The Organon group in the Netherlands were the first to isolate the hormone, identified in a May 1935 paper "On Crystalline Male Hormone from Testicles (Testosterone)".[184] They named the hormone testosterone, from the stems of testicle and sterol, and the suffix of ketone. The structure was worked out by Schering's Adolf Butenandt, at the Chemisches Institut of Technical University in Gdańsk.[185][186]
The bogus products that have been draining your wallet and fattening the bank accounts of supplement companies are the so-called “natural testosterone boosters.” Billed as the saving grace to your low testosterone levels, poor body composition, and pitiful strength levels, natty test boosters were viewed by consumers as the answer to everything that was wrong.
Fifteen home remedies for acne Many home remedies can help people reduce their acne by treating oily skin, killing bacteria, and providing antioxidants. Natural treatments that reduce acne flare-ups include aloe vera gel, honey, and tea tree oil. Learn about 15 natural home remedies and how to use them to improve acne, pimples, and oily skin here. Read now

Oral/buccal (by mouth). The buccal dose comes in a patch that you place above your incisor (canine or "eyetooth"). The medication looks like a tablet but you should not chew or swallow it. The drug is released over 12 hours. This method has fewer harmful side effects on the liver than if the drug is swallowed, but it may cause headaches or cause irritation where you place it.


Sprinting has been shown numerous times that it has positive effects on testosterone levels. One 2011 study (ref 84) looked at weightlifters who performed 4x35m sprints twice a week. In contrast to the control group (who continued lifting but did not sprint), it was found that “After the 4-week training program, total testosterone and the total testosterone/cortisol ratio increased significantly in the (sprinters) EXP group”.
The amount of testosterone synthesized is regulated by the hypothalamic–pituitary–testicular axis (see figure to the right).[133] When testosterone levels are low, gonadotropin-releasing hormone (GnRH) is released by the hypothalamus, which in turn stimulates the pituitary gland to release FSH and LH. These latter two hormones stimulate the testis to synthesize testosterone. Finally, increasing levels of testosterone through a negative feedback loop act on the hypothalamus and pituitary to inhibit the release of GnRH and FSH/LH, respectively.

I am 31, been on HRT for about 6 months now. Started with Oxandralone (orally, 3 x 10mg tablets per day) and found a 20-30% increase in strength and outlook on life. Stopped taking it and now use Primo Testostin Depot (test enanthate – 1 x 250mg shot every 2 weeks). In the first week I feel a lot stronger, voice deepens etc but these benefits quickly diminish after about 5-7 days
If you are serious about losing weight, you have got to strictly limit the amount of processed sugar in your diet, as evidence is mounting that excess sugar, and fructose in particular, is the primary driving factor in the obesity epidemic. So cutting soda from your diet is essential, as is limiting fructose found in processed foods, fruit juice, excessive fruit and so-called "healthy" sweeteners like agave.
In accordance with sperm competition theory, testosterone levels are shown to increase as a response to previously neutral stimuli when conditioned to become sexual in male rats.[40] This reaction engages penile reflexes (such as erection and ejaculation) that aid in sperm competition when more than one male is present in mating encounters, allowing for more production of successful sperm and a higher chance of reproduction.
Use of this web site acknowledges users agreement to the terms of use and privacy policies associated with this web site. The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional or any information contained on or in any product label or packaging. You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. You should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem. You should not start or stop taking any medication without first consulting your physician. No prescription will be provided unless a clinical need exists based on required lab work, physician consultation, physical examination, and current medical history. Please note agreeing to lab work and physical exam does not guarantee a finding of clinical necessity or prescription for hormone therapy including Testosterone, HCG or HGH. The statements on this website have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. No claim or opinion on this website is intended to be nor should it be construed to be medical advice or a hormone diagnosis.

