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Do “testosterone boosters” really increase serum total testosterone? A systematic review

International Journal of Impotence Research (2023)Cite this article

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Abstract

Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone. Lax industry regulation has allowed sales of supplements to thrive in the absence of verification of their purported benefits. Our primary objective was to systematically review all data published in the last two decades on testosterone boosters and determine their efficacy. Our outcome of interest was total testosterone increase versus placebo in four different populations: male athletes, men with late-onset hypogonadism infertile men and healthy men. Following search and screening, 52 studies were included in our review, relating to 27 proposed testosterone boosters: 10 studies of cholecalciferol; 5 zinc/magnesium; 4 Tribulus terrestris and creatine; 3 Eurycoma longifolia and Withania somnifera; 2 betaine, D-aspartic acid, Lepidium meyenii and isoflavones; while the remainder were single reports. Our findings indicate that most fail to increase total testosterone. The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes. Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor™) and purified Shilajit extract (PrimaVie™) can be considered possibly effective for men with late-onset hypogonadism; Eurycoma longifolia and Withania somnifera possibly effective for healthy men; and a non-hormonal aromatase inhibitor (Novadex XT™) possibly effective for male athletes.

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Data availability

The data that support the findings of this study are available from the corresponding author, AM, upon reasonable request.

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Acknowledgements

The author would like to acknowledge the support from the other members of the Young Academic Urologist (YAU) Male Sexual and Reproductive Health group who are not cited as authors.

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Authors and Affiliations

  1. Serviço de Urologia, Centro Hospitalar Universitário São João, Porto, Portugal

    Afonso Morgado

  2. Department of Urology, Oxford University Hospital NHS Trust, Oxford, UK

    Georgios Tsampoukas

  3. 2nd Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Ioannis Sokolakis

  4. Urology Department, University Hospital Center Bichat Claude Bernard, Paris, France

    Nadja Schoentgen

  5. Department of Urology, St. Elizabeth’s Medical Center, Boston, MA, USA

    Ahmet Urkmez

  6. Department of Urology, Gülhane Research and Training Hospital, Ankara, Turkey

    Selcuk Sarikaya

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The authors confirm their contribution to the paper as follows: study conception and design: AM; data collection: AM, GT, IS, NS, AU, SS; analysis and interpretation of results: AM, GT, IS, NS, AU, SS; draft manuscript preparation: AM, GT, IS, NS, AU, SS. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Afonso Morgado.

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Morgado, A., Tsampoukas, G., Sokolakis, I. et al. Do “testosterone boosters” really increase serum total testosterone? A systematic review. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00763-9

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