The general recommendation is that men 50 and older who are candidates for testosterone therapy should have a DRE and a PSA test. If either is abnormal, the man should be evaluated further for prostate cancer, which is what we do with everybody whether they have low testosterone or not. That means a biopsy. But if all of those results are normal, then we can initiate testosterone therapy. The monitoring that needs to happen for men who begin testosterone therapy is really very simple: DRE, PSA, and a blood test for hematocrit or hemoglobin, once or twice in the first year and then yearly after that, which is pretty much what we recommend for most men over age 50 anyway.
For people who are worried about low or high testosterone, a doctor may perform a blood test to measure the amount of the hormone in the patient's blood. When doctors find low-T, they may prescribe testosterone therapy, in which the patient takes an artificial version of the hormone. This is available in the following forms: a gel to be applied to the upper arms, shoulders or abdomen daily; a skin patch put on the body or scrotum twice a day; a solution applied to the armpit; injections every two or three weeks; a patch put on the gums twice a day; or implants that last four to six months.
Benefits: Maca roots originates from the mountains of Peru. For a long time, natives have been using Maca roots as not only a food supply but for it’s properties for increasing sexual potency. It has been prove to improve erectile dysfunctions, libido and sperm production. Maca roots stimulate semen volume, sperm count and sperm motility, which makes Maca a powerful Aphrodisiac.
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The testosterone booster pills are effective from 4 to 8 hours. To maintain testosterone levels high during the whole day, you need a multiple daily dosing regimen. 2-times daily dosing still not always can improve hormone production to the greatest extent. 3-4-times daily dosing is the best solution to make your body normalize testosterone synthesis and prevent it from decreasing before you take another pill. Don’t forget that the regularity of daily supplement intake is crucial if you really aspire to give a boost to hormone production.
How is it that women for many years have had HRT available and it is common place and acceptable for them? Men are expected to just have a decline and when they start to look into this, immediately they are looked at as they just want to do steroids. This is not the case for any of the comments I have read. I too simply like having my levels where they should be and if taken for this reason should be common place just as it is for estrogen replacement in women.
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A man with shrinking levels of testosterone actually may lose some body hair. Testosterone replacement therapy comes with a few potential side effects, including acne and breast enlargement. Testosterone patches may cause minor skin irritation. Topical gels may be easier to use, but great care must be taken to avoid transferring testosterone to someone else though skin-to-skin contact.

For facts sake I am 51yr old male and I am fat. I do have a large and muscular fat, but I also have a good amount of at on top of that. My body shape is not the typical huge “beer belly” gut that is hard and dangerous, rather, I am fat all over proportionally, but still considered obese. The fat on my body and around my middle is quite soft compared to male friends who have those large and hard bellies. Still, my doctor and reading indicate that fat has an effect on T potentially lowering the overall level that my T would be if I lost a good amount of that fat.
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.
Dr. Darryn Willoughby, a professor of health, human performance and recreation and the director of the Exercise and Biochemical Nutrition Laboratory at Baylor University, told us that even in studies where there was an increase in testosterone, it was only around 15–20 percent. “In men with clinically normal testosterone levels, this modest increase will most likely not be anabolic enough to improve exercise performance,” he says. So if you have normal testosterone levels, and are simply trying to get an extra edge in gaining muscle, losing weight, or some extra time in the bedroom — you might see some results from taking a testosterone booster. But really, these will be most useful for men with low testosterone trying to get back to a healthy testosterone range.
As mentioned earlier, too much protein can negate testosterone production quite a bit. If your protein intake is over 0.85g/lb of body weight a day, then you may not be making full use of each of the nutrients. Consuming these high amounts of protein can cause your cortisol and SHBG levels to increase, which in turn lowers testosterone production. What do you get out of this deal? Increased fat gain and lower testosterone levels.
Testosterone boosters are formulated for men in most cases, though there are a few brands that are appropriate for women. These are generally for men who want to improve their lean muscle mass, stamina, and energy levels. If you have low testosterone levels, these are great to ward off symptoms like low energy, excessive body fat, and a low sex drive. Some athletes might benefit from these boosters. You should always check with your doctor before adding these supplements or any other supplements to your regimen, particularly if you have chronic health conditions or if you are already taking medications or supplements.
There have been case reports of development of prostate cancer in patients during treatment with testosterone, including one case series of twenty patients (Gaylis et al 2005). It is not known whether this reflects an increase in incidence, as prostate cancer is very common and because the monitoring for cancer in patients treated with testosterone is greater. Randomized controlled trials of testosterone treatment have found a low incidence of prostate cancer and they do not provide evidence of a link between testosterone treatment and the development of prostate cancer (Rhoden and Morgentaler 2004). More large scale clinical trials of longer durations of testosterone replacement are required to confirm that testosterone treatment does not cause prostate cancer. Overall, it is not known whether testosterone treatment of aging males with hypogonadism increases the risk of prostate cancer, but monitoring for the condition is clearly vital. This should take the form of PSA blood test and rectal examination every three months for the first year of treatment and yearly thereafter (Nieschlag et al 2005). Age adjusted PSA reference ranges should be used to identify men who require further assessment. The concept of PSA velocity is also important and refers to the rate of increase in PSA per year. Patients with abnormal rectal examination suggestive of prostate cancer, PSA above the age specific reference range or a PSA velocity greater than 0.75 ng/ml/yr should be referred to a urologist for consideration of prostate biopsy.
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.
Remember that each person is unique, and each body responds differently to treatment. TT may help erectile function, low sex drive, bone marrow density, anemia, lean body mass, and/or symptoms of depression. However, there is no strong evidence that TT will help memory recall, measures of diabetes, energy, tiredness, lipid profiles, or quality of life.