For this reason I recommend doing your own research on this supplement before taking it. 5g of ground up dried powder is what was used in the studies. I recommend taking 1-2 capsules of the concentrated form from Paradise Herbs. Alternatively, the Aggressive Strength Test Booster also has MP in its formula so you may prefer to use that blend instead. 
Testosterone is necessary for normal sperm development. It activates genes in Sertoli cells, which promote differentiation of spermatogonia. It regulates acute HPA (hypothalamic–pituitary–adrenal axis) response under dominance challenge.[22] Androgen including testosterone enhances muscle growth. Testosterone also regulates the population of thromboxane A2 receptors on megakaryocytes and platelets and hence platelet aggregation in humans.[23][24]
Vitamin D and zinc are both essential to testosterone production. A year-long study looked at the vitamin D and testosterone levels of 2299 men. It found that men with vitamin D levels above 30 nmol/L had more testosterone and lower levels of sex hormone-binding globulin (SHBG). SHBG binds to hormones so your cells can’t use them, and if you have too much of it, your testosterone levels drop [8]. Men with vitamin D deficiency had lower testosterone and higher SHBG levels.

A large number of trials have demonstrated a positive effect of testosterone treatment on bone mineral density (Katznelson et al 1996; Behre et al 1997; Leifke et al 1998; Snyder et al 2000; Zacharin et al 2003; Wang, Cunningham et al 2004; Aminorroaya et al 2005; Benito et al 2005) and bone architecture (Benito et al 2005). These effects are often more impressive in longer trials, which have shown that adequate replacement will lead to near normal bone density but that the full effects may take two years or more (Snyder et al 2000; Wang, Cunningham et al 2004; Aminorroaya et al 2005). Three randomized placebo-controlled trials of testosterone treatment in aging males have been conducted (Snyder et al 1999; Kenny et al 2001; Amory et al 2004). One of these studies concerned men with a mean age of 71 years with two serum testosterone levels less than 12.1nmol/l. After 36 months of intramuscular testosterone treatment or placebo, there were significant increases in vertebral and hip bone mineral density. In this study, there was also a significant decrease in the bone resorption marker urinary deoxypyridinoline with testosterone treatment (Amory et al 2004). The second study contained men with low bioavailable testosterone levels and an average age of 76 years. Testosterone treatment in the form of transdermal patches was given for 1 year. During this trial there was a significant preservation of hip bone mineral density with testosterone treatment but testosterone had no effect on bone mineral density at other sites including the vertebrae. There were no significant alterations in bone turnover markers during testosterone treatment (Kenny et al 2001). The remaining study contained men of average age 73 years. Men were eligible for the study if their serum total testosterone levels were less than 16.5 nmol/L, meaning that the study contained men who would usually be considered eugonadal. The beneficial effects of testosterone on bone density were confined to the men who had lower serum testosterone levels at baseline and were seen only in the vertebrae. There were no significant changes in bone turnover markers. Testosterone in the trial was given via scrotal patches for a 36 month duration (Snyder et al 1999). A recent meta-analysis of the effects on bone density of testosterone treatment in men included data from these studies and two other randomized controlled trials. The findings were that testosterone produces a significant increase of 2.7% in the bone mineral density at the lumber spine but no overall change at the hip (Isidori et al 2005). These results from randomized controlled trials in aging men show much smaller benefits of testosterone treatment on bone density than have been seen in other trials. This could be due to the trials including patients who are not hypogonadal and being too short to allow for the maximal effects of testosterone. The meta-analysis also assessed the data concerning changes of bone formation and resorption markers during testosterone treatment. There was a significant decrease in bone resorption markers but no change in markers of bone formation suggesting that reduction of bone resorption may be the primary mode of action of testosterone in improving bone density (Isidori et al 2005).
Cruciferous vegetables like broccoli are rich in indoles, anti-cancer compounds that indirectly boost testosterone production by breaking down and flushing the system of excess estrogen, which inhibits the production of male sex hormones. As men age, their estrogen levels gradually rise, while testosterone levels fall. Indoles can help strike the balance. In one study, supplementing with indole-3-carbinol from cruciferous vegetables for just 7 days cut the estrogen hormone estradiol in half for men. Another study found indole supplementation significant increased urinary excretion of estrogens among men.
On review of the patient’s history, he was found to have undergone laboratory tests before starting to use the aforementioned testosterone booster product. All blood parameters (testosterone hormone and full chemical profile) before product intake were in the normal range. A physical examination that included blood pressure and pulse assessments showed nothing out of the ordinary, and the man appeared to be in good condition before product consumption. After that medical checkup, the athlete began to consume the product for 42 continuous days divided into 2 cycles (each cycle comprised 24 days). The daily dose was a single pack of Universal Nutrition Animal Stak (ingredients are listed in Table 1), following the exact direction of the manufacturing company hoping to get the best results.
But can testosterone replacement therapy help with heart disease? Study results are mixed. Small studies in the early 2000s found that men with heart disease who underwent testosterone therapy saw only slight improvements. Some were able to increase their walking distance by 33 percent. Another study found that hormone therapy only widened healthy arteries but had no effect on angina pain.
The bones and the brain are two important tissues in humans where the primary effect of testosterone is by way of aromatization to estradiol. In the bones, estradiol accelerates ossification of cartilage into bone, leading to closure of the epiphyses and conclusion of growth. In the central nervous system, testosterone is aromatized to estradiol. Estradiol rather than testosterone serves as the most important feedback signal to the hypothalamus (especially affecting LH secretion).[119] In many mammals, prenatal or perinatal "masculinization" of the sexually dimorphic areas of the brain by estradiol derived from testosterone programs later male sexual behavior.[120]
Vitamin D3. Vitamin D3 actually isn’t a vitamin, it’s a hormone — a really important hormone that provides a whole host of health benefits. Our bodies can naturally make vitamin D from the sun, but recent studies have shown that many Westerners are vitamin D3 deprived because we’re spending less and less time outdoors. When we do decide to venture outside, we slather our bodies with sunscreen, which prevents the sun reaching our skin to kick-off vitamin D3 production. If you’re not getting enough sun, you may have a vitamin D3 deficiency, which may contribute to low T levels. If you think you need more vitamin D3, supplement it with a pill. Studies have shown that men who take this supplement see a boost in their testosterone levels. Because I have a darker complexion — which makes me prone to Vitamin D3 deficiency — I took 4,000 IU of vitamin D3 in the morning.
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In non-human primates, it may be that testosterone in puberty stimulates sexual arousal, which allows the primate to increasingly seek out sexual experiences with females and thus creates a sexual preference for females.[39] Some research has also indicated that if testosterone is eliminated in an adult male human or other adult male primate's system, its sexual motivation decreases, but there is no corresponding decrease in ability to engage in sexual activity (mounting, ejaculating, etc.).[39]

