For most men, it starts quietly. They’re active for decades—the type to hit the gym a few days a week, run on weekends—and keep their nutrition in check. Then, almost overnight, the wheels start to fall off. Weight creeps on, energy dissipates, and curious aches settle into muscles and joints. Morning workouts get skipped, recovery feels fleeting, and irritability replaces vigor. Low libido and erectile dysfunction become the scarlet A they’re desperate to keep under wraps.
In years past, the physical decline was almost as crushing as the silence they carried. Talking about feeling weaker or less interested in sex carried a stigma, especially when the culprit might be low testosterone. Instead of opening up, many men ignored the signs that something deeper might be off.
Today, “hopping on” something or talking about “low T” is more commonplace, and the wellness industry is eating it up. The top digital providers don’t present testosterone as strictly a medical treatment; they package it like a lifestyle enhancement, priced monthly and tracked like macros.
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The Testosterone Boom
Celebrities have jumped on the bandwagon, too. Actor Josh Duhamel, who’s admitted to being on testosterone replacement therapy (TRT) for several years, just recently co-founded Gatlan Health, a wellness brand aimed at helping men regain energy and confidence through what it markets as “holistic support.”
It might seem all about vanity (it’s Hollywood, after all). But he says the primary driver was reclaiming his energy and drive to fully participate in work and be present with family.
“Overall, I feel like I have more energy, more oomph, more desire in all facets of my life to just get out and do things,” he says. “I’ve got young kids. I want to run around and play with them, so that’s also a huge motivating factor for me.”
His experience illustrates the appeal on an individual level, but it also reflects a larger trend. Actor and podcaster Dax Shepard has talked openly about his testosterone use on his show, Armchair Expert, while neuroscientist Andrew Huberman, Ph.D., and Peter Attia, MD, are often heard highlighting the benefits, normalizing testosterone as a performance tool rather than strictly a medical treatment. It’s not just about restoring your levels or following a prescription plan, it’s being framed as living up to your potential.
The fact that more men have access to treatments that help them feel stronger and more engaged as they age is, in many ways, a step forward. But some experts are starting to question the culture forming around TRT—how it’s moving beyond medicine and into the realm of lifestyle marketing. The question isn’t just whether testosterone therapy works, but whether it’s quietly shifting from a treatment for medical need to a tool designed to sell the idea of an upgraded self.
“As traditional avenues to demonstrate manhood have eroded—like secure jobs for working-class men that disappeared with the fall of unions or the rise of globalization—most men walk around with some degree of anxiety,” says Joseph Vandello, Ph.D., social psychologist and professor at the University of South Florida. “Men have to continually prove and reprove their manhood.”
That anxiety isn’t just economic or emotional, it’s physical, with more and more men chasing “optimized” physiques out of fear of losing relevance or attractiveness. Body dysmorphia among men isn’t relegated to bodybuilders, it rears its head across every age bracket and echelon of society, and many see TRT as the fountain of youth.
But it isn’t all psychological. Men are seeking real solutions to common symptoms, including low libido, fatigue, increased body fat, and depression, and they’re doing so in a way that’s proactive rather than reactive.
Christopher Griffith
The New Face of Treatment
“Traditional endocrinology practices have often focused on treatment only once symptoms have become severe,” says Peter J. Stahl, M.D., SVP of Men’s Sexual Health and Urology at Hims & Hers, and former director of Male Reproductive and Sexual Medicine at New York-Presbyterian Hospital. “Platforms like Hims are changing that by helping men take charge of their health earlier, offering access to testing and treatment before issues escalate.”
The growing interest in testosterone, fueled by wellness culture, media, and lifestyle marketing, has coincided with a sharp rise in prescriptions. Numbers have jumped from 7.3 million in 2019 to 11 million in 2024, as more men seek to look, feel, and perform better. Once reserved for those facing serious symptoms or rapid aging, testosterone therapy is now easier than ever to access thanks to telehealth platforms that bring care directly to consumers.
The process is far from the underground needle-in-the-gym stereotype it once carried. These days, starting TRT can be as easy as a few clicks and a video consultation.
According to Stahl, the first step is confirming whether a man truly has low testosterone, which involves more than a checklist of symptoms. Morning testosterone levels are measured, and a comprehensive clinical assessment looks at fatigue, low libido, decreased muscle mass, erectile dysfunction, or brain fog.
Next, providers determine whether further evaluation is needed. “For example, very low testosterone levels can indicate an underlying issue that might require additional hormone tests or even imaging studies to rule out deeper medical causes.”
Safety screenings also assess medical history for conditions like prostate cancer or blood clots, and consider fertility goals to ensure the treatment plan fits the patient’s needs.
Still, not every man experiencing these issues actually needs testosterone. Often, the root causes lie in lifestyle factors rather than hormone deficiency (sleep, diet, and exercise habits, for example).
“People are seeking treatment without testosterone deficiency to ‘optimize their testosterone levels,’” says Jordan Feigenbaum, M.D., M.S., founder of Barbell Medicine, a holistic healthcare company that combines medical care with strength training and lifestyle strategies to help people improve their health and performance. “If you really want to optimize your testosterone, it’s mostly through lifestyle—addressing underlying conditions like sleep apnea, obesity, and so on.”
Feigenbaum has seen firsthand the problems that can arise when men jump on TRT without a clear medical need. In-person discussions with specialists and across discussions on Barbell Medicine’s online forum, some men are realizing their symptoms weren’t actually linked to testosterone in the first place.
A quick look at the forum reveals men started TRT hoping to boost confidence, libido, or muscle mass, only to find that it wasn’t their underlying issue. One user reported seeing “no benefits since starting TRT” aside from a rise in testosterone numbers. Others in Feigenbaum’s practice echoed similar experiences—numbers went up, but symptoms didn’t improve. These stories highlight a key point: TRT’s potential is appealing, but the reality is more nuanced.
Moreover, men need to understand that this is usually a lifelong commitment with some exceptions. For example, obesity-related low T is reversible. Stopping TRT can also bring fatigue, low libido, mood swings, and low energy for months, but these effects are usually temporary. Permanent testicular issues are rare and mostly linked to high-dose steroid use.
For those who wish to stop TRT, gradually tapering off the therapy and using medications, such as enclomiphene or hCG, can help accelerate recovery and reduce symptoms.
Ian Talmacs/Unsplash
The Bigger Question
The surge in testosterone use raises questions beyond the clinical, though. In a culture where physical performance, energy, and sexual vitality are often seen as badges of masculinity, the popularity of TRT reflects more than just a medical demand. It seems to intersect with a broader wellness culture obsessed with optimization, where measurable progress and lifestyle metrics shape the way men view themselves. At the same time, the line between treatment and enhancement is increasingly blurred.
For men with clear medical indications, testosterone therapy can be life-changing. But as more men without clinical need explore it, society faces a subtle shift. What was once a treatment is increasingly framed as a lifestyle choice. Men navigating aging, biological realities, and cultural expectations must now weigh health decisions alongside social pressures, asking not just whether they need testosterone, but whether they want it, and why.
Ultimately, TRT’s rise isn’t just a medical story; it’s a cultural one. It challenges how men perceive aging, health, and masculinity, and invites a conversation about the social implications of making hormone therapy a routine part of wellness.
Related: Inside the Booming World of Wellness Clubs, Where Men Unplug, Reset, and Build Community
