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What to know about testosterone replacement therapy

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What to know about testosterone replacement therapy

US Secretary of Defense Pete Hegseth speaks during a press briefing at the Pentagon in Washington, DC, on April 8, 2026.

Mandel Ngan | Afp | Getty Images

Testosterone replacement therapy has shifted from the doctor’s office to the center of a massive cultural phenomenon focused on performance, longevity and men’s health. 

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Now, the treatment is back in the spotlight after Defense Secretary Pete Hegseth announced last week that the U.S. military will begin testing service members’ testosterone levels and make replacement therapy available to those who qualify, saying the goal is to help troops operate at their “absolute best.” The effort also builds on a larger push by the Trump administration to promote and expand public access to testosterone replacement therapies, which are made by pharmaceutical companies such as AbbVie, Pfizer and Marius Pharmaceuticals.

The announcement puts a new focus on a treatment that has grown increasingly popular in recent years, fueled by men’s health clinics, telehealth companies and online influencers, who promote testosterone, or “T-maxxing,” as a way to address fatigue, aging and declining performance. Health and Human Services Secretary Robert F. Kennedy Jr. has also touted testosterone therapy as part of his anti-aging regimen.

Prescriptions rose from 7.3 million in 2019 to more than 11 million in 2024, according to healthcare research firm IQVIA. But there has long been a debate around the safety of taking synthetic forms of testosterone, the hormone that affects sex drive, mood and other health factors. 

While some research has shown benefits for patients who qualify, including improvements in bone density and muscle mass, questions remain about the therapy’s long-term risks and its use among men without a clear medical need. 

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The concern is significant: up to a third of men taking testosterone have never been formally diagnosed with testosterone deficiency and may not benefit from treatment, according to the American Urological Association.

Physicians also stress that testosterone therapy is not a universal solution for low energy or normal aging. It is generally intended for men with clinically confirmed testosterone deficiency, and experts say determining who qualifies requires more than a single blood test — which appears to be the military’s plan. Excess testosterone can also carry risks, including reduced sperm production.

“I’m not saying that testosterone is bad. It is good for people that need it,” said Dr. Adrian Sandra Dobs, an endocrinologist at the Johns Hopkins School of Medicine. “But to overreplace it – we have to be very careful about that.”

As testosterone therapy enters a new national conversation, here’s what doctors say we know – and don’t know – about its benefits, risks and who should consider treatment.

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Who is the therapy intended for? 

Testosterone replacement therapy, which is commonly administered through injections, gels, implantable pellets and oral medications, is intended for a more narrow population than social media may suggest.

Physicians say it’s generally reserved for men with clinically diagnosed hypogonadism –  a condition in which the body does not produce enough testosterone.

That generally means persistently low testosterone levels alongside symptoms such as reduced sex drive, fatigue, erectile dysfunction, depressed mood, low bone density, or loss of muscle mass and strength.

Dobs said low testosterone can stem from several causes. While testosterone levels naturally decline with age, that alone does not typically qualify as a deficiency. Certain conditions can also suppress testosterone production, including sleep disorders such as sleep apnea, damage to the testicles, pituitary disorders, some cancer treatments and chronic illnesses. 

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In some men, doctors may diagnose what’s known as functional hypogonadism, in which testosterone levels fall because of potentially reversible factors such as obesity or chronic disease, even though the reproductive organs are structurally intact.

“Obesity, stress, fatigue, and poor sleep are very common and these conditions can reduce testosterone,” said Marcus Goncalves, director of the Holman Division of Endocrinology, Diabetes and Metabolism at NYU Langone Health. “The correct solution is to improve those aspects and let testosterone naturally come back up, but that is easier said than done.”

But diagnosing the condition typically requires more than a single blood test, Goncalves added.

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Because testosterone levels fluctuate throughout the day, medical guidelines generally recommend confirming low levels with two separate morning blood draws and evaluating patients for potential underlying causes before considering therapy, he said.

A low testosterone result also does not always mean someone needs treatment. Testosterone levels can temporarily decline during periods of severe stress, illness, weight loss, or intense physical exertion and may return to normal once those factors resolve, said Dr. Richard Auchus, professor of internal medicine at the University of Michigan.

