"Are you falling asleep after dinner?"
"Do you have a decrease in libido?"
"Have you noticed a recent deterioration in your ability to play sports?"
"It could be low T."
Welcome to the latest big marketing push by U.S. drug companies. In this case, it's a web page for Abbott Laboratories' Androgel, a billion-dollar-selling testosterone gel used by millions of American men struggling with the symptoms of growing older that are associated with low testosterone, such as poor sex drive, weight gain and fatigue.
Androgel is one of a growing number of prescription gels, patches and injections aimed at boosting the male hormone that begins to decline after about age 40.
Drugmakers and some doctors claim testosterone therapy can reverse some of the signs of aging - even though the safety and effectiveness of such treatments is unclear.
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"The problem is that we don't have any evidence that prescribing testosterone to older men with relatively low testosterone levels does any good," says Dr. Sergei Romashkan, who oversees clinical trials for the National Institute on Aging.
The rise of such therapies is being fueled by both demographics and industry marketing.
Baby boomers are living longer and looking for ways to deal with the infirmities of old age: Life expectancy in the U.S. today is 78 years, up from 69 years a half-century ago.
Doctors say that's led to an increase in men seeking treatment for low testosterone. Prescriptions for the hormone have increased nearly 90 percent over the last five years, according to IMS Health. Last year, global sales reached $1.9 billion.
"People are living longer and want to be more active," says Dr. Spyros Mezitis, a hormone specialist at Lenox Hill Hospital in New York. "They no longer consider that because they're older they shouldn't have sexual intercourse."
Despite its rising popularity, testosterone therapy is not completely new. Testosterone injections were long used for men with hypogonadism, a disorder defined by low testosterone caused by injury or infection to the reproductive or hormonal organs.
But the latest marketing push by drugmakers is for easy-to-use gels and patches that are aimed at a much broader population of otherwise healthy older men with low testosterone, or androgen deficiency.
The condition is associated with a broad range of unpleasant symptoms ranging from insomnia to depression to erectile dysfunction. Drug companies peg this group at about 15 million American men, though federal scientists do not use such estimates.
But government researchers worry that medical treatments have gotten ahead of the science.
Male testosterone is mainly produced in the testes and affects muscle mass, sperm production and various sexual characteristics.
Typical testosterone levels for younger men range between 300 and 1,000 nanograms per deciliter, but once levels begin dropping there is little consensus on what makes a "normal number."
Some doctors believe testosterone levels below 300 lead to sexual dysfunction, but the rule does not cover all cases.
Evidence of the benefits of testosterone is mixed.
The long-term side effects are not entirely understood because most trials to date have only followed patients for a few months.
The most serious risks include heart problems and prostate cancer. All testosterone drugs warn that the hormone should not be given to men who have a family history of prostate cancer.