In decades past, this essentially meant that once your body hit a certain age, it no longer kept up with the young at heart. Luckily, today there is a variety of solutions to combat declining testosterone levels, including Test Boosters, dietary supplements which are formulated to help naturally stimulate the body’s production of testosterone. Sounds good, but not sure where to start? We’ve compiled the Top 10 Test Boosters for 2018 to help you make the best choice.
Hi my names Graham. I’ve suffered with Gyno for most of my adult life. Even when I’ve lost a ton of weight , those two unhelpful bags of fat are still there. To save me 4 to 6 grand on liposuction or surgery, will an estrogen blocker and testosterone booster help. I’ve also heard of a cream called andractim that can help , but they are expensive. Any advice would be great . Thanks.
It goes without saying that what you eat significantly influences your hormone balance and body composition. This is nothing new. There are countless athletes and bodybuilders who are paying a close attention to what they eat for a reason. For example, if you consume a lot of so-called junk food, then you inevitably end up with a poor nutritional profile. In plain English, you can forget about a six-pack and the high testosterone.
14. Volek JS, Volk BM, Gómez AL, Kunces LJ, Kupchak BR, Freidenreich DJ, Aristizabal JC, Saenz C, Dunn-Lewis C, Ballard KD, Quann EE, Kawiecki DL, Flanagan SD, Comstock BA, Fragala MS, Earp JE, Fernandez ML, Bruno RS, Ptolemy AS, Kellogg MD, Maresh CM, Kraemer WJ. Whey protein supplementation during resistance training augments lean body mass. J Am Coll Nutr. 2013;32(2):122-35. PMID: 24015719
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.