“It’s not that easy to tell whether someone is sufficient in testosterone and whether that is kind of a functional and reversible situation, or if that is an irreversible permanent problem,” Auchus said.

What are potential benefits and risks? 

The benefits of testosterone replacement therapy can be real for the right patients. 

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“I would say that we try to limit the treatments to people we know are going to benefit,” said Auchus.

For men with clinically confirmed testosterone deficiency, treatment can increase sex drive, improve erectile dysfunction, help restore muscle mass and bone density, and boost energy levels and mood. It can also improve bone mineral density, reducing the risk of osteoporosis and fractures in men with low hormone levels. 

But experts say it is less clear whether raising testosterone in people who already have normal or only mildly low levels provides meaningful benefits for energy, cognition, athletic performance or overall health. Evidence supporting testosterone as a broad anti-aging or performance-enhancing treatment remains limited, they added. 

“It doesn’t make you any smarter. It won’t make you a better pilot,” Dobs said. 

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Even for appropriate patients, physicians say testosterone therapy carries risks and requires ongoing monitoring.

One concern is that the treatment can increase red blood cell counts, potentially thickening the blood and raising the risk of complications such as blood clots, NYU Langone’s Goncalves said. 

While earlier studies raised concerns that testosterone therapy might increase cardiovascular risk, more recent evidence has been reassuring. A major 2023 trial – the largest and most comprehensive to date – found no higher rate of heart attack, stroke or cardiovascular death among men receiving testosterone therapy than among those given a placebo. 

Researchers did observe higher rates of certain conditions, including atrial fibrillation, acute kidney injury and pulmonary embolism, underscoring the need for careful patient selection and monitoring.

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The treatment can also suppress the body’s natural production of the hormone, reducing sperm production and potentially affecting fertility, he added. Physicians generally discourage testosterone therapy in men who may want to have children. 

Other potential side effects include acne, breast tenderness or enlargement, fluid retention and worsening symptoms of untreated sleep apnea.

How might this apply to the military? 

The military’s plan to test service members’ testosterone levels raises a key question: How should doctors interpret hormone levels in people undergoing extreme physical and psychological stress?

Goncalves said that intense military training, sleep deprivation and prolonged physical exertion can temporarily suppress testosterone production. In one study of U.S. Marines undergoing Survival, Evasion, Resistance and Escape, or SERE, training, testosterone levels fell by roughly half during the exercise before recovering afterward.

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“There is no evidence that restoring [testosterone] levels during that period improves performance,” he said, though he added that the question would be worth studying.

That also highlights a challenge for any large-scale testing program, some experts said. A low testosterone reading may not reflect a permanent deficiency requiring treatment, but rather a temporary response to demanding conditions.

Auchus also cautioned that testosterone therapy can create long-term issues for otherwise healthy service members. Because treatment suppresses the body’s natural testosterone production, men who remain on therapy for extended periods may become dependent on it to maintain normal hormone levels, he said. 

Auchus said that raises questions about what could happen if a service member receiving testosterone were suddenly unable to access treatment during a deployment or other military operation.

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More broadly, experts say testosterone replacement therapy should not be viewed as a shortcut to improved military performance.

“Testosterone is not going to make men more macho or better fighters,” Dobs said. “You need brains to win a war.”

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General Mills launches ‘blasted’ pizza rolls

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General Mills launches ‘blasted’ pizza rolls

The new line features Totino’s Pizza Rolls coated in seasonings for additional flavors.

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Embraer and Saab sign deal for 20 more Gripen jets in Brazil

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Wall Street is selling more rental homes, as buying ban takes effect

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Wall Street is selling more rental homes, as buying ban takes effect

A version of this article first appeared in the CNBC Property Play newsletter with Diana Olick. Property Play covers new and evolving opportunities for the real estate investor, from individuals to venture capitalists, private equity funds, family offices, institutional investors and large public companies. Sign up to receive future editions, straight to your inbox.

