• Testosterone-maxxing is a hot trend in fitness and longevity, but too much can have side effects.
• New research suggests a majority of men are getting testosterone therapy without the right safeguards.
• A urologist explains who can benefit from testosterone and who should avoid it to prevent risks.

America is reaching peak testosterone.

In 2026, interest in the hormone is everywhere, from T-maxxing trends on social media to the US government's MAHA campaign. Testosterone replacement therapy (TRT) use has quadrupled in the past three decades, up to as many as 11 million Americans.

For some of them, the treatment may be doing more harm than good, new research suggests.

A majority of men who are prescribed testosterone don't meet the current guidelines for safe, effective treatment, according to a study from the University of Michigan.

That could worsen the risk of serious side effects, including infertility, heart attack, and stroke, and long-term dependence on TRT, which can dampen the body's natural production of testosterone.

While testosterone is an essential hormone for health, finding the right balance is complex because there's no one-size-fits-all treatment. A urologist explains what to know about the risks and benefits of testosterone, and how hormone trends are changing the landscape of men's health.

Who can benefit from testosterone therapy?

Healthy testosterone levels are crucial for energy, sex drive, muscle, and metabolism.

T-maxxing influencers might promise that it can get you a six-pack and supercharge your focus and performance, but doctors say the benefits are much more modest — if you need a boost at all.

A blood test can check if you have low testosterone and could benefit from TRT. It's typically taken first thing in the morning, and confirmed with a follow-up blood test on a different day.

Low testosterone is anything below 300 nanograms per deciliter for most healthy adult men.

You should also rule out conditions like sleep apnea, which are linked to low testosterone but can worsen with testosterone therapy.

Men who could benefit from testosterone might experience symptoms ranging from brain fog and low energy to reduced libido and erectile dysfunction. It can take anywhere from a few weeks to a few months for TRT to make a difference, depending on the symptoms.

When T backfires

In the latest research, endocrinologists looked at data from 200 men who were prescribed testosterone at the university clinic.

They found that only 12% of the men met the criteria for treating low testosterone, confirmed by two blood tests.

That means the other 88% — 176 men — may have been inappropriately given TRT, including some who had sleep apnea or prostate cancer.

On average, the men studied were in their 50s, but some as young as 18 were also prescribed testosterone.

If they don't need it, young men on testosterone could be putting their long-term health at risk, since taking TRT can make it harder for the body to produce its own supply of the hormone over time.

High testosterone levels can also increase the body's volume of red blood cells, a risk factor for high blood pressure that, in extreme cases, may lead to a heart attack or stroke. It can also impair fertility by temporarily reducing sperm count.

And taking T can potentially exacerbate serious health conditions like prostate cancer, potentially fueling tumor growth, per the Mayo Clinic.

The findings are concerning, given how popular testosterone has become in the wellness industry and the potential for misuse without clear guidelines, said study authors Dr. Maria Papaleontiou and Dr. Sophia Sinha, both professors at the University of Michigan.

"Testosterone has been coined as the 'fountain of youth' to optimize performance through enhancing muscle and improving energy levels in social media," they told Business Insider in a joint email interview. "Testosterone therapy can help some people who truly have low testosterone, but it is not risk-free."

Major update coming soon for testosterone therapy guidelines

Doctors understand that this is not a black-and-white issue.

While testosterone treatment can have side effects, low testosterone is also a health concern, Dr. Justin Dubin, director of men's sexual health at Baptist Health Medical Group, told Business Insider.

Dubin, who was not involved in the study, said prescribing TRT outside the guidelines may not always be harmful. Yes, TRT can be overprescribed to men who don't need it, but it is also underprescribed to men who could benefit, Dubin said.

"Guidelines are guidelines, they're not law," Dubin said. "There are gray areas, and we need to give care in the gray. That's where most doctors live and where most patients live."

The benchmark for healthy testosterone is so nuanced, Dubin said, that the American Urological Association has gathered a panel to discuss a major update to its guidelines on treating testosterone deficiency in the coming year or two.

For now, Dubin said the growing popularity of testosterone is a good thing, as it's prompting a more proactive approach to medical care for men, who are notorious for avoiding the doctor's office until there's an emergency. As long as guys are going about it the right way by speaking to their doctor instead of just buying stuff online, he's all for it.

"I think that's a wonderful thing because this is a gateway to men's health. This is how we can access a lot of guys, get them in to learn about their blood pressure, whether they have diabetes, heart disease," he said. "I'm actually excited and hopeful."

• A "worry window" involves scheduling time to worry each day to prevent stress consuming our lives.
• The goal is delaying worrying to stay in the present moment, giving you more control.
• Health reporter Kim Schewitz felt more productive after trying it, but the pay-off wasn't big enough to keep going.

They say the only constant in life is change, but in my case, worry is on the list too.

How will I get my to-do list done in time? What if my alarm doesn't go off in the morning? Did I wish my cousin a happy birthday last month? Do my friends secretly hate me? Besides being relentless, taunting, and stressful, listening to my internal monologue is, frankly, time-consuming.