This study [9] also reported significantly increased glutathione levels. Glutathion has been shown to have a synergetic effect with l-citrulline as their combination further increases nitrate and nitrite levels and contributes to the sustained release of NO. While some previous studies have indicated that glutathione stimulates L-arginine turnover and increases nitric oxide synthase (NOS).


I am 56 and I have been taking 100 mg of Test Cyp IM once a week for the last 4 months. My total T fluctuates between 500 and 1000 and my E2 has been staying under 30 with the help of Arimidex 0.5 mg every 3.5 days. I do not know what my free T is due to the expense but I feel much better than I did. Not great but much better so I will continue. If you are not feeling good on TRT then you should have your E2 checked because it is probably over 30 which will counteract the effects of your free T.
The IOM report estimated that a study of whether there is an increased risk of prostate cancer in men on testosterone therapy might require following 5,000 men for three to five years. Before launching such an endeavor, the report recommended more firmly establishing the effectiveness of testosterone-replacement therapy, saying that studies of long-term risks and benefits should be conducted only after short-term efficacy has been proven. That means the male equivalent of the WHI remains far off.
61y/o with 18month progressive lethargy, depressed mood, no sex drive, no erections. Doc put me on cymbalta (slept even more than 14hrs daily) then on Wellbutrin. All the time I was pushing for T testing. Came back low in March of this year and put on IM cypionate 100mg q3 weeks. Even I knew that was too low and infrequent. Nonetheless, that how it’s been since April. Finally got urology consult in Shreveport and got a level done at that time. Was 127 just two weeks after last injection. He is going to bump me up to 300mg q2 weeks and do a level 2 days after first injection and 1 day before next shot. Since I’m getting care thru VA, it’s a waiting game. Saw urologist last week. Prob won’t see testostosterone in mail for another week or two. I’m excited to feel like living again, not sleeping all the time, and perhaps some nooky now and then . Appreciated this article arm subsequent posts and personal trials. Would love to find a competent and assertive urologist in my area of Louisiana. I’m around Monroe….so if you know one, let me know!
The doctor regularly measured my levels to be sure they were within the normal range for a male my age. In other words, I wasn’t taking ‘roids to get big; I was getting control of hormones that were not functioning well. This is how you should look at testosterone therapy – it is a gentle nudge to help you be in normal ranges, not a big push to get you huuu-yge. If you’re like me, you want “normal ranges” of a 27-year-old, not of a 60-year-old. It’s my plan to keep my testosterone where it is now (around 700) no matter what it takes. Right now, the Bulletproof Diet and the other biohacks I’ve written about do that! I’m 43.
Great product. I'm a 41 yearold and found myself with low energy constantly. Since taking these pills I'm more energized and don't get home from work and just sit around the house anymore. Bonus the wife has been loving the extra benefit that they are giving us. I never thought I had a problem in that area but since I started taking these I've noticed a way longer lasting performance time.

Jeff- I read your post and I can relate to your problem. Perhaps you’ve already received some help but I can tell you this much. I recovered from prostate cancer about 2 yrs ago. My oncologist is also a graduate of Harvard like the doc that wrote this article. He put me on Axiron about 8 months ago after I complained to him of symptoms similar to you. He has no concerns that the T will cause me to get prostate cancer again. I do my 4 month check ups and have my T tested at that time along with my PSA. Everything is normal so far. My T count was initially 50 and now I am in the low 300 range. The Axiron has gotten me back to normal and then some!! I’m 58 and I told him at my last appt that I feel like I’m 40.
The bogus products that have been draining your wallet and fattening the bank accounts of supplement companies are the so-called “natural testosterone boosters.” Billed as the saving grace to your low testosterone levels, poor body composition, and pitiful strength levels, natty test boosters were viewed by consumers as the answer to everything that was wrong.
Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder.[37]

