Are You Man Enough?

Whatever else you may think about testosterone, you can tell it's a hot topic. Every time you mention that you happen to be writing about it, the first thing people ask is "Can you get me some?" (Everybody, even the women.) Maybe that's not so surprising. If there is such a thing as a bodily substance more fabled than blood, it's testosterone, the hormone that we understand and misunderstand as the essence of manhood. Testosterone has been offered as the symbolic (and sometimes literal) explanation for all the glories and infamies of men, for why they start street fights and civil wars, for why they channel surf, explore, prevail, sleep around, drive too fast, plunder, bellow, joust, plot corporate takeovers and paint their bare torsos blue during the Final Four. Hey, what's not to like?

Until now, it was easy to talk about testosterone but hard to do much about it. About 4 million men in the U.S. whose bodies don't produce enough take a doctor-prescribed synthetic version, mostly by self-injection, every one to three weeks. But the shots cannot begin to mimic the body's own minute-by-minute micromanagement of testosterone levels. So they can produce a roller coaster of emotional and physical effects, from a burst of energy, snappishness and libido in the first days to fatigue and depression later. The main alternative, a testosterone patch, works best when applied daily to the scrotum, an inconvenient spot, to put it mildly. Some doctors recommend that you warm that little spot with a blow dryer, which may or may not be fun.

All of that will change this summer when an easy to apply testosterone ointment, AndroGel, becomes generally available for the first time by prescription. The company that developed it, Illinois-based Unimed Pharmaceuticals, promises that because AndroGel is administered once or more a day, it will produce a more even plateau of testosterone, avoiding the ups and downs of the shots. Though the body's own production of this hormone trails off gradually in men after the age of 30 or so, not many men now seek testosterone-replacement therapy (not that they necessarily need to) or even get their T levels tested. But replace the needles and patches with a gel, something you just rub into the skin like coconut oil during spring break at Daytona Beach, and suddenly the whole idea seems plausible.

Testosterone, after all, can boost muscle mass and sexual drive. (It can also cause liver damage and accelerate prostate cancer, but more on that later.) That makes it central to two of this culture's rising preoccupations: perfecting the male body and sustaining the male libido, even when the rest of the male has gone into retirement. So will testosterone become the next estrogen, a hormone that causes men to bang down their doctor's doors, demanding to be turned into Mr. T? Do not underestimate the appeal of any substance promising to restore the voluptuous powers of youth to the scuffed and dented flesh of middle age. If you happen to be a man, the very idea is bound to appeal to your inner hood ornament, to that image of yourself as all wind-sheared edges and sunlit chrome. And besides, there's the name: testosterone! Who can say no to something that sounds like an Italian dessert named after a Greek god?