At the National Population and Family Development Board in Malaysia, men between the ages of 31 and 52 were given two capsules of the herb (E. longifolia) in Andro400 every day for three weeks. They reported erections were stronger and, in some cases, lasted longer. Overall, they felt more virile. Their levels of testosterone doubled within three weeks.5
Well, this is another area of confusion and great debate, but I don’t think it’s as confusing as it appears to be in the literature. When most doctors learned about testosterone in medical school, they learned about total testosterone, or all the testosterone in the body. But about half of the testosterone that’s circulating in the bloodstream is not available to the cells. It’s tightly bound to a carrier molecule called sex hormone–binding globulin, which we abbreviate as SHBG.

Ashwagandha is sometimes included in testosterone supplements because of the hypothesis that it improves fertility. However, we couldn’t find sufficient evidence to support this claim (at best, one study found that ashwagandha might improve cardiorespiratory endurance). WebMD advocates caution when taking this herb, as it may interact with immunosuppressants, sedative medications, and thyroid hormone medications.
Caffeine. Use caffeine moderately. Too much of the jittery juice increases cortisol, which decreases testosterone. Moreover, consuming caffeine late in the day hurts sleep, which lowers testosterone production. But one recent study indicates that caffeine consumed before working out may boost testosterone levels and help you exercise more efficiently. During my experiment I popped a piece of caffeinated gum five minutes before my workouts. Each piece had 100 mg of caffeine, about the same amount in a cup of coffee. That was usually it for my caffeine intake that day.

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The science backs up the soldier’s self discovery, in fact, exposure to radiation (whether it’s from an army radar or the cell phone in your pocket, or the wifi router in your house) has been shown to lower sperm quality, fertility and testosterone. This is true not only for military personnel (88, 89,90) but all males living in a modern world (91).
Feeling low energy, lack of enthusiasm, but not so much on the sexual side, seems okay. At age 63 started an exercise program. nothing seem to help bring me back, so had my blood test at age 64. 150. 6 months later 165. My doctor started me on testosterone patches after a heart and prostate exam. Now two months into program, now using the gel, there seems little change. Disappointed. I am guess my next blood test will show less than 200. I am disappointed sufficiently to decide not to continue the program. I mean, the drugs cost $500 a month, although my cost is less. I guess my question is if I quit the program, will my body return to its normal, or will it be worse. i can live with a low normal, but less would not not be acceptable.
A: Testosterone products can improve a male's muscle strength and create a more lean body mass. Typically, these effects are not noticed within the first two weeks of therapy, but it is possible that he is more sensitive and responds well to the therapy. Some of the other more common side effects of testosterone patches are headache, depression, rash, changes in libido, acne, male pattern baldness, and increased cholesterol levels. This is not a complete list of the side effects associated with testosterone patches. Megan Uehara, PharmD
“I have seen them work for people,” says GP and hormonal therapy expert at Omniya London, Dr Sohere Roked. “I think sometimes people feel that it’s not a good thing to do or they’re just wasting their time taking it, but I have seen people who combine that with a good diet and exercise and have noticed a change in their physique, their energy, their mood, and the sort of things that testosterone would naturally help.”

Our bodies need zinc to make testosterone. Zinc also blocks the action of aromatase, the enzyme that converts testosterone to estrogen. Oysters offer the highest amount of zinc per serving of any food. Just six oysters contain about 500 percent of the mineral’s recommended daily allowance (RDA). Other zinc-rich foods include lean meats and spinach.
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.