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.
The steroid hormone known as dehydroepiandrosterone, DHEA, plays an important role in sexual behavior, mental health and muscle growth. Your body uses this hormone to make sex steroids. Thus, taking a DHEA supplement should increase your circulating testosterone. A 2018 paper in the International Journal of Sports Medicine explored this possibility in athletic women.
Workouts lasting longer than about an hour may begin to spike cortisol levels and subsequently decrease testosterone. Additionally, research has demonstrated that a shorter rest period between sets (1 minute versus 3 minutes) elicited higher acute hormonal responses following a bout of resistance training.11 To maximize your testosterone response, keep your rest periods short and total workout time to 60 minutes or fewer.
There are several supplements on the market claiming to be natural testosterone boosters. I get these sorts of things in the mail all time. The companies that produce these products claim that the herbs (typically stinging nettle and tribulus) in their pills increase free testosterone by reducing SHBG. They also throw in some B vitamins for “increased energy and vitality.”
Such sort of injuries varies in severity and extent of damage markedly from one person to the other and withdrawal of the drug/supplement coupled with proper medical attention suffice in terms of alleviating the symptoms.[8,12] This was observed in the present case. However, the liver injury observed here may not be confidently linked to product consumption as the subject later reported that the following recovery he consumed two more courses of the booster with no side effects. Tests performed following hospital discharge, and repeated use of the product showed AST and ALT to be slightly high, whereas the rest of the blood parameters tested appeared to be normal. The AST/ALT ratio is considered to be a very important parameter for the evaluation of liver diseases, such as non-alcoholic fatty liver disease,[13] though it is rarely considered alone. Overall, the evidence was inconclusive in the present work in terms of linking the use of a testosterone booster with liver injury. However, even though a single case report cannot establish causality with statistical power.[13] Further research on the usage of a commercial testosterone booster within large populations for a long period is necessary to investigate whether the symptoms shown in the present case were significantly present in other athletes consuming the same commercial product or not. To guarantee an optimal outcome with no severe side effects, further research is warranted to confirm the present findings and determine whether the effects observed in this case report would be statistically significant in larger samples.

If you're completely inactive, or if you're completely burned out from overly intense training, neither one is going to help your T-levels. And when it comes to nutrition, eating enough—and getting adequate dietary fats—are both essential for healthy testosterone levels, and for general health.[2] In "All About Testosterone," Chris Lockwood, Ph.D., notes that extreme low-calorie dieting and fasting will hinder testosterone levels from staying at their peak, along with better-known villains like chronic stress.
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.
Thanks for reaching out buddy. Sorry to hear about your situation. First off, what I’d suggest is to forget about creams, they are a waste of money unless you are trying to moisturize your body – which I guess you’re not. As for estrogen blockers, the same goes here – but testosterone boosters on the other hand, they work with your body instead of against it to give you everything your body is missing – it sounds like it’s the missing piece to your puzzle. Bear in mind Graham, you’ll need to pay close attention to your diet – aim to cut down on refined carbohydrates and simple sugars – these are terrible for testosterone production and weight gain. If you drink more water, eat a balanced diet, and exercise occasionally while supplementing with testofuel.com you’ll soon be back on track. All the best!
61y/o with 18month progressive lethargy, depressed mood, no sex drive, no erections. Doc put me on cymbalta (slept even more than 14hrs daily) then on Wellbutrin. All the time I was pushing for T testing. Came back low in March of this year and put on IM cypionate 100mg q3 weeks. Even I knew that was too low and infrequent. Nonetheless, that how it’s been since April. Finally got urology consult in Shreveport and got a level done at that time. Was 127 just two weeks after last injection. He is going to bump me up to 300mg q2 weeks and do a level 2 days after first injection and 1 day before next shot. Since I’m getting care thru VA, it’s a waiting game. Saw urologist last week. Prob won’t see testostosterone in mail for another week or two. I’m excited to feel like living again, not sleeping all the time, and perhaps some nooky now and then . Appreciated this article arm subsequent posts and personal trials. Would love to find a competent and assertive urologist in my area of Louisiana. I’m around Monroe….so if you know one, let me know!
Male hypogonadism becomes more common with increasing age and is currently an under-treated condition. The diagnosis of hypogonadism in the aging male requires a combination of symptoms and low serum testosterone levels. The currently available testosterone preparations can produce consistent physiological testosterone levels and provide for patient preference.