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.
It has also been found that college graduates with higher levels of T (men and women alike) are more likely to go into riskier careers. Another study discovered that among financial traders, a trader’s morning level of testosterone accurately predicted his day’s profitability – higher levels of T mean he’s more likely to take risks that day and score big.

There are many Supplements: Zinc for starters about 1/3 of Men have to low Zinc. Make shure you get a good chemical form no oxides best are chelates or citrates. Then there is Arginin and L-Citrullin two amino acids that help Blood flow basacly natural viagra. And then there are things like maca(a plant that you can get in powder form) that hightens libido but not like zinc it doesnt highten the testosteron level. My dad takes the combo of these 3 things kosts you about 30-60$ per Month. Dont be lazy do research on the stuff to make shure you get right dosages and good quality Sups
My genetic make-up is 47XXY. I was diagnosed in September, 1976, and have been on some kind of T-therapy since – injections, pills, gels, patches, pellets, now back on injections. At this time, now, I inject 1/2cc deep IM, every 7-8 days. I suffered a blood clot between my knee and my groin (right leg) in January, 2017. I am now on Eliquis through June, 2017. My blood has always been quick to coagulate. I’ve read through all of this, and only found mention of blood clots sporadically in relation to T-therapy. I’m 70 yoa, have never had a problem before. Can you give me any info I can pass along to my doctor? Thank you.
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Testosterone is a sex hormone that plays important roles in the body. In men, it’s thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm. A small amount of circulating testosterone is converted to estradiol, a form of estrogen. As men age, they often make less testosterone, and so they produce less estradiol as well. Thus, changes often attributed to testosterone deficiency might be partly or entirely due to the accompanying decline in estradiol.

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.

Testosterone increases the tolerance for risk-taking. Testosterone has a strong link with one’s willingness to take risks. Studies show that men with low levels of power and status, but high levels of T, are motivated to take risks in order to gain status and power. On the other hand, men with high T, who already have power and status, are more risk-averse, because they want to hold on to what they have.

Testosterone is significantly correlated with aggression and competitive behaviour and is directly facilitated by the latter. There are two theories on the role of testosterone in aggression and competition.[81] The first one is the challenge hypothesis which states that testosterone would increase during puberty thus facilitating reproductive and competitive behaviour which would include aggression.[81] Thus it is the challenge of competition among males of the species that facilitates aggression and violence.[81] Studies conducted have found direct correlation between testosterone and dominance especially among the most violent criminals in prison who had the highest testosterone levels.[81] The same research also found fathers (those outside competitive environments) had the lowest testosterone levels compared to other males.[81]
Beast Sports recommends taking four capsules twice per day. The pills are about the same size as a multivitamin or a Tylenol liquid gel pill — not tiny tablets, unfortunately, but they aren’t horse pills. They smell like the boxes of raisins your Mom packed into your school lunch, but stale, like they were forgotten in the pantry for a few years, and a little spicy, like she sprinkled curry powder on them. If you follow this eight pills per day regime, your $46 bottle will last you twenty-two days, and cost you about $2 per day.

