We start with plastic. A lot of plastic contains bisphenol A (BPA); BPA is a weak synthetic estrogen. Like many other chemicals used in making plastics, BPA is a hormone disruptor and can block or mimic hormones and how they act in the body (34). If you think you’re safe with BPA plastic, think again. Research shows that BPA free plastic has similar estrogen-like effects on the body.
Insulin causes lower Testosterone levels, so go easy on the carbs and eat more protein right? Well you need to be careful with protein consumption – Excess protein without fat can also cause insulin spikes. So go easy on that chicken breast with a side of egg white omelets washed down with a protein shake. From an insulin point of view you may as well drink a can of soda with some aminos acid! So what should you do? Eat more fat.
The researchers found that men who received hormone treatment experienced an increase in bone strength and density. Strength increases were greater in the spine than they were in the hip. However, as with other T Trials, more research needs to be done. A larger study over many years would need to be performed to determine whether testosterone could decrease risk of bone fracture.
Keep more weapons in your arsenal: Occasionally use lifting methods like forced reps, negatives, and dropsets to further stress your body. Personal trainer and fitness journalist Michael Berg explains in "6 Ways to Crank Up Your Testosterone Levels" that going beyond muscular failure with these techniques has been shown to pump up T-levels in study subjects.[16]

I just started TRT gel. On the first day I noticed an improvement in my awareness/energy level. This is now day three and I feel much better. Before I was tired and lacked the mental clarity I now feel. I have not yet noticed and increase in my libido but I think it is improving. Probably need the stimulation from my fiancé and more time to get my T levels up. Before I started the gel, total T levels were 450, and then 500+. I went to an Integrative MD who suggested Free T. That level was low and my SBGH was 100 (high). I then went to an NP who ordered the Free T. She referred me to an Endocrinologist. She along with her Attending interviewed me and decided to prescribe. They asked if I wanted the gel or the injections. I opted for the gel. I will wait and see how the gel works. So far so good.


Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.
The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression".[82][83] Testosterone and other androgens have evolved to masculinize a brain in order to be competitive even to the point of risking harm to the person and others. By doing so, individuals with masculinized brains as a result of pre-natal and adult life testosterone and androgens enhance their resource acquiring abilities in order to survive, attract and copulate with mates as much as possible.[82] The masculinization of the brain is not just mediated by testosterone levels at the adult stage, but also testosterone exposure in the womb as a fetus. Higher pre-natal testosterone indicated by a low digit ratio as well as adult testosterone levels increased risk of fouls or aggression among male players in a soccer game.[84] Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males.[85][86][87][88][89]
Testosterone therapy improves body composition (increase in lean body mass, decrease in fat mass) in men with hypogonadism.1 There is a supplementary improvement in muscle strength and physical function. The benefits of testosterone treatment on body composition have consistently been demonstrated in clinical studies of testosterone therapy in hypogonadal men or men with borderline low testosterone levels,1,6,8,12,13 and confirmed by systematic reviews or meta-analyses of randomized controlled trials.4,5,6,13
It's not enough just to increase the testosterone your body produces, because as we age, the testosterone we naturally produce is often bound by SHBG (sex hormone binding globulin) thus becoming unavailable for use in the body. It’s imperative that your testosterone remains unbound or “free” if you want to enjoy all the wonderful benefits testosterone provides.

