When I first started TRT, my physician prescribed a cream that you rub into your skin. The cream version of TRT is not too convenient, because if someone touches you while you have the cream on, the testosterone can rub off on him/her. This can be really bad around kids or pregnant women. If you’re sleeping next to someone, the cream can get on the sheets and transfer over that way, too. The cream can be annoying, but it works. There’s also a gel version called AndroGel; I skipped it because it doesn’t absorb as well as the cream does.

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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.
Grape seed extract is another ingredient with not enough research to suggest a dosage. Grape seed extract can interact with drugs like “blood thinners, NSAID painkillers (like aspirin, Advil, and Aleve), certain heart medicines, cancer treatments, and others.” If this sounds like you (or if you ever pop an Advil to clear off a headache), you’ll need to speak with a doctor to make sure this supplement is safe to take.
In the hepatic 17-ketosteroid pathway of testosterone metabolism, testosterone is converted in the liver by 5α-reductase and 5β-reductase into 5α-DHT and the inactive 5β-DHT, respectively.[1][155] Then, 5α-DHT and 5β-DHT are converted by 3α-HSD into 3α-androstanediol and 3α-etiocholanediol, respectively.[1][155] Subsequently, 3α-androstanediol and 3α-etiocholanediol are converted by 17β-HSD into androsterone and etiocholanolone, which is followed by their conjugation and excretion.[1][155] 3β-Androstanediol and 3β-etiocholanediol can also be formed in this pathway when 5α-DHT and 5β-DHT are acted upon by 3β-HSD instead of 3α-HSD, respectively, and they can then be transformed into epiandrosterone and epietiocholanolone, respectively.[157][158] A small portion of approximately 3% of testosterone is reversibly converted in the liver into androstenedione by 17β-HSD.[156]
Of course, testosterone’s primary function is to bring about secondary sexual characteristics in men. A healthy dose of testosterone is shown to treat conditions such as impotence. Men with fertility issues benefit from increased levels of testosterone in the body. The aging process slows down the rate of testosterone production by the adrenals and testes. It is irreversible and one of the only means to mediate the effects of low testosterone concentration is to include testosterone boosting agents in your regimen.
These berries are known to improve your overall stamina and mood. But that’s not all, they also keep temperatures in the scrotum at the optimum level. The scrotum contains the testes which produce sperm. Higher temperatures tend to hamper the sperm production and decrease the volume that is released in a man’s ejaculate. They also promote sperm production by improving blood circulation and protecting against free radical damage.
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).
Testosterone is responsible for increased muscle mass. Leaner body mass helps control weight and increases energy. For men with low testosterone, studies that treatment can decrease fat mass and increase muscle size and strength. Some men reported a change in lean body mass but no increase in strength. It’s likely you’ll see the most benefits when you combine testosterone therapy with strength training and exercise.

Anabolic–androgenic steroids (AASs) are synthetic derivatives of testosterone that are commonly used among athletes aged 18–40 years, but many reports have demonstrated the presence of numerous toxic and hormonal effects as a result of long-term use of an AAS.[9] Testosterone-foods act as natural libido boosters. Due to the growing interest in herbal ingredients and other dietary supplements worldwide, the use of testosterone boosters is becoming more and more mainstream among athletes, but several side effects were documented. Hence, this study established to help in the assessment of the side effects and health risks which could occur among athletes consuming testosterone boosters.


We kept it simple, and followed the premise of testosterone boosters: testosterone affects muscle gain, weight loss, and libido, so by increasing the amount of testosterone in the body, we can improve on each of those goals. This meant that we looked for ingredients proven to increase testosterone levels, not ingredients that might increase libido or help build muscle mass independently of testosterone (like having a healthy diet and feeling good about yourself). In addition, we dove deep into the specific ingredient lists of our finalists and cross-checked them against WebMD and the National Institutes of Health (NIH) database to make sure that they did not contain ingredients known to be harmful.
I had been on testosterone cyperonate 250-300 mg every 2 weeeksfor one year when diagnosed as having hypercythemic. I was cut of treatments immediately. Scanned from head to toe side to side. All clear. My urologist refuses to resume any HRT as my total testosterone is 701 immunoassay. However, he never mentions my Free % T value of 1.3. The labs range is 1.6-2.9. SHGB =70.6. Albumin 4.1. Is not the Free T we should be concerned with? Do I not need to go “Uologist Hunting”????
It seems like today it’s a badge of honor to train every day until exhaustion. The ethos is to push yourself harder and harder every day. If that’s your philosophy towards exercise, you might be sabotaging your testosterone levels (as well as your 20 Mile March). Studies have shown that overtraining can reduce testosterone levels significantly. Yes, it’s important to exercise hard, but it’s even more important to give your body rest so it can recuperate from the damage you inflicted upon it.