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Actually he knows exactly what he is talking about. The fact your a doctor gives zero confidence that you have any knowledge in HRT, in fact I believe it where you wonderful doctors that started the larger opioid epedemic the world has ever seen. Make sure if your considering HRT you see a doctor that specializes in it, otherwise you very well could be getting terrible advice by a doctor with no knowledge of the subject as is the case here. Do your research on the doctor, and make sure you are getting a doctor that specializes in HRT. Don’t forget somebody had to finish at the bottom of the class in med school, and based on this doctors comments he probably was one of them. Doctors can be as dangerous as they are helpful; as we have seen quite clearly with the opioid epidemic being experienced in this country, as I mentioned above. This epidemic was caused 100% by doctors in this country. I own several HRT clinics and employ some of the top doctors in the HRT field. Our doctors put our patients health above all else especially above the all mighty dollar. I assure you the comment by this Dr. claiming the post above makes absolutely no sense (I believe it makes no sense to him, because he has zero knowledge on the subject) is dead wrong, and the poster was pretty much right on point with what he said.
Testosterone is the main hormone associated with muscle mass, strength gains, and libido. But that's far from the only thing it does in the body. As Chris Lockwood, Ph.D., explains in the article "All About Testosterone," it impacts everything from mood and memory to bone health—but yes, to be clear, it also makes muscles bigger and stronger, and helps increase endurance and athletic performance.
The FDA approved testosterone therapy only for men having a low testosterone (hypogonadism) as the result of a diagnosed medical condition (ie, genetic defects), or as a side effect of cancer chemotherapy.3 However, testosterone frequently has been prescribed off-label to men who have had no diagnosed medical condition, other than an age-related decrease in circulating testosterone, also known as “low T”.
These researchers took saliva samples from recreational women athletes before and after playing 10 minutes of flag football. The data showed that this short, intense burst of competitive sport triggered the immediate release of testosterone. Interestingly, the subjects' mental state also contributed to the data. Self-rated performance scores were directly related to testosterone levels.
Statins are some of the most prescribed drugs in the world for reducing cholesterol levels and preventing heart disease. Various studies in the 1990s, including a study published in the ‘European Journal of Clinical Nutrition,’ supported the claim that Fenugreek could help reduce cholesterol levels[2]. One possible explanation is the high fiber content in fenugreek.  A fiber-rich diet has been shown to help reduce the levels of LDL (‘bad’ cholesterol) in your blood. (Note: The validity of the various studies from the 1990s have been questioned though because of small sample sizes[3])
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]
Get some sun – I know many people say you should avoid the sun like a vampire unless you want to get skin cancer but we actually do need some sunlight. This is because the sun is the best source of vitamin D which plays a huge role in testosterone production and other bodily functions. Keep your sun exposure in moderation but do not avoid it altogether.
Before we go any further, know that fenugreek is an herb of Asian origin, commonly used in Indian cuisine.  The Indians have been consuming it as an aphrodisiac and an herbal cure-all for centuries which might explain why that waiter in your local Indian restaurant is always smiling. As it turns out, there is actually some validity to the purported claims.
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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!
Overseas right now, and have an appointment in a few days to get all my levels checked. BTW, I want to just throw this out there. There are a number of companies that are selling “legal pro-hormones” or “test boosters”. I used several types. They were banned several times, and re-introduced, and ultimately have no real FDA oversight. Specifically LG Sciences, and a couple of others I tried. They do work, you will see gains, and quickly. You will gain a lot of water weight. You will get angry. You will eventually damage your liver no matter what their advertising tells you. I had a general physical, and my doctor thought I was an alcoholic…when I do not drink, he was shocked. I’ve flushed it all down the toilet, and the doc said to trim down the powdered supplements as well, as they can be very harmful. So….please heed my warning, that stuff will hurt you.