Newly enacted housing legislation that bans institutional investors from purchasing single-family rental homes has those same investors putting up more “for sale” signs.

The number of homes owned by institutional investors listed for sale is, as of this month, more than double what it was at the start of February, according to an analysis provided exclusively to Property Play by Parcl Labs, a real estate data provider.

Listings have gone from 4,166 on Feb. 1, when Parcl launched its full research, to now 9,447 homes representing $3.1 billion in total asking price.

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“The rate of for-sale change is something to keep an eye on,” said Jason Lewris, co-founder of Parcl Labs. “These numbers won’t materialize into actual dispositions for months given how long the sales cycle can be, but it’s the fastest read into institutional behavior.”

The legislation defined institutional investors as those owning 350 or more homes. That was a surprise to the industry, which traditionally set that bar at 1,000 homes. It does not force them to sell the homes they currently own, but they are barred from buying any more homes unless they fall under certain exceptions, including build-to-rent.

The charge by lawmakers was that these investors, most of whom were able to buy the homes with all cash, were inflating prices and sidelining regular owner-occupant buyers. The call for a ban was bipartisan.

Large-scale investors first entered the market during the financial crisis in 2008, when foreclosures were rampant and bulk auctions were popping up in the hardest-hit markets, like Atlanta, Las Vegas and Phoenix. Private equity firms purchased thousands of homes in a short period, converting them to rentals and creating a new single-family rental asset class.

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The cohort of investors with 350 or more homes that therefore fall under the new legislation now own roughly 589,000 homes, or 3.9% of the 14 million single-family rental homes in the U.S., according to Parcl. They account for roughly 40% of the net selling year to date.

The largest landlords — Progress Residential, Invitation Homes, AMH, Tricon, FirstKey, Amherst and VineBrook — are all net sellers year to date, with 3,180 more homes sold than bought since Jan. 1. To put that in perspective, they still own about 400,000 homes, so it’s not exactly a liquidation sale, with one exception. VineBrook currently has nearly 10% of its portfolio on the market, roughly 1,900 homes with a total asking price of $285 million.

Invitation homes and AMH, the two publicly traded, single-family rental REITs, have 549 and 536 homes for sale, respectively. The largest landlord, Progress Residential, has the least of the larger players, just 143 for sale.

“There is broad recognition now both by the White House and lawmakers, in an overwhelming majority, that private capital has a very big role to play for a component of the American population that wants to rent a home,” said Stephen Scherr, co-president of Pretium, in an interview last week on CNBC’s “Squawk on the Street.” Pretium is the parent company of Progress Residential. 

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Progress is now focusing on the areas that the new legislation allows and which the industry fought hard for during the legislative process.

“We can buy build-to-rent, which is a predominant component of new housing. We can buy under various other exceptions including rent-to-renovate, where we improve the housing stock or we buy under a homeownership boost, where we give people an opportunity to transition where they want from renters to owners,” Sherr said.

The build-to-rent play has been gaining significant steam over the past few years as demand for single-family rental housing grows.

AMH started early, in 2017, building its own homes. It has so far developed more than 14,000 homes for rent in 180 communities, according to the company. Invitation Homes purchased an Atlanta-based homebuilder, ResiBuilt, at the beginning of this year. 

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“The financing case has materially changed with the forced disposition mandate removed. Lenders can underwrite [build-to-rent] again, and we’re starting to see this happen,” Chris Nebenzahl, vice president of rental research at John Burns Research and Consulting, wrote in a report. 

The investors who are selling are offering discounts on the properties. Nationally, 38.7% of all listings for sale today have had price cuts compared with 54% within the institutional, single-family rental cohort, according to Parcl Labs. Since early May, markdowns have deepened from about 3.1% to 4% of asking value. Meanwhile, 54% of the investor listings for those in the more than 350 homes category carry a price cut.

“From what we can tell, given where U.S. home prices are, some of this is attributed to shifts in strategy — collect high dollar values off of top U.S. home values by culling underperforming assets and redirect that capital towards growth areas, i.e. build-to-rent, for example,” Lewris said in a statement, adding that the next six to eight weeks will be telling.