It feels like it robs hours of my life, draining my energy, and taking me out of the present moment. That's why, when my editor said she was looking for someone to try a technique designed to ease stress called a "worry window," I volunteered.

The technique involves making a note, mental or physical, when worries enter your mind throughout the day, and deferring thinking about them until a designated 15 to 30 minute window in which your only job is to, well, worry.

The aim is to delay worry and redirect attention to the present, over time giving you more control over anxiety.

There is no set way to do the worrying, but psychologists I spoke to recommended writing or typing out worries at around the same time each day in a relatively comfortable spot, but not in bed (you don't want to associate bedtime with worry).

"The muscle to build is to recognize you've written it down, it's going to be saved for your structured worry time, and then to redirect your attention," Dr. Simon Rego, professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine, told me.

In his experience, pretty quickly, people realize that if they defer worrying and stay in the moment, the anxiety starts to die down.

The worry window draws on key strategies used in cognitive behavioural therapy, rooted in the idea that our thoughts and actions impact how we feel, Rego said. Through discussion with a therapist and practical exercises, CBT is "a way of not getting stuck in just how you feel, but learning to see how what you feel is influenced by, and influences, your thoughts and actions," Rego said.

The worry window was created for people with Generalized Anxiety Disorder, he added, but can be helpful for anyone experiencing stress.

I had found myself more stressed than usual. Fretting constantly over my seemingly never-ending to-do list and struggling to relax at the end of the day. I was skeptical that the technique would make any difference, but I was willing to give it a shot.

I worried for 10 minutes a day for 2 weeks

For two weeks between 6 p.m. and 8 p.m., I sat at my desk with a notebook and pen, and set a timer for ten minutes.

I spent most of the time writing out a list of everything I needed to do, and dividing it into urgent (to be done today) and less pressing (in the coming days). I also noted down approximately how long I thought each task would take, to help me plan.

I spent the rest of the time writing about my stress-related thoughts and feelings.

In retrospect, I probably should have done the suggested 15-minute minimum, since studies testing the efficacy of worry windows used 15 to 30-minute sessions, but that felt unrealistic for me at the time.

As my insurmountable to-do list was a big part of my stress, I didn't set any rules or intentions, to make my worry sessions as stress-free and fluid as possible.

Knowing I would worry later helped me dismiss worries in the moment

Pretty soon after I started using the worry window, I noticed some small but tangible differences in how I coped with stress.

Writing down everything on my mind during the day helped me figure out what to prioritize, and I often realized I was making a mountain out of a molehill. It turned out that remembering to fold laundry or reply to a friend's message did not warrant triggering my fight-or-flight response.

I feel like I got more done during the two weeks than I usually would. Instead of spending time worrying about my to-do list, scheduling tasks reassured me they were taken care of. I was able to identify and do what was urgent, and let go of what wasn't. Similarly, when a pang of stress randomly hit me during the day, I often found that reminding myself I had already worried about this thing, or was scheduled to, helped me to dismiss it.

I also found myself using other CBT techniques I learned in the past, like analyzing thoughts, during the worry window. For example, I would write down the more existential worries I was having or negative self-talk, and that would help me see how mean I was being to myself and notice familiar patterns. That helped me unhook from those thoughts and feel better.

It's wasn't fun

The biggest challenge was sitting down and doing my worry window every day, because it wasn't particularly enjoyable.

It was another daily task and, after a long day, I generally just didn't feel like it. Admittedly, there were a few days when I was in the office and had a social plan after work that I ended up not completing my worry window.

Dr. Sarah Berger, a psychologist based in Bethesda, Maryland, who specializes in CBT and anxiety and often uses worry windows with clients, told me that my experience is common. "The major downside of this technique is getting people to do it," she said, "nobody enjoys this activity. It's not fun. It's not supposed to be fun."

But people who practise regularly typically get great results, she said. She recommended committing to a "short, almost training period of 'let's try this every day for two weeks and see how it works,'" she said.

Next time, I'll follow the rules strictly, for longer

After my two-week experiment, I stopped scheduling time to worry. I felt like I hadn't seen enough of an improvement to muster the discipline required to do a fairly unpleasant activity every day. However, after speaking to experts, my perspective on this changed a little.

As someone with entrenched worrying habits, I would probably need to follow the rules more strictly and continue for longer to see significant, long-lasting results.

Rego said to ask yourself: "How chronically have you worried in your life? Is it new? Does it seem to have emerged in the last few months, or have I been a worrier for my entire life?'

"Some of those factors can influence the amount of time required to really retrain the way you think," he said.

Initially, I thought of the worry window as a potential life hack, but, as with most things good for our health, it's not a quick fix.

"It's a short-term sacrifice, like going to the gym where you're going to feel some pain today for the long-term gain of making progress towards some sort of life balance or worry control," Rego said.

I plan to try again when I'm ready to fully commit.