for dependence, testosterone is classed as a Schedule III substance along with drugs such as ketamine and buprenorphine, also known as Suboxone, which treats opioid use disorder.  Today, androgens are the second-most prescribed Schedule III substance in Connecticut, after opioid partial agonists such as buprenorphine. They saw the largest increase in prescriptions out of all drugs in its schedule class since January 2023, the earliest data available. The increase coincides with a national rise in testosterone prescriptions. Adam Mayerson, an endocrinologist at Yale New Haven Health, said there are three main groups that are prescribed testosterone. Transgender individuals assigned female at birth may seek testosterone for gender-affirming care, and postmenopausal women might take it to increase libido. But, Mayerson said, most prescribed testosterone is going to men who believe the hormone can help them battle afflictions associated with “low T” — decreased sex drive, lack of energy and brain fog. “There’s kind of an epidemic of younger men and middle-aged men seeking this treatment,” he said. The question — to prescribe or not prescribe? — lies in whether “low T” is a cause of men’s symptoms or a symptom of something else. A person’s testosterone levels naturally decline with age, and a variety of other factors such as chronic illness, depression and obesity correspond with lower testosterone.  Guidelines created by the Endocrine Society in 2018 recommend prescribing men with testosterone replacement therapy if their testosterone levels do not reach a certain threshold. Men whose levels fall below the threshold often experience sexual dysfunction, fatigue and loss of muscle mass.  Concerns about “low T” became popularized in the 2000s thanks to advertising campaigns for testosterone products. But since the second Trump administration, testosterone has taken center stage in debates about public health and masculinity. Health and Human Services Secretary Robert F. Kennedy Jr., whose “anti-aging protocol” includes testosterone replacement therapy, has repeatedly expressed concerns over what he dubs America’s “fertility crisis” and has called decreasing testosterone levels “an existential problem.” Mayerson also attributes the increase in prescriptions to increasing numbers of social media influencers promoting testosterone products. A March study of social media posts advertising these products found that such posts “prey on men’s insecurities” and promote the “consumption of testosterone products for improving the masculine self without supporting evidence.” Many influencers do not inform viewers about side effects such as hair loss and erectile dysfunction, or risks such as pulmonary embolism and infertility, the study said. Mayerson estimates that only 20% of patients who have come to him asking about testosterone therapy met the Endocrine Society’s threshold for low testosterone. If following the route of traditional health care, an individual’s primary care physician prescribes them testosterone, which is covered by insurance. But those who have tried and failed to receive a prescription through conventional means, or are too embarrassed to speak about personal issues in a general setting, may seek alternative paths such as online telehealth companies or clinics targeted at men’s or women’s health.  A search for “testosterone clinics in Connecticut” on Google Maps reveals that there are at least 30 pop-up clinics in the state offering testosterone therapy. Eight of them belong to Gameday Men’s Health, a franchise with more than 400 locations in the country focused on “empowering men’s health through hormone optimization, vitality and longevity care,” according to its website. “Most traditional endocrinologists are a little bit tougher in terms of prescribing,” Mayerson said. “[Many men’s health clinics] really look for reasons to prescribe as opposed to reasons not to prescribe.” One recent Facebook post by Gameday Men’s Health West Hartford encourages viewers to “optimize your biology” before directing them to testimonies of “men who refused to settle for standard baselines.”  “Don’t accept fatigue and brain fog as a normal part of getting older,” reads another post, published in June. “By balancing your hormones and optimizing your health, you can actively thrive in your career, your workouts, and your relationships.” A representative at Gameday Men’s Health West Hartford declined to comment on the clinic’s prescription process and Facebook posts. Though Mayerson is wary of the potential for unnecessary prescription and misinformation, he noted that increased attention to testosterone levels has prompted more honest discussions about men’s physical and mental health.  “The phrase ‘low T’ makes it a lot less embarrassing for a man to say, ‘I’m having sexual dysfunction problems,’” he said. “And sometimes it allows men to open up and just talk about other things that are bothering them.” ...read more read less