Manly Meds Part II: Testosterone

In addition to the “annoyances” category of Prednisone side effects, there are a number of potentially harmful complications. One of the more common of these problems is a reduction in bone density. I’ve been getting annual bone density exams since I started on it—so far no problems yet.

Since Prednisone alters the performance of your adrenal gland there can be hormonal implications as well. In fact, it is also related to the bone density issue. Long-term prednisone use can result in low testosterone levels. Low testosterone can show itself in a number of ways, some of which can certainly threaten a man’s sense of manliness, for sure. But the problem that doctors are more concerned about is that testosterone plays a role in bone growth and decay. It’s not clear to me how the cause and effect chain works, but I surmise that they’re all connected.

As part of my effort to keep apprised of how my body is affected by IBD and the medications I take for it, I went to an endocrinologist to look after the possible hormonal changes. The doc ordered a variety of blood tests, some for various hormonal levels, and another to check for diabetes which can be another complication of long-term prednisone therapy.

My blood tests revealed only one abnormality: very low testosterone levels. That came as a surprise since I hadn’t noticed anything awry through the more traditional indicators. But the news certainly made me feel a little strange. How manly could I be with a mere fraction of the normal testosterone range?

It turns out this can be addressed rather simply by taking a testosterone supplement. While this seems straightforward enough, it troubles me because it is clearly crossing a new threshold. Not because of the content of the medicine, but for the concept. Stacking up medicines to treat issues caused by other medicines gives me the creeps. Do we really understand the human body well enough to effectively manage all of these complex interactions? Meanwhile, I still want to be sure I don’t end up with fragile bones prematurely, so I decide to go ahead with the treatment.

The typical solution comes in gel form. You dispense it from a pump bottle and rub it into your shoulders. As for side effects, the doc had said, at most, the testosterone might make me hungrier for activity and exercise. Nothing wrong with that, I guess.

I also asked the pharmacist what I should expect while taking it. He mentioned that I might notice the return of certain “inclinations” that might have been lacking before. I think I caught his meaning, happily avoiding the actual terms. Sex drive might be a topic some people feel comfortable talking about with their doctor, but it’s hardly the sort of conversation I’d want to have at the pharmacy counter. Since I hadn’t really noticed that kind of change with the low testosterone, I was curious how the supplement might affect me physically.

So, I asked another question, quasi-covertly wondering whether I’d be making tent poles all day.

“Oh, naw, nothing like that,” he said. “What I gather is that guys tend to experience… a general sense of well being.”

Well, that sounded harmless enough. Hey, taking this stuff might even be a good thing.

So, I took it home and read the directions before administering my first dose. There are all sorts of warnings against allowing it to come into contact with women and children. While the reasoning seems obvious given its hormonal content, the “for men only” part only adds to the masculine connotation of this medicine. For that and the other reasons, I’ve taken to calling it The Man Gel. Reading further through the instructions I learned the most intriguing part of it all: It’s highly flammable! What could possibly be manlier than combustible medication?

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About the Author

Andrew Tubesing is an acclaimed advocate and humorist on the subject of inflammatory bowel disease.