Looking for ingredients that work in the realm of supplements can be like finding a needle in a haystack. Testosterone boosters, like all dietary supplements, are not approved by the Food and Drug Administration prior to marketing. This lack of oversight dates back to the 1994 Dietary Supplement Health and Education Act (DSHEA), which stipulated that purveyors of supplements weren’t required to prove the safety of their products or the veracity of what’s on the labels to the FDA before listing them for sale. Often, there isn’t a lot of scientific backing behind an ingredient, or research has been done solely on animals, not humans.
Testosterone levels naturally rise in response to sexual arousal and activity. Men with higher levels of testosterone usually have greater sexual activity. Older men need more testosterone for libido and erectile function. But it’s important to note that erectile dysfunction is often due to other conditions or medications rather than low testosterone levels.
I turned 50 and noticed I had low energy and no desire to workout. I decided to try a testosterone enhancer. I bought these and upon taking them I felt immediate results. I then ordered 3 more bottles on the spot. It is truly amazing how much of a difference it has made in my strength and endurance. Not to mention stamina. I never would've guessed that anything would have such a noticeable positive effect on strength and energy. I am so impressed.
Actually he knows exactly what he is talking about. The fact your a doctor gives zero confidence that you have any knowledge in HRT, in fact I believe it where you wonderful doctors that started the larger opioid epedemic the world has ever seen. Make sure if your considering HRT you see a doctor that specializes in it, otherwise you very well could be getting terrible advice by a doctor with no knowledge of the subject as is the case here. Do your research on the doctor, and make sure you are getting a doctor that specializes in HRT. Don’t forget somebody had to finish at the bottom of the class in med school, and based on this doctors comments he probably was one of them. Doctors can be as dangerous as they are helpful; as we have seen quite clearly with the opioid epidemic being experienced in this country, as I mentioned above. This epidemic was caused 100% by doctors in this country. I own several HRT clinics and employ some of the top doctors in the HRT field. Our doctors put our patients health above all else especially above the all mighty dollar. I assure you the comment by this Dr. claiming the post above makes absolutely no sense (I believe it makes no sense to him, because he has zero knowledge on the subject) is dead wrong, and the poster was pretty much right on point with what he said.
Men who watch a sexually explicit movie have an average increase of 35% in testosterone, peaking at 60–90 minutes after the end of the film, but no increase is seen in men who watch sexually neutral films.[43] Men who watch sexually explicit films also report increased motivation, competitiveness, and decreased exhaustion.[44] A link has also been found between relaxation following sexual arousal and testosterone levels.[45]
That said, keep in mind that using leucine as a free form amino acid can be highly counterproductive as when free form amino acids are artificially administrated, they rapidly enter your circulation while disrupting insulin function, and impairing your body's glycemic control. Food-based leucine is really the ideal form that can benefit your muscles without side effects.
This evidence, together with the beneficial effects of testosterone replacement on central obesity and diabetes, raises the question whether testosterone treatment could be beneficial in preventing or treating atherosclerosis. No trial of sufficient size or duration has investigated the effect of testosterone replacement in primary or secondary prevention cardiovascular disease. The absence of such data leads us to examine the relationship of testosterone to other cardiovascular risk factors, such as adverse lipid parameters, blood pressure, endothelial dysfunction, coagulation factors, inflammatory markers and cytokines. This analysis can supply evidence of the likely effects of testosterone on overall cardiovascular risk. This has limitations, however, including the potential for diverging effects of testosterone on the various factors involved and the resultant impossibility of accurately predicting the relative impact of such changes.