Have you ever wondered why? When we are under stress, our body produces cortisol that is bad for our testosterone levels. This particular component blocks the production of testosterone. In addition, if there is a lack of Z’s then this is the bad news for your testosterone. You should know that the huge amounts of testosterone are produced during our sleep. Every guy knows that the “morning wood” comes only after a good night sleep.
Both testosterone and 5α-DHT are metabolized mainly in the liver.[1][155] Approximately 50% of testosterone is metabolized via conjugation into testosterone glucuronide and to a lesser extent testosterone sulfate by glucuronosyltransferases and sulfotransferases, respectively.[1] An additional 40% of testosterone is metabolized in equal proportions into the 17-ketosteroids androsterone and etiocholanolone via the combined actions of 5α- and 5β-reductases, 3α-hydroxysteroid dehydrogenase, and 17β-HSD, in that order.[1][155][156] Androsterone and etiocholanolone are then glucuronidated and to a lesser extent sulfated similarly to testosterone.[1][155] The conjugates of testosterone and its hepatic metabolites are released from the liver into circulation and excreted in the urine and bile.[1][155][156] Only a small fraction (2%) of testosterone is excreted unchanged in the urine.[155]
Gary Womble… Get out of here with your quackery nonsense. No one likes trolls that want to push diet and weight loss pills as a serious solution to low t and ED. Anyone who reads your comment will waste at least 20 seconds of their life. What’s worse, they might listen to you instead of getting real medical advice that might actually help with an issue that is devastating to their lifestyle. And btw, before you decide to respond to this with more quackery, testimonials or fake research, know that I am a pharmaceutical scientist and won’t fall for your bogus statements
High levels of testosterone in the bloodstream lead to increased energy and aggressiveness. The latter pertains to one’s sense of motivation to train harder to achieve optimum muscle growth. Increased aggressiveness or motivation during a workout due to the intake of testosterone boosters guarantees faster progress to beginners as well as professional athletes and bodybuilders.
I noticed that you say that those that have prostate cancer should not have testosterone replacement therapy, Why-in light of the studies that say that there is no danger from testosterone therapy to one that had/has prostate cancer? If this is your opinion do you have any suggestions as to what I should do about my symptoms? Does testosterone replacement therapy actually do anything?
Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.
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Why the difference? The discrepancy in findings between these studies is likely due to the initial training status and base testosterone levels of the subjects. While more research is warranted on this ingredient, D-AA is one of several ingredients suggested to be effective in boosting test levels, especially for older men whose natural testosterone levels have declined due to the natural course of aging.
Studies have demonstrated reduced testosterone levels in men with heart failure as well as other endocrine changes (Tappler and Katz 1979; Kontoleon et al 2003). Treatment of cardiac failure with chronic mechanical circulatory support normalizes many of these changes, including testosterone levels (Noirhomme et al 1999). More recently, two double-blind randomized controlled trials of testosterone treatment for men with low or low-normal serum testosterone levels and heart failure have shown improvements in exercise capacity and symptoms (Pugh et al 2004; Malkin et al 2006). The mechanism of these benefits is currently unclear, although a study of the acute effects of buccal testosterone given to men with chronic cardiac failure under invasive monitoring showed that testosterone increased cardiac index and reduced systemic vascular resistance (Pugh et al 2003). Testosterone may prove useful in the management of cardiac failure but further research is needed.

