AndroGel Cognitive Function Impact: What the T-Trials and Current Evidence Show

Does testosterone gel improve memory?

The best test is the Cognitive Function Trial within the Testosterone Trials. It randomized 788 men aged 65 or older with serum testosterone below 275 ng/dL and impaired sexual function, physical function or vitality to testosterone gel or placebo gel for one year [6]. The primary analysis covered the 493 men who met criteria for age-associated memory impairment, and the primary outcome was change in delayed paragraph recall at 6 and 12 months [6]. Scores rose in both groups, from 14.0 to 16.2 with testosterone and from 14.4 to 16.5 with placebo, with no significant difference between groups [6]. Visual memory (P=0.24), executive function (P=0.14) and spatial ability (P=0.89) did not differ significantly either [6]. The authors concluded that testosterone was not associated with improved memory or other cognitive functions in these men [6].

What the other trials measured

The T-Trials results paper assigned 790 men aged 65 or older with serum testosterone below 275 ng/dL to testosterone gel or placebo gel for one year, with each man taking part in one or more of three trials: Sexual Function, Physical Function and Vitality [1]. Sexual activity rose (P<0.001), with higher desire and better erectile function, and men on testosterone reported slightly better mood and less severe depressive symptoms; vitality showed no significant benefit [1]. When participants in all three trials were counted, 20.5% of men receiving testosterone and 12.6% receiving placebo increased their six-minute walking distance by at least 50 meters (P=0.003) [1].

TRAVERSE, the larger trial of 1.62% testosterone gel, tracked cardiovascular events rather than cognition [2]. In 5,246 men aged 45 to 80 with hypogonadism and preexisting or high cardiovascular risk, the primary cardiovascular endpoint occurred in 7.0% on testosterone gel versus 7.3% on placebo [2].

Why memory is discussed at all

A review of the animal and human background describes androgen deprivation causing loss of hippocampal synapses in rodents and nonhuman primates, increased amyloid deposition in human and rodent models, and altered prefrontal neurotransmission in rodents. It also notes that conversion of testosterone to estradiol or to androgen metabolites may matter for preserving memory with age [4]. The same review points out discrepancies between animal-model studies and studies of human cognition, and says studies of low androgen levels in older men may not index the same biological mechanisms as gonadectomy in animals [4].

What the labels say

FDA states that none of the approved testosterone products are approved for low testosterone that lacks an associated medical condition [3]. The generic testosterone gel 1% label, which says its dosage and administration differ from testosterone gel 1.62%, is labeled for primary hypogonadism from testicular failure and hypogonadotropic hypogonadism from pituitary or hypothalamic causes [5]. Its limitation of use states that safety and efficacy in age-related hypogonadism have not been established [5]. In June 2026 FDA requested removal of that limitation and revision of prostate safety information; the generic gel 1% label still carries the limitation [3][5].