Made many mistakes growing up. Late highschool, small group of guys tried Testosterone and obviously it worked great on all levels especially on the football field etc. College years we did it again and again but not anywhere near the levels of body builders we knew and saw at the gym. When it became harder to find, then….. poof it became “legal” in the form of Pro-hormones. Great right? Not so. It worked but it also worked on everything else in a negative way. Mainly liver toxicity that I noticed and just the general idea of not really knowing what was in it. When I was 38 I had a bad event with diverticulitis. I was hospitalized for 4 days and it was horrible. This is in an infection in a diverticula that forms in your intestines. It was so bad and fast that it spread with a rapid onset of epididymitis ( infection on the epididymis of your testical). After the hospital I went see my gastro who was a board member of a large anti aging group of doctors. We did bloodwork and My testosterone levels were lower than a woman! Like 110. He also explained to me that I had probably never fully recovered normal test levels from my last “get in shape” run with pro hormones 2 years before and it probably played a part in the weakening of my intestinal wall and immune system and after discussion I realized that I had exhibited all of the text book effects of low T to the letter. After spilling my guts to my doctor we decided upon the gel. It worked great but having kids around I was worried about it affecting them so we switched to in ejections taken every 2 weeks of cypionate 200mg and my wife helps me with that at home and I never stray from the regime . My levels are around 700 to 750 and basically PSA that is non existent. I am now 41 and feel great , go to Doctor twice a year for bloodwork and all is well. My doctor also tells me that in his opinion our environmental factors play a huge role in this, meaning hormones in meats, milks, public water etc. and because of that together with “Poor decision making (me in highschool, college etc) America is in the midst of an epidemic that is being under advertised and overlooked. I constantly read up on the latest info I can find and I liked reading this and your posts. Sometimes I feel guilty because I get comments on how I look and my energy levels and I wonder is this too good to be true? But if I am following a strict regiment and bloodwork reports good things…. Do I need to worry about anything else??? This is my story and I have never shared it with ANYONE other than my wife. Big move for me!! Last point……. This is a generalization but…….all women take hormones. It’s is universally accepted and part of a woman’s life without a doubt. Why is it Taboo to publicly discuss men and hormones? I guarantee if you are a man 35 and above and you did dumb things like me and or exhibit symptoms of low T, do yourself a huge favor and go see a doctor and get blood work done. More than likely you have it! I still hide all of this and I don’t want to shout it out because I feel embarrassed. WHY? Enough already!!!!
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 may increase competitiveness. Men are known to be a competitive bunch and testosterone is likely responsible for our drive to win. Testosterone is linked with a man’s desire for power and status (Dabbs & Dabbs 2000). Testosterone ramps up before a fight or competition – producing effects on muscle mass and hemoglobin, quickening reactions, improving visual acuity, and increasing your feelings of endurance and indomitability. It also increases your “gameness:” One study showed that a man’s testosterone level after losing a game predicted whether or not he got back in for another round. Men who experienced a severe drop were less likely to play again, while men who experienced little or no drop in T levels got back into the game. Researchers concluded from this observation that T is one of the factors driving competitiveness in men.
A4M, which stands for “The American Academy of Anti-Aging Medicine” is dedicated to the advancement of tools, technology, and transformations in healthcare that can detect, treat, and prevent diseases associated with aging. They promote the research of practices and protocols that have the potential to optimize the human aging process. The organization is also dedicated to educating healthcare professionals and practitioners, scientists, and members of the public on biomedical sciences, breakthrough technologies, and medical protocols through our advanced education entity: Metabolic Medical Institute (MMI). Their event in Vegas each year is, in my opinion, well worth checking out.
Clinical trials of the effect of testosterone on glucose metabolism in men have occurred in diabetic and non-diabetic populations. Data specific to aging males is not available. A series of studies investigated the effects of testosterone or dihydrotestosterone given for 6 weeks or 3 months to middle aged, non-diabetic obese men (Marin, Holmang et al 1992; Marin, Krotkiewski et al 1992; Marin et al 1993). It was found that physiological treatment doses led to improved insulin resistance, as measured by the gold standard technique using a euglycemic clamp and/or serum glucose and insulin responses during glucose tolerance test. These improvements were associated with decreased central obesity, measured by computered tomography (CT) or waist-hip ratio, without reduced total fat mass. Insulin resistance improved more with testosterone than dihydrotestosterone treatment and beneficial effects were greater in men with lower baseline testosterone levels. Increasing testosterone levels into the supraphysiological range lead to decreased glucose tolerance.