Binge drinking on the other hand does impact Testosterone levels – especially on a short term basis. Two studies (22 & 23) show that large acute quantities of alcohol consumption in a short period led to decreases in Testosterone levels by a whooping 20-23% after 24hours! Note however this is drinking to extreme excess! Likewise, chronic alcohol abuse is known to reduce testosterone more notably (as seen in alcoholics).
Sustain Alpha is the first ever transdermal testosterone booster to hit the Top 10 and it’s here for good reason. Users have been reporting increased sense of well-being and improved libido just shortly after their first dose with muscular definition and strength improvements after just 2 weeks! The transdermal technology allows users to avoid the traditional route of digesting their supplements and instead allows for them to be absorbed through the skin and directly in the bloodstream. This innovative approach has been delivering and for those looking to try something a bit different, Sustain Alpha is your go to. 
In a subsequent study of 345 men with normal PSA and low testosterone, we found the cancer rate was similar: 15%. And we had a large enough group to look at the impact of testosterone on cancer risk. For men whose total testosterone or free testosterone value was in the lowest third, the odds of having a positive biopsy were double the odds in the rest of the men. That’s the first evidence that low testosterone may be an independent predictor for the development of prostate cancer.
Use natural grooming products. Most grooming products these days contain parabens, another type of xenoestrogen. And by most, I mean more than 75% of all products. To reduce my exposure as much as possible, I became a hippy during my experiment and started using all natural, paraben-free grooming products. You can find most of these items at most health food stores:
Hello everyone. First off, thank you Dr. Abraham Morgentaler, for the excellent and refreshing article. I do not intend to spill my guts about symptoms or values on here as it has already been done so many times over. I will say that I am an RN BSN and have been on HRT for going on 6 yrs. I live in Oklahoma and when I first started noticing symptoms I knew something was wrong and began to do research myself. With an initial level of 241 no doctor here at that time, would even consider HRT as I was only 35ish at the time.
I’m currently 64 y.o. After close to 10 years of twice-weekly injections of 20 units of testosterone cypionate my PSA gradually increased from 4.4 to more than 16. My urologist has performed 4 biopsies and one prostate MRI over that time, all of them negative. The last was 15 months ago. Early last year, after my fluctuating PSA reached 16, I discontinued the injections for about 6 months. My PSA dropped back to 6.1, and by the end of that time, my testosterone levels were about 240 but my libido seemed almost non-existent. I resumed the injections at a reduced level, 15 units, and 3 months later, the testosterone level was in the 700 range but the PSA was back to 16. My doctor told me to discontinue the injections pending another biopsy when I’m 65 in June.(I can’t afford another one immediately because of a high insurance deductible and previous family medical bills.) I am now gradually reducing the injections to 10 units once weekly, in hopes of limiting the withdrawal. Am I playing with fire or doing the right thing and have you had other patients with similar histories?
As you can see, the entire workout is only 20 minutes. Twenty minutes! That really is a beautiful thing. And within those 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You're really only working out intensely for four minutes. It's hard to believe if you have never done this that you can actually get that much benefit from four minutes of exercise. That's all it is.
Testosterone is a hormone that is produced primarily in the testicles for men and the ovaries and adrenal glands for women. This hormone is essential to the development of male growth and masculine characteristics. For women, testosterone comes in much smaller amounts. Testosterone production increases about 30 times more during adolescence and early adulthood. After early adulthood, it’s natural for levels to drop slightly each year. Your body may see a one percent decline after you’re 30 years old.
There are many Supplements: Zinc for starters about 1/3 of Men have to low Zinc. Make shure you get a good chemical form no oxides best are chelates or citrates. Then there is Arginin and L-Citrullin two amino acids that help Blood flow basacly natural viagra. And then there are things like maca(a plant that you can get in powder form) that hightens libido but not like zinc it doesnt highten the testosteron level. My dad takes the combo of these 3 things kosts you about 30-60$ per Month. Dont be lazy do research on the stuff to make shure you get right dosages and good quality Sups
Ok. So this product is meant to be taken continuously and without side-effects. But my question is, will there be replenishment from this product in aiding the body's natural ability to produce testosterone? In other words, will there ever be a time when I can say well I don't have to take this any more as my body is producing testosterone again on it's own and my muscle mass has been enhanced?
Herbalists have used _Trifolium pratense_, red clover, to treat menopausal symptoms like hot flashes. The mechanisms underlying these effects remain unknown. Testosterone decreases hot flashes in some postmenopausal women, so red clover may work in this way. A 2015 paper in the Avicenna Journal of Phytomedicine reviewed the literature testing this idea.
Fenugreek, in the form of a capsule, testofen, or Fenugreek tea could do the trick. The fact that fenugreek increases libido is not mythology; it is backed by a clinical study which showed the libido of men aged 25-52 increased by 25%[1] on average when taking fenugreek extract for six weeks.  According to Lee Myer, of www.peaktestosterone.com fame, fenugreek will help you achieve orgasm as well, so if this is an issue for you, fenugreek may be the answer.  It’s a frustrating problem to have.
The T Trials are a set of seven clinical trials hosted at 12 sites around the country. In the aggregate, 790 men aged 65 or older with low levels of testosterone and associated symptoms participated. First, participants had to qualify for one of the main three trials: the Sexual Function Trial, the Physical Function Trial, or the Vitality Trial. Then, participants could participate in any of the other trials for which they qualified.
My biggest symptom was fatigue. Interestingly, I had and have no problem with erections at all. Granted, I wasn’t getting spontaneous erections like when I was a teenager and into my late 20’s, but that was a good thing as getting an erection whenever and having no way to relieve it can get annoying. Anyway, my biggest concern with low T was/is energy levels and loss of muscle mass.

“Our hypothesis was that testosterone would be good for the coronary arteries because we thought that by repleting testosterone to healthy levels there would be an improvement in the cholesterol panel and atherosclerosis burden. But what we found was the opposite, that atherosclerosis actually progresses faster under the influence of testosterone.”

The medical conditions that cause excess testosterone are rare, argues Drincic. "Many people mistake the symptoms of anabolic steroid abuse with symptoms of high testosterone,” he says. Anabolic steroids, which are sometimes abused by athletes and body builders, are synthetic versions of the male hormone testosterone. They can cause behavior and mood changes that include rage, paranoia, irritability, and poor judgment.

