From the article:
The epidemic of testosterone prescribing over the last decade has been primarily pushing testosterone as a tonic for sexual dysfunction and/or reduced energy in middle-aged men, neither of which are genuine testosterone deficiency states.“
[…]
“Clearly, previous attempts to warn doctors and the public of this disease mongering that is potentially medically harmful and costly have not been effective. Now however,” said Perls, “with the FDA’s recent dual commission findings that testosterone treatment is not indicated for age-associated decline in serum testosterone, alternatively called ‘andropause,’ ‘late-onset hypogonadism’ and marketed as ‘low T,’ we have the opportunity to highlight why hormone replacement (also euphemistically called "bioidentical hormone replacement”) for aging with not only testosterone but also growth hormone is disease mongering, that the conjured benefits are unfounded and are far outweighed by the risks, and to provide suggestions about how this deceptive practice can be stopped."
The authors point out that for many men, testosterone does not decline with age among men retaining excellent general health, and if it does, the decline is due to common underlying problems such as obesity and poor fitness. Those who hawk testosterone and growth hormone have developed advertising and in some cases professional-appearing questionnaires that focus on common complaints among older men such as decreased energy, feeling sad, sleep problems, decreased physical performance or increased fat.
Additionally, the authors highlight that many times, a testosterone level won’t even be obtained and the patient is told that, simply based on these common symptoms alone or with minor reductions in serum testosterone, they have “late onset hypogonadism,” or that their erectile dysfunction may be improved with testosterone treatment.
In the case of growth hormone, the FDA requires that doctors perform a test to demonstrate that the body does not produce enough growth hormone. “Those who market and sell HGH for these common symptoms nearly never perform the test because if they did a properly performed test, it would almost never be positive because the diseases that cause growth hormone deficiency in adults, such as pituitary gland tumors, are very rare,” said Perls.