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.


^ Butenandt A, Hanisch G (1935). "Umwandlung des Dehydroandrosterons in Androstendiol und Testosterone; ein Weg zur Darstellung des Testosterons aus Cholestrin" [About Testosterone. Conversion of Dehydro-androsterons into androstendiol and testosterone; a way for the structure assignment of testosterone from cholesterol]. Hoppe-Seyler's Z Physiol Chem (in German). 237 (2): 89–97. doi:10.1515/bchm2.1935.237.1-3.89.


Smoking doesn’t promote maintaining male hormone levels healthy. The study has shown that smoking deprives the body from zinc. Zinc deficiency is dangerous for men because it is fraught with testosterone deficiency. The matter is that zinc is a kind of structural material for building the testosterone molecules. So, smoking combined with unhealthy diet strikes a blow against normal testosterone production.
I am still on T therapy. But here’s what pisses me off: No one tells you that you will be hooked on the drug virtually forever! Don’t ever stop it abruptly! I did and I had a major crash: physically and emotionally. I went into the darkest depression ever…and I was lacking in energy so much that I had to have 4 naps a day…just to get through the day. I was also robbed of any initiative to do anything.

Millions of men use testosterone therapy to restore low levels and feel more alert, energetic, mentally sharp, and sexually functional. But it's not that simple. A man's general health also affects his testosterone levels. For instance, being overweight, having diabetes or thyroid problems, and taking certain medications, such as glucocorticoids and other steroids, can affect levels. Therefore, simply having low levels does not always call for taking extra testosterone.


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!!!!

You should also know that a lot of people are deficient in Vitamin D. In the USA & many other western regions in the world, vitamin D deficiency is at epidemic proportions. The best way to increase your D levels is sun exposure. You only need 20-30 minutes of exposure to a large amount of skin (i.e., take your shirt off and go for a walk during the day).
And the ads have been working: The number of prescriptions written for testosterone have skyrocketed by more than 300 percent since 2001, reaching 7.2 million in 2013, according to a report published in 2016. Another study, published in JAMA in 2017, found that between 2009 and 2013, testosterone testing and treatment rose substantially in areas of the U.S. where such ads were very common.
This product is to be taken once daily on an empty stomach. Is there a particular time frame when food can be eaten? If I were to take this in the morning right when I wake up and then eat breakfast an hour later, is that fine? Also, mostly the only time of day my stomach is usually empty is right before going to bed. If it is taken at this time, will this affect sleep at all?
Today we take a look at some of the physical and psychological benefits that come with having optimal testosterone levels (I’ll talk about what “optimal” means regarding T later this week). You probably know about some of the benefits already, but some of the ones I discuss may surprise you. When appropriate, I’ll report any health benefits that I experienced during my own 90-day testosterone boosting experiment.

Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (DHT) by the cytoplasmic enzyme 5α-reductase. DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T.[118] The T-receptor or DHT-receptor complex undergoes a structural change that allows it to move into the cell nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA. The areas of binding are called hormone response elements (HREs), and influence transcriptional activity of certain genes, producing the androgen effects.
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.