Testosterone may strengthen your heart. Research on testosterone’s relation to heart health is split. Some scientists have found that men with higher testosterone levels have an increased risk of heart disease, while recent studies have shown that men with below-normal T levels are more at risk for heart problems. The research is still on-going, but many doctors find the evidence compelling that optimal testosterone levels can help prevent cardiovascular disease.
In 1927, the University of Chicago's Professor of Physiologic Chemistry, Fred C. Koch, established easy access to a large source of bovine testicles — the Chicago stockyards — and recruited students willing to endure the tedious work of extracting their isolates. In that year, Koch and his student, Lemuel McGee, derived 20 mg of a substance from a supply of 40 pounds of bovine testicles that, when administered to castrated roosters, pigs and rats, remasculinized them.[183] The group of Ernst Laqueur at the University of Amsterdam purified testosterone from bovine testicles in a similar manner in 1934, but isolation of the hormone from animal tissues in amounts permitting serious study in humans was not feasible until three European pharmaceutical giants—Schering (Berlin, Germany), Organon (Oss, Netherlands) and Ciba (Basel, Switzerland)—began full-scale steroid research and development programs in the 1930s.
Total levels of testosterone in the body are 264 to 916 ng/dL in men age 19 to 39 years,[169] while mean testosterone levels in adult men have been reported as 630 ng/dL.[170] Levels of testosterone in men decline with age.[169] In women, mean levels of total testosterone have been reported to be 32.6 ng/dL.[171][172] In women with hyperandrogenism, mean levels of total testosterone have been reported to be 62.1 ng/dL.[171][172]
Shilajit in its natural state has no chemical definition. In order to yield a consistent and efficacious form of shilajit, the shilajit is obtained from carefully selected rocks and is put through a patented technology where it is purified and standardized. This form of shilajit is now assured of optimal levels of bioactive components such as fulvic acid and dibenzo-pyrones, and is known as the patented PrimaVie.

Amazing this thread is going after 3 years. Very good indeed. I have low cortisol and my doctor decided to check testosterone. It came back at 5! Not 500, but 5! My doctor did not believe this to be correct. She indicated I would not be able to grow facial hair and that my arm hair would have fell out. She retested. It came back at 23. WTH. So she wanted to start me on Clomid. Well of course my insurance would not cover this. Most pharmacies wanted $300-400 for a 30 day supply. Can’t afford that! The 2 pharmacies that were reasonable cannot get it from their suppliers at this time. So my doctor wants to start weekly injections. I do not know what to think but am trying to find all the information I can on the subject as I am quite nervous. So if anyone else is still reading or comes across this please let me know what you think or your story. it would very much be appreciated. i will be 38 next month and am a little “lost” about all of this. Many thanks! 🙂
Meat. Meat, particularly beef, provides our bodies with the protein it needs to create muscle (more muscle = more T) and the fats and cholesterol to make testosterone. My meat topping of choice was sliced up chuck steak. I grilled two of them on Monday and it lasted me until the next Monday. Every now and then I’d slow-cook some ribs or brisket to use as my meat topping. My philosophy was the fattier, the better.
Likewise, the amino acids in a protein-rich diet play a big role in both testosterone and muscle growth. As Chris Lockwood, Ph.D., explains, "When combined with training, which increases the sensitivity of androgen receptors, and the consumption of essential amino acids necessary to support protein synthesis, the effects of testosterone on muscle and performance is significantly amplified."[3,4]
Testosterone may help you woo a woman. In the animal kingdom, higher testosterone levels have long been shown to be associated with a male’s dominance in the competition for mates. But a recent study has shown this is true for human males as well. When a pair of men were instructed to compete for the affection of an attractive female undergraduate, the men’s assertiveness, ability to control the conversation, and ultimately, their chances of having the woman say she “clicked” with them most, were positively associated with their pre-competition testosterone levels. So there is truth to the idea that men with swagger get the girl, and this self-assuredness may be partly rooted in T.
I am now 65 & have had Low-T problems since I was about 60. I took topical Testosterone for a few years until insurance stopped covering it. Then I took injections at a Men's Health-Low-T Clinic. Then I was diagnosed with Prostate Cancer & was told to stop taking Testosterone. I underwent radiation treatment to cure the Prostate cancer, but since there is a theory that taking Testosterone can lead to Prostate cancer, I have chosen not to resume taking it. While I am glad to be free of the cancer, I have been feeling extremely fatigued & tired all the time to the point that doing much of anything like a little yard work would leave me exhausted for days.
Studies have demonstrated reduced testosterone levels in men with heart failure as well as other endocrine changes (Tappler and Katz 1979; Kontoleon et al 2003). Treatment of cardiac failure with chronic mechanical circulatory support normalizes many of these changes, including testosterone levels (Noirhomme et al 1999). More recently, two double-blind randomized controlled trials of testosterone treatment for men with low or low-normal serum testosterone levels and heart failure have shown improvements in exercise capacity and symptoms (Pugh et al 2004; Malkin et al 2006). The mechanism of these benefits is currently unclear, although a study of the acute effects of buccal testosterone given to men with chronic cardiac failure under invasive monitoring showed that testosterone increased cardiac index and reduced systemic vascular resistance (Pugh et al 2003). Testosterone may prove useful in the management of cardiac failure but further research is needed.
Increased testosterone can have an impact on body composition. Possible benefits include gains in lean muscle mass, reduced body fat and increased bone density. Testosterone inhibits uptake of triglycerides and increases lipid mobilization from adipose tissue, and the increase or decrease of testosterone will usually have an inverse effect on fat stores, with higher testosterone generally causing a decrease in body fat. "The Journal of Clinical Endocrinology and Metabolism" published a study in 2007 that showed decreases in body fat and increases in lean mass in HIV-positive obese men given testosterone therapy. In 1989, a study of the effects of testosterone on muscle mass at the University of Rochester School of Medicine and Dentistry suggests that increasing testosterone increases protein synthesis in muscles. Body composition changes from increased testosterone were also demonstrated in a 1999 study at the School of Exercise Science and Sports Management, Southern Cross University in Australia performed on male weight-training subjects, which showed increases in arm girth and body weight and decreased body fat following a 12-week cycle of testosterone enanthate.