I see this is an older thread, but still very appropriate. After feeling lethargic, gaining weight, and generally having a declining sexual appetite I took some advice from a friend and got the Test check done. Turns out I was around 189, and it explained a lot. Now, I am a bigger guy, and I do hit the gym regularly, and I do push weights a lot. Big arms and chest, kinda flabby gut. Doc recommended Andro Gel. Glad I had insurance, because it is EXPENSIVE!!!!! Noticed after a week of two pumps that energy was coming back, and I could concentrate better at work. A little bit of face acne, some around shoulders, and a little on the chest. I also noticed a little acne on the contact areas on my arms where I applied it. Nothing like a teenager, but I noticed. It did help in the gym a little bit, as I would put on muscle a little faster, and kept it a bit longer. I also noticed some extra water weight gain around my gut.
Natural testosterone boosters also help to increase the amount of free testosterone in the body. There are a couple of different ingredients they use that help with this. One of these ingredients is stinging nettle. Stinging nettle is actually able to bind to the globulin in place of testosterone, therefore leaving more free testosterone in the body that is unbound.

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.

Some of the effects of testosterone treatment are well recognised and it seems clear that testosterone treatment for aging hypogonadal men can be expected to increase lean body mass, decrease visceral fat mass, increase bone mineral density and decrease total cholesterol. Beneficial effects have been seen in many trials on other parameters such as glycemic control in diabetes, erectile dysfunction, cardiovascular risk factors, angina, mood and cognition. These potentially important effects require confirmation in larger clinical trials. Indeed, it is apparent that longer duration randomized controlled trials of testosterone treatment in large numbers of men are needed to confirm the effects of testosterone on many aspects of aging male health including cardiovascular health, psychiatric health, prostate cancer and functional capacity. In the absence of such studies, it is necessary to balance risk and benefit on the best available data. At the present time the data supports the treatment of hypogonadal men with testosterone to normalize testosterone levels and improve symptoms. Most men with hypogonadism do not have a contraindication to treatment, but it is important to monitor for adverse consequences including prostate complications and polycythemia.
According to a study in the International Journal of Reproductive BioMedicine, D-Aspartic acid increases testosterone levels in some animals. However, studies that have looked at its effects on humans are inconclusive and mainly of poor quality. The paper says there is an urgent need for more research on this chemical, which occurs naturally in some human tissues.

A: Androderm comes in the form of a transdermal patch and is used for testosterone replacement therapy in patients who have insufficient levels of testosterone. Testosterone is a hormone produced in the body that plays a key role in many physiological processes in men. In some men, however, the body does not produce enough of the hormone, resulting in a variety of symptoms including decreased libido, erectile dysfunction, muscle loss, anemia and depression, among others. Androderm helps treat these symptoms and raise low testosterone levels by delivering therapeutic amounts of the hormone, which are absorbed through the skin. According to the prescribing information for Androderm, depression was a reported side effect of the medication. Other common side effects of Androderm include itching and redness at the application site, prostate abnormalities, headache, and burning or hardening of the skin at the application site. Less common side effects of Androderm include reduced libido (sex drive), fatigue, high blood pressure, anxiety, confusion, increased appetite, and body pain. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Your physician can determine if your dosage of the medication needs to be adjusted or if an alternative medication should be considered. Lori Poulin, PharmD
Vitamin D3 has the ability to naturally boost testosterone levels.  Increasing serum vitamin D levels in the body can help increase testosterone production, allowing you to potentially build muscle at a faster rate. If you don’t live in an area of the world that allows for a good amount of sunlight, you could become deficient and could benefit from a vitamin D supplement.
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]
Another effect that can limit treatment is polycythemia, which occurs due to various stimulatory effects of testosterone on erythropoiesis (Zitzmann and Nieschlag 2004). Polycythemia is known to produce increased rates of cerebral ischemia and there have been reports of stroke during testosterone induced polycythaemia (Krauss et al 1991). It is necessary to monitor hematocrit during testosterone treatment, and hematocrit greater than 50% should prompt either a reduction of dose if testosterone levels are high or high-normal, or cessation of treatment if levels are low-normal. On the other hand, late onset hypogonadism frequently results in anemia which will then normalize during physiological testosterone replacement.
Why bother with such common micronutrients? Because it's not uncommon for athletes to suffer from zinc and magnesium deficiencies, partly due to inadequate replenishing of levels after intense bouts of exercise. Deficiencies in these key minerals can lead to a poor anabolic hormone profile, impaired immune function, and increased cortisol, ultimately leading to decreases in strength and performance.[6]