The hormone also plays a role in sex drive, sperm production, fat distribution, red cell production, and maintenance of muscle strength and mass, according to the Mayo Clinic. For these reasons, testosterone is associated with overall health and well-being in men. One 2008 study published in the journal Frontiers of Hormone Research even linked testosterone to the prevention of osteoporosis in men.


DHEA (dehydroepiandrosterone) extract - this is a chemical that used in your body which a ‘hormone precursor’. This means it’s the chemical used by the body to create hormones like oestrogen or testosterone. When taken as supplement it is believed to boost testosterone levels, but DHEA has not been shown to increase testosterone in men. DHEA comes in two form:
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. 🙂
Eggs often come up in reproductive health discussion. This time we’re talking about dietary eggs, as in omelets, and the role they play in boosting testosterone. The hormone boost from eggs comes primarily from the yolks, which are rich in dietary cholesterol, mono- and saturated fats—nutrients once demonized by health experts that have since proven to positively influence waistlines and hormone-health.

Fenugreek is an enigma, deep-fried in a mystery, and wrapped in secrecy. It can actually LOWER your testosterone levels while simultaneously increasing your libido and athletic performance, 2 effects that correlate with elevated testosterone levels.  Strange.  This is the first supplement I have come across that might have the opposite of the desired effect, and yet be worth taking anyway.
^ Butenandt A, Hanisch G (1935). "Uber die Umwandlung des Dehydroandrosterons in Androstenol-(17)-one-(3) (Testosterone); um Weg zur Darstellung des Testosterons auf Cholesterin (Vorlauf Mitteilung). [The conversion of dehydroandrosterone into androstenol-(17)-one-3 (testosterone); a method for the production of testosterone from cholesterol (preliminary communication)]". Chemische Berichte (in German). 68 (9): 1859–62. doi:10.1002/cber.19350680937.

If you’re an older man with low testosterone and interested in taking testosterone, this decision should be carefully considered with your physician. Your physician will be able to better assess the balance of your conditions and whether hormone replacement could put you at potential risk. It's a bad idea for anybody to engage in hormone supplementation without the supervision of a physician. Just because hormones occur naturally in the body does not mean that they can be taken without negative effects.
Discussing the clinical utility of these findings, Dr. Budoff told EndocrineWeb, “in the short-term, I am going to check my patients for atherosclerosis before instituting testosterone therapy. We still need a definitive study to show whether or not heart attacks are increased by supplemental testosterone, but advancing atherosclerosis is not a good thing. These results should make us more cautious about whom we treat and what doses we use.”
Ginger rhizome powder was reported to posses an antioxidant and androgenic activity in doses of 50 mg/kg and 100 mg/kg daily [1]. Ginger administration significantly increased serum testosterone levels at 100 mg/kg [1]. There was also an increases in testosterone at 50 mg/kg daily but it failed to reach statistical significance [1]. A study by Kamtchouing et al. [2] also reported significantly increased serum and testicular testosterone levels as well as increase in weight of the testis and testicular cholesterol level in healthy rats. Another study using doses of 500 mg/kg and 1000 mg/kg indicated that extract of Zingiber officinale possesses pro-fertility properties [3]. Compared with the controls there was a dose and duration dependent increases in the serum testosterone levels and seminal quality [3]. At a very high dose (2000 mg/kg for 35 days), ginger led to slightly reduced weights of testes which might be due to negative feedback reaction from androgenic activity [4]. Combination of ginger and zinc appears to further increase testosterone in rats [24].
The study population in these TTrials included men aged 65 years or older with mean morning serum testosterone concentrations of 275 ng/dL or less and symptoms of impaired sexual function, physical function, or vitality. These trials were placebo-controlled and the testosterone treatment group received 1% testosterone gel at variable doses adjusted to maintain plasma testosterone at levels normal for young men (500-800 ng/dL).

When you’re under stress (be it from lack of sleep, workplace stress, emotional stress, stress from a bad diet, overtraining etc.), your body releases cortisol. Cortisol blunts the effects of testosterone (47), which makes sense from an evolutionary point of view – if we were stressed as cavemen chances are it was a life or death situation – not running late to a meeting - in this state (i.e. running from a lion) the body wouldn’t care if you couldn’t get it up, there was more to worry about!
Forged Methyl EAA stands out as it has a special concentrated derivative of D-Aspartic Acid (DAA) which is touted as being 50 times more effective than normal DAA. The formula is so strong that Transform supplements had to put an estrogen blocker as when your testosterone levels get boosted very high, your body will start to convert it to estrogen. It comes with a hefty price tag but many users have considered it to be hands down the strongest on the market.