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Peter Kyle sacked as Business Secretary in Burnham reshuffle

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Peter Kyle sacked as Business Secretary in Burnham reshuffle

Peter Kyle has been sacked as business secretary on Andy Burnham’s first day in Downing Street, leaving the government’s flagship late payment crackdown without the minister who built it while the bill is still midway through parliament.

Kyle became the third cabinet minister dismissed on Monday afternoon as the new Prime Minister assembled his own top team, following housing secretary Steve Reed and deputy prime minister David Lammy out of the door. Rachel Reeves was also sacked as chancellor, as Burnham moved swiftly against ministers most closely associated with Sir Keir Starmer.

No successor has been confirmed. The Financial Times has reported that Jonathan Reynolds could return to the brief, the role he handed to Kyle only last September.

For business owners, though, the more pressing question is not who next sits behind the desk at the Department for Business and Trade, but what happens to the agenda Kyle leaves behind.

Chief among it is the Small Business Protections (Late Payments) Bill, laid before parliament in May. The legislation caps payment terms at 60 days for large firms paying smaller suppliers, imposes mandatory interest of 8 per cent above the Bank of England base rate on overdue invoices, and hands the Small Business Commissioner powers to investigate and fine serial offenders. Government figures suggest poor payment practices drain roughly £11 billion a year from the economy and contribute to the closure of an estimated 38 small businesses every day.

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Kyle had made the bill personal. He told Business Matters in May that he would not “resile from delivering” what he called a “step change in the relationship between all larger businesses and their supply chains”, adding: “Sixty days is a solid, reasonable outer limit for paying a small business.”

With the CBI and the British Retail Consortium already pressing concerns ahead of committee stage, the departure of the bill’s most vocal defender hands corporate lobbyists an opening at an awkward moment for small firms. Whoever inherits the brief faces an immediate test of nerve: hold Kyle’s line, or let the toughest payment rules in the G7 soften on the way to the statute book.

The churn itself will grate. Kyle’s successor will be the third business secretary since Labour took office two years ago, an unhappy echo of the revolving door at the business department that firms endured under successive Conservative administrations. Kyle used his ten months in post to promise an active, interventionist department, setting a target of nurturing Britain’s first $1trn company and pledging to make the UK the best place to start and scale a business.

His exit also lands amid a wider reorganisation of the Whitehall machinery that matters to growing firms. Officials have been asked to draw up plans to close the science and technology department, with its responsibilities split between the business department and the culture department, a proposal that has already provoked a revolt from tech leaders. The next business secretary could therefore take on a substantially bigger empire, and a year of restructuring to go with it.

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Burnham, for his part, has promised to “bring forward the biggest changes in the last 40 years”, with a return to public ownership, a 10-year plan for the country and cost-of-living measures expected as early as Tuesday.

For SMEs, three things now bear watching: who gets the business brief, whether the late payments bill survives committee stage intact, and where the science department’s funding streams end up. On all three, owners will hope the new Prime Minister moves faster than the reshuffle rumour mill.


Jamie Young

Jamie Young

Jamie Young is Senior Reporter at Business Matters, covering SME finance, employment law and Westminster policy since 2016. He has reported on every Budget and Autumn Statement since 2018, helped make sense of the ‘covid era’ and the bounce-back loan scheme from launch through the fraud investigations, and broke the magazine’s coverage of the 2024 late-payment reforms. He joined Business Matters straight from completing his BA in Administration from Exeter University and is NCTJ-qualified. Reach him at jyoung@cbmeg.co.uk

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Poland stocks higher at close of trade; WIG30 up 1.62%

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Opinion: Turning trust into opportunity

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OPINION: Australia is already engaged in a borderless conflict and Canberra’s defences are struggling to keep pace.

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Viper Energy: A Good, But Not Great Option

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The Better Trade In Permian Water: Pairing WaterBridge With LandBridge (NYSE:WBI)

Viper Energy: A Good, But Not Great Option

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GM announces new gas-powered Cadillac vehicles amid EV pullback

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GM announces new gas-powered Cadillac vehicles amid EV pullback

2025 Cadillac Escalade V-Series SUV

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DETROIT — General Motors will launch new gas-powered Cadillac vehicles beginning next spring as the automaker continues to shift gears away from all-electric vehicles.