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]
Spinach/Spring Salad Mix. This was the base of my salad. I used Organic Girl Greens from Whole Foods. Yeah, I know. The base of my Man Salad came from a company called Organic Girl. Spinach and other leafy green vegetables contain minerals like magnesium and zinc, which have been shown to aid in testosterone production (study on magnesium, and another; study on zinc)

Zinc is little more of a nice-to-have ingredient than a must-have. It’s on our radar as an ingredient that possibly boosts testosterone levels, and while we couldn’t find enough supporting evidence that taking zinc would increase natural testosterone, low zinc levels have been connected to infertility. A low zinc level is also possibly a sign of hypogonadism. The closest support we found is in a study which found that people recovered from nutritional deficiency-related problems more quickly if they took a zinc supplement than those who did not. Zinc is available in many foods, such as oysters, fortified breakfast cereals, and red meat.

In essence, there are two types of testosterone boosters, namely natural and synthetic supplements. Anabolic steroids which are under the synthetic category are known to deliver positive results as well as nasty side effects. It is due to this reason that an increasing number of bodybuilders and athletes are now utilizing safer testosterone boosters.
When looking for a solid natural testosterone booster, you’ll want one that has the ability to increase natural testosterone levels, increase muscular strength, improve performance and stamina, and help pack on lean muscle mass.  With a mix of key ingredients like D-AA, Tribulus, Fenugreek, and DIM, Evlution’s booster aims to take your training to the next level.  It can also help improve your sleep which is vital in allowing the body to recover from intense sessions in the gym.
Fortunately supplementation of Vitamin D3 has been noted to significantly boost testosterone levels up to 20%.[40,41] This occurs via a reduction in sex-hormone binding globulin (SHBG) and aromatase expression, which limits the breakdown of testosterone into estrogen. It’s also worth mentioning that Vitamin D3 has been shown to raise levels of the anabolic hormone IGF-1.[42,43]
Lean beef, chicken, fish, and eggs are some of your options. Tofu, nuts, and seeds have protein, too. Try to get about 5 to 6 ounces per day, although the ideal amount for you depends on your age, sex, and how active you are. When you don't eat enough of these foods, your body makes more of a substance that binds with testosterone, leaving you with less T available to do its job.

One study showed that six months of zinc supplementation among slightly zinc-deficient elderly men doubled serum levels of testosterone. And another eight-week trial found that college football players who took a nightly zinc supplement showed increased T-levels and increased leg strength that was 250 percent greater than a placebo! Holy quads, Batman! Research has also shown deficiencies in zinc to be a risk factor for infertility caused by low testosterone levels.

Produced primarily by the testicles, testosterone is the hormone responsible for developing male sexual traits and maintaining muscle mass, bone density and red blood cell levels. Testosterone levels peak in adolescence and early adulthood then begin to decline with age, typically at a rate of 1 to 2 percent per year after age 30. Testosterone levels influence physical, emotional and sexual well being, with higher testosterone generally having a favorable effect on attitude and performance. Though increasing testosterone can have benefits, changes to testosterone levels can affect hormonal production elsewhere in the endocrine system, so consult a doctor prior to attempting to raise your testosterone.
Vitamin D3: Vitamin D3 is actually more hormone than it is a vitamin. Vitamin D is taken in by around 10% of our diets and D3 is mostly absorbed from the sun, which can be linked to greater testosterone production. The link between the two is a result from the luteinizing hormone playing its role. Read more about how vitamin D3 effects testosterone — the evidence is staggering.
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.
If you're looking for a miracle pill, this one is NOT one either. But if you're looking for a supplement that works as good as any out there in the market for an unbelievable price, please buy this product. It works after a short period of consistently taking the product and the results are noticeable in the gym as well as on your person. Whether you buy this as a training supplement or a male vitality enhancer, you won't be disappointed.
In my late 20’s, I visited an anti-aging doctor who was one of the pioneers of what we now call functional medicine. I got a full hormone test. Shockingly, my testosterone was lower than my mother’s. No wonder I felt crappy and was overweight. My other sex hormones were out of whack too, especially my estrogen levels. They were high because the little testosterone I did make my body converted into estrogen. I went on a mix of topical replacement testosterone cream, plus small doses of pharmaceuticals like clomid and arimidex in order to keep my other sex hormones functioning properly.
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.
While researchers in Brisbane, Australia, found that while Testofen (“a standardized [fenugreek] extract and mineral formulation”) significantly improved the sexual arousal, orgasm, and the general quality of life of participants, it did not remarkably increase testosterone above normal levels. Participants who took Testofen were more satisfied with their energy, well-being, and muscle strength than those who took the placebo.

While researchers in Brisbane, Australia, found that while Testofen (“a standardized [fenugreek] extract and mineral formulation”) significantly improved the sexual arousal, orgasm, and the general quality of life of participants, it did not remarkably increase testosterone above normal levels. Participants who took Testofen were more satisfied with their energy, well-being, and muscle strength than those who took the placebo.