One thing that is often overlooked when it comes to testosterone boosters is the dosing. Test boosters aren’t like other supplements where you can just take the one dosing per day and forget about until the next day. As with any supplement, it only stays in your system for 4-8 hours. This means you need to be taking more than one dose per day. 2 doses are better but it still is not enough. If you want to keep your test levels up all day you will need to be taking at least 3 and preferably 4 doses per day to keep your testosterone levels high throughout the day and to keep them from dropping between doses. You should also be sure to take them every day and try to not miss any doses to get the most out of them.

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.


Nutritional developers formulated Nugenix® with Testofen®, a key natural ingredient to help boost “free” testosterone along with resistance training. This key ingredient is carefully extracted from the fenugreek plant. A Testofen® study in Irvine, California indicated positive free testosterone-related results. Nugenix also includes L-Citrulline Malate, Tribulus, Zinc, plus Vitamins B6 and B12 to help promote overall health and performance.*
I was depressed, getting fat, and zero libido. My doc did a full blood work up. My Total Testosterone level was 289 ng/dl. He offered TRT but I declined because I knew, at 53, that if I went on TRT my own testosterone production would shut down and at my age I would have a pretty difficult time kick starting it up again. I researched and researched for about a month. I started on Vitamin D 10,000 iu per day ( I knew this was a safe amount because I tested at 26ng/dl and optimum level is anywhere between 40-80ng/dl. I also took 1,200 mg of magnesium, 9mg of Boron and Vitamin K Complex. Tested again 3 months later and blood work showed I was at 720.
Are you getting enough vitamin D? Vitamin D is an essential nutrient, but it can be difficult for people to know if they are getting the right amount. Some people will be able to get enough vitamin D from sunlight. Others may need to make dietary changes or take supplements. Here, we explain how to get vitamin D from sunlight, food, and supplements. Read now
Garlic is a very effective food that has been used for centuries in treating various physical ailments including heart problems and respiratory infections. What most people don’t know is that it is also a potent aphrodisiac and very effective in boosting sperm volume. It contains a compound called allicin which improves blood flow to the male sexual organs, increasing sperm production and semen volume.
Boron, a mineral, keeps the cell walls of plants strong. Eating dried fruits and nuts gives you abundant amounts of boron. You can also take boron supplements. It's important to keep your daily boron intake at less than 20 mg, however, according to a current factsheet available from the U.S. National Library of Medicine. High doses of boron can cause serious side effects such as skin inflammation and peeling, irritability, tremors or depression.
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.
There is a polymorphic CAG repeat sequence in the androgen receptor gene, which codes for a variable number of glutamine amino acids in the part of the receptor affecting gene transcription. A receptor with a short CAG sequence produces greater activity when androgens attach, and men with shorter CAG polymorphisms exhibit androgenic traits, such as preserved bone density (Zitzmann et al 2001) and prostate growth during testosterone treatment (Zitzmann et al 2003). Indirect evidence of the importance of androgens in the development of prostate cancer is provided by case control study findings of a shorter, more active CAG repeat sequence in the androgen receptor gene of patients with prostate cancer compared with controls (Hsing et al 2000, 2002).
The diagnosis of late-onset hypogonadism requires the combination of low serum testosterone levels with symptoms of hypogonadism. Questionnaires are available which check for the symptoms of hypogonadism. These have been validated for the assessment of aging patients with hypogonadism (Morley et al 2000; Moore et al 2004) but have a low specificity. In view of the overlap in symptoms between hypogonadism, aging and other medical conditions it is wise to use a formal method of symptom assessment which can be used to monitor the effects of testosterone replacement.
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