Although the operation is relatively simple, many men find it psychologically devastating to lose their testicles — and for this reason alone decide against it. Another factor to consider is that, unlike medication options, orchiectomy is permanent. Some men continue to choose this option, however, because it remains the most efficient way to reduce testosterone levels, and it eliminates expenditures on medications and multiple visits for monitoring side effects that would be needed to achieve the same results. The option of orchiectomy is also sometimes recommended for elderly men who cannot readily visit a doctor for an injected medication, or who cannot risk the cardiovascular side effects of diethylstilbestrol (DES).
Some of the approved drugs are synthetic versions of the natural hormones, such as trenbolone acetate and zeranol. Just like the natural hormone implants, before FDA approved these drugs, FDA required information and/or toxicological testing in laboratory animals to determine safe levels in the animal products that we eat (edible tissues). Furthermore, FDA required that the manufacturers demonstrate that the amount of hormone left in each edible tissue after treatment is below the appropriate safe level. As described above, a safe level is a level which would be expected to have no harmful effect in humans.