Hi Dean, thanks for reaching out bro! While testosterone boosters will help increase your T levels, strength, and libido, you need to make sure you’re eating the right foods and exercising in the right way. What is your current diet and workout plan? Maybe we can help? If you’re serious about getting in shape, a quality testosterone booster can certainly help. If you have a look at our top testosterone booster page, you’ll see TestoFuel is our best choice. If you have any more questions, don’t hesitate to write back! All the best bro, don’t give up, you can do it!
How do you boost testosterone naturally? Testosterone is a male sex hormone. Low levels can cause changes to the distribution of body fat and muscle strength. Testosterone reduces with age, but people can boost it with lifestyle changes, including diet and exercise. Adequate sleep, nutritional supplements, and stress reduction may also help. Learn more here. Read now
I think we’ll also find out in five years that there very well may be general health benefits of having normal testosterone compared to low testosterone. There are growing data for all-cause mortality that men who have low testosterone die earlier than those who have normal testosterone. A study by the Veterans Administration reported about a year ago showed low testosterone levels were associated with a dramatically increased mortality rate. It’s hard to know why that is, but I think we’ll be focused on that in the coming years.
In addition to weightlifting, studies have shown that HIIT workouts can also help boost testosterone levels. For those of you who don’t know, HIIT stands for high-intensity interval training. It calls for short, intense bursts of exercise, followed by a less-intense recovery period. You repeat with the intense/less-intense cycle several times throughout the workout. In addition to increasing T, HIIT has been shown to improve athletic conditioning and fat metabolism, as well as increase muscle strength.
TT may help you but it may have adverse (harmful) results. (See discussion of these side effects below.) The Federal Drug Administration (FDA) has said that testosterone drug labels should state that there is a risk for heart disease and stroke for some men using testosterone products. All men should be checked for heart disease and stroke before, and periodically while on, TT. The AUA however, on careful review of evidence-based peer review literature, has stated that there is no strong evidence that TT either increases or decreases the risk of cardiovascular events.
You should also know that a lot of people are deficient in Vitamin D. In the USA & many other western regions in the world, vitamin D deficiency is at epidemic proportions. The best way to increase your D levels is sun exposure. You only need 20-30 minutes of exposure to a large amount of skin (i.e., take your shirt off and go for a walk during the day).
The general recommendation is that men 50 and older who are candidates for testosterone therapy should have a DRE and a PSA test. If either is abnormal, the man should be evaluated further for prostate cancer, which is what we do with everybody whether they have low testosterone or not. That means a biopsy. But if all of those results are normal, then we can initiate testosterone therapy. The monitoring that needs to happen for men who begin testosterone therapy is really very simple: DRE, PSA, and a blood test for hematocrit or hemoglobin, once or twice in the first year and then yearly after that, which is pretty much what we recommend for most men over age 50 anyway.

during therapy. It is very hard to find a local endo who is thinking with his head vs complying with old trt programs. I tool clomid in the past to see what it would do and it elevated my t level to 520 in 2 weeks from low 220. Aromason will do same but clomid is more potent. Not sure what the long effect would be since you tend to get bit moody on clomid after 2 months. LH is also being affected in negative way since the lh receptors can burn out to a degree. I will contact the trt clinic in order to start my trt as they have much more experience with these things.


In males, testosterone is synthesized primarily in Leydig cells. The number of Leydig cells in turn is regulated by luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In addition, the amount of testosterone produced by existing Leydig cells is under the control of LH, which regulates the expression of 17β-hydroxysteroid dehydrogenase.[132]
Likewise, there are also natural ways to pep up your testosterone through diet, exercise and other lifestyle changes. So if you’re the wrong side of 30 and not feeling as strong in the gym anymore, or if you’re gaining weight where there wasn’t weight before, or if you can't find the energy to finish the day, let alone pleasure your partner, then keep reading — our expert advice may restore you to the peak of masculinity.
We do note that Beast Sports’ supplemental magnesium level is fairly low — 26 mg per serving, up to 52 mg per day. If your diet is not particularly rich in magnesium (found in leafy greens, nuts, and whole grains), Beast Sports may not give you enough to meet the daily recommended dose. However, if you’re taking other multi-vitamins or supplements with magnesium, you’re less likely to cross that 350mg daily upper limit.
The fact of the matter is the better quality protein you use the better quality muscle gains you will get. The best thing to combine Advanced BCAA’s is to get our Peptopro or Bio serum 1. This will create a protein powder supplement that is far superior than any protein supplement available today. Essentially you will create a super protein powder. Use with a carb powder like our Oatmuscle to really make a muscle growing protein supplement. Finally combine with Heliogen casein at night and this will give your body a great chance for recovery for the next day ..
However, studies have found that social success among men is actually linked with high testosterone levels. For example, teenage boys who were perceived as socially adept and dominant had higher levels of testosterone than boys that were low on the totem pole. What’s even more interesting is that this same study found that teenage boys who had a history of being anti-social and displaying high physical aggression were found to have lower testosterone levels at age 13 compared with boys with no history of high physical aggression.
In addition to weightlifting, studies have shown that HIIT workouts can also help boost testosterone levels. For those of you who don’t know, HIIT stands for high-intensity interval training. It calls for short, intense bursts of exercise, followed by a less-intense recovery period. You repeat with the intense/less-intense cycle several times throughout the workout. In addition to increasing T, HIIT has been shown to improve athletic conditioning and fat metabolism, as well as increase muscle strength.
Levels of testosterone naturally decrease with age, but exactly what level constitutes "low T," or hypogonadism, is controversial, Harvard Medical School said. Testosterone levels vary wildly, and can even differ depending on the time of day they're measured (levels tend to be lower in the evenings). The National Institutes of Health includes the following as possible symptoms of low testosterone:
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.
The testicles produce an enzyme called 11ßHSD-1 which protects your testosterone molecules from the effects cortisol.  During times of prolonged stress and chronically elevated cortisol, there simply is too much cortisol for 11ßHSD-1 to handle.  This results in testosterone molecules being destroyed inside the gonads before they even enter the bloodstream (8, 9).
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.
Alphamax XT’s testosterone boosting formula is so potent that they had to include an estrogen blocker in the formula. User’s have reported that the product’s effects rivals a hardcore pre-workout in terms of aggression and intensity. When the workout is done user’s have also been reporting accelerated muscle recovery, fat loss, and increased muscle definition.
In this podcast, I will review the key biomarkers for achieving peak male health, along with the most potent and effective practices for optimizing biological variables for men's fertility and longevity. I will also unveil a host of little-known biohacks proven to enhance or restore peak testosterone and drive, along with how to practically implement a blend of ancestral wisdom and modern science to amplify sexual performance.
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.
Leafy green vegetables such as spinach are rich sources of folic acid. Low levels of folate can give rise to distorted sperm shapes such as ones with two heads or two tails. The sperm are also at an increased risk of chromosomal abnormalities. This means that firstly your sperm will find it difficult to reach an egg and even if it does reach an egg, it will not be able to fertilize it. Furthermore, even if these sperms are able to fertilize an egg, the chances of birth defects are quite high in such cases.

