Rx vs. XXX

Porn or prescriptions? It hardly sounds likes a typical fork in the road. But it's the choice that middle-aged American males apparently may face if they suffer from symptoms of low testosterone—as around five million men do, a figure that seems to be growing along with male girths, diabetes and the aging boomer generation. (Story continued below...)

At issue are competing claims about the testosterone-hiking benefits of medication versus manual labor of the most private kind. The case for pornography derives from research showing that adult fare can help restore a sapped male mojo. Monkeys that see sexually active females register as much as a 400 percent jump in testosterone (nature's own performance-enhancing drug) promoting lean muscle and quick recovery times, according to the Yerkes Center for Primate Research at Emory University. In humans, German researchers have found that just having an erection is enough to spur testosterone levels. it makes no difference whether a man is watching sex on a screen or having it in real life, his testosterone levels will go up. Just having an erection, in fact, is enough to spur production.

Such findings, along with work that shows family life to be a drain on testosterone levels, prompted Rutgers University sex researcher Helen Fisher to advise this month that males in the "captivity situation"-her term for married with kids-"go on the Internet and look at porn" as a kind of hormone-replacement therapy. "[Porn] drives up dopamine levels, which drives up your testosterone," she tells NEWSWEEK, while kissing your wife or hugging your kids drives it down.

Competing with your Playboy subscription, however, are prescription drugs-including the futuristic sounding AndroGel, a testosterone foam that hormone-challenged men have been rubbing on their bodies for almost a decade. More than 10 million prescriptions have been filled in that time, and now the maker, Solvay Pharmaceuticals, is trying to raise its legal steroid to a Viagra-level of visibility, making "Low T" as recognizable a phrase as "E.D."

In a series of new commercials released this month, and slated to blanket more than a dozen cable channels and guy-friendly print media over the next six weeks, the company goes after male anxiety about the four horsemen of aging: less energy, a fatter gut, a fouler mood and sexual incompetence. Ads show a paunchy everyman haunted by the shadow of his former self-a golf-ball-driving, all-night-dancing lothario. "Don't blame it on aging," the announcer chides, even though in many cases these "symptoms" overlap with perfectly normal signs that a guy is reeling in the years. Instead, we're told that the slouch toward old age may be a "treatable condition" called "low T'"-a benign but somehow insidious-sounding malady. That "T" in place of testosterone is no accident. In the male name game, "T "generally stands for tough: Ice-T, T-Rex, T-Bone, Mr T. With the exception of "high tea," in fact, the more T in a man's life the better.

So what's a guy to do? Perhaps nothing. Testosterone loss is a natural part of aging. Most men lose about 1 percent of their supply annually starting at age 30, more if they are obese, diabetic, a binge drinker, a vegetarian, a yo-yo dieter or have a pituitary-gland disorder. The line between normal and low testosterone is also highly contested, with members of the Endocrine Society's expert panel disagreeing over the level at which doctors should prescribe hormone replacement therapies.

The result is a potentially huge drug market-especially if AndroGel can encourage men to believe that "lost height," "falling asleep after dinner" and a "deterioration of your ability to play sports" are symptoms that can be fixed the same way Viagra fixes erectile dysfunction. Men have never relinquished their youth lightly, so the sales job shouldn't be too difficult. As many as 13 million men may have low testosterone levels, but have not sought treatment.

It's unlikely that the porn industry will begin a marketing campaign touting the hormone-replacement benefits of their products, though there is some chance that doctors could start recommending regular porn to their testosterone-challenged patients. The more socially acceptable—and typically American—solution is medication. After all, there are dozens of studies supporting the idea that regular exercise can be just as good a mood elevator as antidepressants, but prescriptions are still booming. (Solvay did not have any comment on how AndroGel compares to natural testosterone-boosting remedies, including masturbation.)
But why not prescribe porn (or sex) to solve the "Low T" pandemic? Porn is cheap, readily available and has the added benefit of helping you reach cloud nine. But your wife probably won't appreciate it (a third of women consider porn to be cheating), you can't do it at work (at least 40 percent of employees busted for misusing the Web are looking at porn) and it could be habit-forming (more than one in 10 users develop an addiction). All that's according to therapist Wendy Maltz, co-author of "The Porn Trap." "Yes it's effective, yes it's powerful, yes it can produce a host of feel-good chemicals but the costs are extraordinary," she says, rattling off a list that includes rampant self-loathing, alienation from one's partner and a penchant for dangerously rough sex. The solution, she says, is to regulate porn like cigarettes by slapping a "Hazard" label on the kinky stuff. "I often feel like doctors must have in the 1950s," she says, "seeing firsthand the devastating consequences of cigarette smoking, while living in a society that continues to glamorize use, ignore research, overlook consequences and resist regulation."

Solvay could have a battle on its hands if it ever comes down to Rx versus XXX. Thanks to the Internet, porn isn't just easily available, it's ubiquitous. Forty million people, most of whom are men and a large chunk of them married, visit a porn site each month. A quarter of all Internet search engine requests and 35 percent of all downloads are for porn. Every 39 minutes a new skin flick is being created in the United States.

As popular as porn is and probably always will be, it doesn't have the allure of youth in a bottle. And make no mistake, that's what the testosterone manufacturers are selling. The FDA-approved Web site for AndroGel reads like the solution to every possible age-related anxiety a weekend warrior might have: "improvement in energy, sexual desire, sexual function, and mood within 1 month," as well as "more muscle mass and decreased body fat within 3 months."

The fine print, of course, tells a different story: possible acne, sweating, dizziness, gynecomastia (breast growth in males), unseemly hair, sensitive testicles and an intriguing yet unexplained "penis disorder." Oh, and maybe fewer visits to cloud nine. That might be the deal breaker.

© 2009