Looking at the ingredients and we see that they used a nice dose of D-Aspartic Acid which we have already talked about how much we like that. They also used a good dose of Fenugreek which boosts testosterone and enhances libido as well as Ginseng Extract which is a natural aphrodisiac. They also use Zinc Gluconate which is a solid testosterone booster and also has shown to be a bit of an aphrodisiac itself.

The mineral zinc is important for testosterone production, and supplementing your diet for as little as six weeks has been shown to cause a marked improvement in testosterone among men with low levels.1 Likewise, research has shown that restricting dietary sources of zinc leads to a significant decrease in testosterone, while zinc supplementation increases it2 -- and even protects men from exercised-induced reductions in testosterone levels.3
Carbs play a big part in determining your Testosterone levels. Let's start with what to avoid. First, research shows that a large serving of sugar (75g of glucose), decreased Testosterone levels by as much as 25%! (25 & 26). I know this is a pretty extreme dosage, but you may want to avoid massive servings of sugar! Also, men who have Metabolic syndrome have lower Testosterone levels (27). Metabolic syndrome is often brought about by chronic high blood sugar which leads to insulin resistance.
There are positive correlations between positive orgasm experience in women and testosterone levels where relaxation was a key perception of the experience. There is no correlation between testosterone and men's perceptions of their orgasm experience, and also no correlation between higher testosterone levels and greater sexual assertiveness in either sex.[34]
What makes TestoFuel different from other testosterone boosters on the market is that the company is constantly researching and updating the ingredients. So, you know you are getting a product that has been formulated using the latest clinical studies. Unlike most other companies that formulate a product and update it every 3 – 5 years or never at all.
February 22, 2018 - Since our last review, the manufacturers of two of our top picks have gone out of business, and some new testosterone boosters have entered the arena. We’ve updated this review to evaluate the current field of testosterone supplements, as well as beef up analysis on what kind of results you can expect from t-boosters. Our only current top pick, Beast Sports Nutrition, is a new player in the industry that contains all four of the ingredients with studies showing a positive effect on testosterone.
A sedentary lifestyle is another scourge for modern civilization. And this is a serious danger for men. After all, if physical activity is minimal, the testosterone levels will decrease steadily. And in this situation, strength training exercises are a proven method for raising testosterone. Thus, sports exercises always helped raise the levels of male sex hormone. As a result, the testosterone levels elevate after every workout.
Although it’s rare to see swelling caused by fluid retention, physicians need to be careful when prescribing testosterone to men with compromised kidney or liver function, or some degree of congestive heart failure. It can also increase the oiliness of the skin, so that some men get acne or pimples, but that’s quite uncommon, as are sleep apnea and gynecomastia (breast enlargement).
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.
Some studies have looked at testosterone therapy and cognition. Although the findings weren’t definitive, there was some evidence of cognitive improvement. Other studies have shown that it improves mood. Testosterone therapy has also been shown to be effective in the treatment of osteoporosis and in increasing muscle bulk and strength. [See “Testosterone’s impact on brain, bone, and muscle,” above.]
It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.

A number of epidemiological studies have found that bone mineral density in the aging male population is positively associated with endogenous androgen levels (Murphy et al 1993; Ongphiphadhanakul et al 1995; Rucker et al 2004). Testosterone levels in young men have been shown to correlate with bone size, indicating a role in determination of peak bone mass and protection from future osteoporosis (Lorentzon et al 2005). Male hypogonadism has been shown to be a risk factor for hip fracture (Jackson et al 1992) and a recent study showed a high prevalence of hypogonadism in a group of male patients with average age 75 years presenting with minimal trauma fractures compared to stroke victims who acted as controls (Leifke et al 2005). Estrogen is a well known determinant of bone density in women and some investigators have found serum estrogen to be a strong determinant of male bone density (Khosla et al 1998; Khosla et al 2001). Serum estrogen was also found to correlate better than testosterone with peak bone mass (Khosla et al 2001) but this is in contradiction of a more recent study showing a negative correlation of estrogen with peak bone size (Lorentzon et al 2005). Men with aromatase deficiency (Carani et al 1997) or defunctioning estrogen receptor mutations (Smith et al 1994) have been found to have abnormally low bone density despite normal or high testosterone levels which further emphasizes the important influence of estrogen on male bone density.

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