To date, no large, double-blind, randomized controlled studies of a link between testosterone treatment and prostate cancer have been completed. In its 2004 report, the Institute of Medicine (IOM) committee studying the need for clinical trials of testosterone-replacement therapy noted that only 31 placebo-controlled studies had been done in older men, with the largest one enrolling just 108 participants. Most of these studies lasted only six months.

There is increasing interest in the group of patients who fail to respond to treatment with PDE-5 inhibitors and have low serum testosterone levels. Evidence from placebo-controlled trials in this group of men shows that testosterone treatment added to PDE-5 inhibitors improves erectile function compared to PDE-5 inhibitors alone (Aversa et al 2003; Shabsigh et al 2004).
When testosterone and endorphins in ejaculated semen meet the cervical wall after sexual intercourse, females receive a spike in testosterone, endorphin, and oxytocin levels, and males after orgasm during copulation experience an increase in endorphins and a marked increase in oxytocin levels. This adds to the hospitable physiological environment in the female internal reproductive tract for conceiving, and later for nurturing the conceptus in the pre-embryonic stages, and stimulates feelings of love, desire, and paternal care in the male (this is the only time male oxytocin levels rival a female's).[citation needed]
It’s perhaps no coincidence that Giacomo Casanova, who was said to eat 50 oysters for breakfast each morning, reportedly bed half of Europe. After all, oysters are brimming with zinc, a mineral that elevates testosterone while simultaneously boosting growth factor hormone—both of which enhance muscle growth and physical performance (in and out of the bedroom).

Osteoporosis refers to pathological loss of bone density and strength. It is an important condition due to its prevalence and association with bone fractures; most commonly of the hip, vertebra and forearm. Men are relatively protected from the development of osteoporosis by a higher peak bone mass compared with women (Campion and Maricic 2003). Furthermore, women lose bone at an accelerated rate immediately following the menopause. Nevertheless, men start to lose bone mass during early adult life and experience an increase in the rate of bone loss with age (Scopacasa et al 2002). Women of a given age have a higher prevalence of osteoporosis in comparison to men but the prevalence increases with age in both sexes. As a result, men have a lower incidence of osteoporotic fractures than women of a given age but the gap between the sexes narrows with advancing age (Chang et al 2004) and there is evidence that hip fractures in men are associated with greater mortality than in women (Campion and Maricic 2003).
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