Benefits: Tongkat Ali works by stimulating the pituitary glands and hypothalamus glands to produce natural testosterone past it’s peak. It also blocks excessive cortisol production. Cortisol turns excessive testosterone into estrogen. Ingredients in the Tongkat ali allows the body to produce testosterone at a steady rate to increase free testosterone while lowering cortisol.
Other stereotypical "macho" behaviors can affect testosterone in women, according to a 2015 report in the Proceedings of the National Academy of Sciences. For example, posing in a powerful way increases testosterone in both women and men. The 2015 report showed that having women role-play a position of power — acting like a boss — had the same effect.
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Vitamin D is arguably the most important vitamin when it comes to testosterone. A study published in the Journal of Clinical Endocrinology examined the relationship between vitamin D supplementation and testosterone levels in men. The authors found that participants with higher levels of vitamin D had significantly higher levels of free testosterone compared to those with insufficient levels of vitamin D.8 Based on these study results, it appears vitamin D has a strong relationship with testosterone levels.
There are pills in the United States for testosterone supplementation, but their use is strongly discouraged because they cause significant liver toxicity. A safe oral formulation called testosterone undecanoate is available in Canada and in Europe, but not in the United States. What’s quite exciting is that an injectable version of testosterone undecanoate (Nebido) was submitted to the FDA for approval in August 2007. (It’s already approved in many other countries.) It lasts for 12 weeks, so a patient could come in and get a shot about four times a year. [Editor’s note: In December 2009, the brand name of the drug in the United States was changed to Aveed. As of January 2011, it was still awaiting FDA approval.]
When looking for a solid natural testosterone booster, you’ll want one that has the ability to increase natural testosterone levels, increase muscular strength, improve performance and stamina, and help pack on lean muscle mass.  With a mix of key ingredients like D-AA, Tribulus, Fenugreek, and DIM, Evlution’s booster aims to take your training to the next level.  It can also help improve your sleep which is vital in allowing the body to recover from intense sessions in the gym.

"I am only 10 weeks into taking your product and I have lost 12 pounds and three inches from my waist. Normally I scoff at radio or TV ads promising results like this. But in this case, my results have far exceeded my expectations. My energy level has increased and my appetite has decreased! All this without any extra exercise program. Thanks from a very satisfied customer!"
Men can experience a range of symptoms if testosterone decreases more than it should. Low testosterone, or low T, is diagnosed when levels fall below 300 nanograms per deciliter (ng/dL). A normal range is typically 300–1000 ng/dL, according to the U.S. Food and Drug Administration. A blood test called a serum testosterone test is used to determine your level of circulating testosterone.
With the help of the three main ingredients, you have the ability to naturally raise your free testosterone levels giving you an increase in strength, muscle mass, stamina, and libido.  NutriSuppz Ultra Test aims to help you sleep better, burn fat easier, and feel energized, and have improved mental alertness.  Another perk of NutriSuppz Ultra Test is that it is a fully transparent profile with no proprietary blends—allowing you to know exactly what you are getting in each dose.
Low testosterone levels have a dramatic effect on emotional state. The American Academy of Family Physicians lists depression, impaired cognition and increased fatigue as symptoms of low testosterone production, or hypogonadism. Testosterone replacement therapy for hypogonadal men has successfully reduced negative moods relating to fatigue and depression while increasing feelings of self-esteem. Increasing testosterone in eugonadal men has also shown positive emotional benefits such as increased feelings of self-esteem and reduction of fatigue. The intensity of these benefits is dependent on dosage; a wide body of literature on testosterone increase has shown that at higher dosage aggression, and aggressive response, can become pronounced.
Consuming high amounts of sugary foods raises your blood glucose levels, which causes your body to release insulin as a response to the raised blood glucose levels. If not managed correctly, the body begins to develop a tolerance to insulin and cannot absorb the sugars in the blood stream as it used to, causing you to become insulin resistant. Being insulin resistant releases cortisol, and as you know, cortisol has extremely negative effects, lowering testosterone by quite a bit.
CrazyBulk USA earned runner-up status, coming in closely behind our first pick. If your goal is bulking, cutting, and maximum strength, these 100 percent legal steroid-alternative testosterone enhancers are what you are looking for. You can bulk up with these safe and legal supplements without worrying about a prescription or getting in trouble with the law.
In the early days of testosterone boosters, the ingredients used were not placed or based on clinical trials that proved the effectiveness of each of them. Most testosterone boosters were compiled with ingredients that were coming from the mouth of a bro scientist, so to speak. These ingredients had no real evidence to back their effects on testosterone production.

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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