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GM CEO Mary Barra said Tuesday that the next-generation Cadillacs will include new versions of the company’s CT5 sedan, outdated XT5 midsize SUV and discontinued three-row XT6 SUV.

“Starting next spring and continuing into 2028, we will begin launching the next generation of Cadillac ICE [internal combustion engine] vehicles,” Barra said during the company’s second-quarter earnings call. She said the vehicles will be in addition to Cadillac’s current all-electric crossovers and Escalade SUV.

The new product announcements add to GM’s pullback in EVs. The automaker had planned for Cadillac to exclusively sell electric vehicles by the end of this decade. The company also has walked back EV plans for other brands and increased gas-powered engine production, including V-8 offerings.

GM has recorded $10.9 billion in EV-related charges since the second half of last year after slower-than-expected electric vehicle adoption as well as U.S. regulatory changes easing emissions standards and eliminating support for EVs.

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Barra reiterated that GM’s plans include “onshoring significant manufacturing” for the Detroit automaker beginning next year, in part by expanding production of its full-size SUVs to a Michigan plant that was previously slated to build EVs.

The full-size SUVs — Escalade, Chevy Tahoe and Suburban, and GMC Yukon and Yukon XL — are currently exclusively produced at the company’s Arlington Assembly plant in Texas.

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Why Your Team Is Your Most Underused Marketing Channel on LinkedIn

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Why Your Team Is Your Most Underused Marketing Channel on LinkedIn

A mid-sized company can spend months perfecting a LinkedIn page that a few hundred people follow, while the audience it actually wants sits quietly in the contact lists of its own staff.

Every employee who logs in brings a network of clients, suppliers, former colleagues and peers. Added together, that reach usually dwarfs anything the corporate account can manage on its own. For smaller businesses without a large media budget, this is one of the few channels where size is not the deciding factor.

The reach already sits inside your business

The instinct of most owners is to push everything through the brand account, then wonder why engagement stays flat. People follow people. A post from a recognisable colleague lands in a feed with a face and a name attached, and it carries a credibility no logo can buy. This is the thinking behind a deliberate employee advocacy strategy: instead of asking the marketing team to shout louder, you give the wider workforce a simple, low-effort way to share what the company is doing in their own words.

The barrier has never really been willingness. Most staff are happy to support the business they work for. The barrier is friction. People do not know what to post, worry about getting the tone wrong, or simply forget. Remove those obstacles and participation climbs quickly.

Turning goodwill into a repeatable habit

The firms that get this right treat sharing as a light routine rather than a campaign: a short prompt, a draft they can edit, a nudge at the right moment. Newer thought leadership software now handles much of that groundwork, suggesting angles based on someone’s role and letting them rewrite a post so it still sounds like them rather than a press release. The technology matters less than the principle: keep it personal, keep it easy, and let consistency do the heavy lifting.

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Measurement helps too, though it is easy to overcomplicate. Track how many people are active, which themes earn replies, and whether any of it turns into conversations with prospects. As recent coverage in the magazine’s business news pages has shown, buyers increasingly research suppliers through the individuals behind them long before they ever fill in a contact form.

There is a cultural payoff as well. When employees post about their work, they tend to feel more connected to it. Recruitment gets easier because candidates can see real people enjoying real projects. The company page becomes a supporting act rather than the entire show, which is exactly where it belongs for most growing businesses.

None of this requires a rebrand or a six-figure agency retainer. It asks for a clear reason to take part, a bit of structure, and the patience to let a handful of regular contributors set the tone. The businesses that build that habit now will own a presence on LinkedIn that competitors with deeper pockets find surprisingly hard to copy, because it rests on something they cannot simply buy: the trust their own people have already earned.

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AMD: Get Out While You Still Can

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AMD: Get Out While You Still Can

AMD: Get Out While You Still Can

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