In fact, high cortisol deals a crushing blow to testosterone in two ways. During, long-lasting stress, high amounts of cortisol release very often and have a direct negative influence on T levels. Thus, cortisol inhibits testosterone synthesis in the testes and hypothalamus. In addition, the production of cortisol is impossible without cholesterol. But testosterone synthesis also demands cholesterol. Since during stress cholesterol is first of all used for making cortisol, T levels simply plummet.
The same study showed that drinking did, however, lower semen count and quality. And I want to remind you – this is an article  on improving testosterone levels, not general health as there are a lot of studies that show drinking leads to an assortment of health issues. This acute spike in Testosterone could be due to the effect alcohol has on libido, and also the energy influx in the liver?
In males, the testosterone test can help find the reason for sexual problems, like reduced sex drive or erectile dysfunction. If you’re having a hard time getting your partner pregnant, the test can tell if your blood testosterone level is low. It can also screen for problems with the hypothalamus or pituitary gland. This controls how much testosterone your body makes.

“I can't tell you how good the product is! I'm in the best shape of my life. I used to take blood pressure medication and I don't even take that anymore. It's changed every aspect of my life. I was a 40 waist and I'm down to a 36. I'm 54 years old, and people tell me I look better than I ever have, and I look like I'm in my early 40s! And I'm telling you it's the Andro. This product is so much better than even the advertisements! From taking Andro400 I immediately notice a burst of energy . . . and my skin color, my sexual advancements, my energy, plus the weight loss, the toning of the body, and the increase strength and endurance . . . it's like night and day where I was then and where I am now, and Andro400 has made the difference. And my wife also takes it, 1 pill every other day, and she has experienced an amazing transformation in her body alone, with her hair, her complexion, and as well as in the gym. It's an outstanding product. My customers, my friends, my family, everybody is noticing the difference!”
Overall, few patients have a compelling contraindication to testosterone treatment. The majority of men with late onset hypogonadism can be safely treated with testosterone but all will require monitoring of prostate parameters HDL cholesterol, hematocrit and psychological state. It is also wise to monitor symptoms of sleep apnea. Other specific concerns may be raised by the mode of delivery such as local side effects from transdermal testosterone.
Testosterone increases dominance and the desire for power. The link between testosterone and dominance has been demonstrated in numerous studies. T motivates men to gain and maintain social status. The desire for dominance can be a bad thing if it leads to criminal behavior, but it’s also what fuels the climb for success, motivates men to resist oppression and buck authority, and may even help you with the ladies…
Although, most studies on TT have been conducted on animals, the results appear promising. One study that looked at sexually sluggish male albino rats found that having been given extracts of TT, the rats "mount frequency, intromission frequency, and penile erection index" all increased, while "mount latency, intromission latency, and ejaculatory latency" all decreased. Who said romance was dead?
AC, I just ran across the thread… definitely start the injections. Should help with levels that low. I’m 36 and have battled low T for 6-7 years. My labs came back to show 90ng/dl when I just turned 30, and I’ve done Testosterone cypionate injections @ 100mg/mL weekly, Testim, Androgel, and Fortesta over the years. I’m actually going to my endocrinologist tomorrow to have new blood work done.
Finally, there's the question of prostate cancer risk. Research over the past few decades has shown little evidence of a link between testosterone replacement therapy and prostate cancer. However, the question has not been entirely laid to rest. Eisenberg recommends that his testosterone replacement therapy patients get a PSA test once or twice a year to check for possible signs of concern.
In addition, the gel forms of testosterone, applied under your arm or on your upper arm and shoulder, can be transferred to others if you don’t wash the area after applying it. Children exposed to the hormone have experienced enlargement of the penis or clitoris, growth of pubic hair, increased libido, and aggressive behavior. Women can experience acne and the growth of body hair and, if they are pregnant or breastfeeding, can transfer the hormone to their babies.
One more thing that I have experienced from getting injected T is that my testicles have shrunk and they have shrunk quite a good amount. I would say that my testicles are about half the size they were just 4 months ago. This is a result that many men get when they get T injections. I have a buddy who also gets injections and his testicles have shrunk a good amount as well. It’s not a bid deal overall as I am 51yrs old and things like that are not bother. However, I do miss feeling/having larger testicles when I catch a glimpse in the mirror or “adjust” my private parts and I can feel less there. 🙂
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What is your opinion of using depo-testosterone injections on women? I am 44 and have had a complete hyserectomy. My OB/GYN was injecting the hormone when I complained of low libido. Unfortunately, the doctor was asked to leave the practice and his replacement refuses to use the injections on me. Any thoughts or suggestions would be greatly appreciated.


