Even then, the levels of testosterone in the athlete’s body must stay within allowed limits. That’s because testosterone is considered a performance-enhancing drug (PED). Even when testosterone is legally prescribed, many sports organizations still ban its use. It is also illegal to buy it from someone else or to use leftover prescriptions. This means it’s treated like other drugs that have medical uses but also carry a risk of abuse. The provider must check if the person really has low testosterone by doing a blood test and medical evaluation. In 2025, these laws are still active and enforced by federal agencies. This means it is a drug that has some medical use but also has the potential to be abused. But because testosterone can also be misused to build muscle or improve athletic performance, the government has put strict rules in place. It is important to know the difference between medical and non-medical use of testosterone. The decision depends on how well the person responds to treatment, how easy it is to use, and how well the body absorbs the hormone. Some transgender men (people assigned female at birth who identify as male) also take testosterone as part of gender-affirming care. Even if the testosterone was prescribed to someone else and then shared or sold, using it without your own prescription breaks the law. If someone has symptoms like low energy, loss of muscle mass, or low sex drive, and tests show low hormone levels, they may qualify for therapy. Doctors can legally prescribe testosterone to treat medical conditions such as hypogonadism (low testosterone production). This means someone must have a real health condition—like low testosterone confirmed by a blood test—to get it legally. During these visits, the doctor will ask about symptoms and order blood tests to check hormone levels, red blood cell counts, and other markers. If you’re not sure, check the clinic’s license or call your state medical board. If a clinic breaks the rules, it can be shut down, fined, or charged with a crime. Patients who use these services could also get in trouble, even if they didn’t know it was illegal. Even though telemedicine has changed a lot since the law was passed in 2008, the rule still applies. Another important law is the Ryan Haight Online Pharmacy Consumer Protection Act. In 2025, a few states have started relaxing these rules, but others are still strict. Even if the coach or employer didn’t directly hand out the drug, giving unsafe or unqualified advice can still lead to legal responsibility. Employers and coaches also face legal risk if something goes wrong after they recommend testosterone. Testosterone is a Schedule III drug under federal law. Some pharmacies mix custom doses of testosterone, known as compounded testosterone. For example, one state might require more testing before starting treatment. States must follow these federal rules, but they can also add more restrictions. This means it has accepted medical uses but also a risk for abuse and misuse. In cases of gender-affirming care, the law depends on the state or country. Testosterone for athletic performance or muscle growth is never legal for minors. Your doctor will check your levels over time and look for side effects. They will ask about your symptoms, check your blood levels, and decide if therapy is right for you. If you think you have low testosterone, the first step is to talk to a doctor. But doing this is risky and can lead to serious legal and health problems.
