Awareness of mortality often leads to wishful thinking about delaying or reversing ageing. With sufficient prosperity, this flourishes into a fashionable hobby which had its zenith in the era of rejuvenation quackery at the turn of the 20th century involving testis extracts, slices or manipulation. This fad vanished in the 1930’s with the discovery of testosterone (T) during the Depression but resurfaced in the last two decades under the guise of “andropause”, “late onset hypogonadism” and “LowT”. Over-interpreting observational studies linking cardiovascular disease and other disorders with low circulating T to assume protective effects of T has led to massive increases in T prescribing. However in men without reproductive system pathology, low circulating T associated with systemic disorders represents a “sick eugonadal” or “non-reproductive illness syndrome” rather than a deficiency state as part of an adaptive hypothalamic response to non-reproductive disorders. As these effects may be beneficial, neutral or harmful, T treatment for non-reproductive system disorders requires rigorous proof of efficacy and safety. In addition, recent studies also provide troubling, albeit inconclusive, adverse cardiovascular safety signals for T treatment of men who have no reproductive system disorders.