According to studies by Srivastava [15] and Thomson et al. [21] ginger can be used as natural antithrombotic agent. Ginger has also been recorded as useful remedy in preventing post-operative nausea and vomiting in humans [13] as well as preventing morning sickness during pregnancy [16]. At high doses (500 mg/kg) aqueous extract of ginger exhibits cholesterol-lowering effect [21].


In addition to its role as a natural hormone, testosterone is used as a medication, for instance in the treatment of low testosterone levels in men and breast cancer in women.[10] Since testosterone levels decrease as men age, testosterone is sometimes used in older men to counteract this deficiency. It is also used illicitly to enhance physique and performance, for instance in athletes.
Trials of testosterone treatment in men with type 2 diabetes have also taken place. A recent randomized controlled crossover trial assessed the effects of intramuscular testosterone replacement to achieve levels within the physiological range, compared with placebo injections in 24 men with diabetes, hypogonadism and a mean age of 64 years (Kapoor et al 2006). Ten of these men were insulin treated. Testosterone treatment led to a significant reduction in glycated hemoglobin (HbA1C) and fasting glucose compared to placebo. Testosterone also produced a significant reduction in insulin resistance, measured by the homeostatic model assessment (HOMA), in the fourteen non-insulin treated patients. It is not possible to measure insulin resistance in patients treated with insulin but five out of ten of these patients had a reduction of insulin dose during the study. Other significant changes during testosterone treatment in this trial were reduced total cholesterol, waist circumference and waist-hip ratio. Similarly, a placebo-controlled but non-blinded trial in 24 men with visceral obesity, diabetes, hypogonadism and mean age 57 years found that three months of oral testosterone treatment led to significant reductions in HbA1C, fasting glucose, post-prandial glucose, weight, fat mass and waist-hip ratio (Boyanov et al 2003). In contrast, an uncontrolled study of 150 mg intramuscular testosterone given to 10 patients, average age 64 years, with diabetes and hypogonadism found no significant change in diabetes control, fasting glucose or insulin levels (Corrales et al 2004). Another uncontrolled study showed no beneficial effect of testosterone treatment on insulin resistance, measured by HOMA and ‘minimal model’ of area under acute insulin response curves, in 11 patients with type 2 diabetes aged between 33 and 73 years (Lee et al 2005). Body mass index was within the normal range in this population and there was no change in waist-hip ratio or weight during testosterone treatment. Baseline testosterone levels were in the low-normal range and patients received a relatively small dose of 100 mg intramuscular testosterone every three weeks. A good increase in testosterone levels during the trial is described but it is not stated at which time during the three week cycle the testosterone levels were tested, so the lack of response could reflect an insufficient overall testosterone dose in the trial period.
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