Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.
Estrogen is important in men, but too high of a level has all sorts of negative consequences – ranging from heart attacks to prostate cancer (32 & 33). The balance between testosterone and estrogen (or estradiol) is critical for a man. If the ratio is out and estrogen starts to dominate you run into all sorts of issues – such as breast cell growth, prostate enlargement and of course lower testosterone.
An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men. The diagnosis of LOH requires biochemical and clinical components. Controversy in defining the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specific nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use. As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. The traditional benefits of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible beneficial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed. Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.
The other problem researchers run into when studying the benefits of testosterone is distinguishing between “cause” and “effect.” Is it T that’s providing all these great health benefits or does simply being healthy give you optimal levels of testosterone? It’s tricky because in some instances the answer is “both.” Testosterone (like all hormones) often plays a part in a “virtuous cycle” that regulates a whole host of  processes in our bodies — as you increase T, you get healthier; as you get healthier, your T levels rise. It can also play a part in a “vicious cycle” — as your T levels go down, your health suffers; as your health suffers, your T levels decrease even more.
The unsexy truth is that increasing T naturally simply comes down to making some long-term changes in your diet and lifestyle. As you’ll see, what I did to increase T largely boils down to eating better, exercising smarter, and getting more sleep. That’s pretty much it. But as with most things in life, the devil is in the details, so I’ll share with you exactly what I did and provide research that explains why the things I did helped boost my testosterone.
NHT works to reach a targeted level of hormones in your body, restoring your body’s natural ability to keep healthy and fit. Hormones are beneficial at any age, but most commonly we administer the therapy to people in their 40’s, when your body naturally begins to slow production of certain hormones. Supplementing these declining hormones can keep your body fit and active for much longer. Bio-identical hormones are made from plants and are identical to the hormones naturally produced by your own body. We never use synthetic hormones, which have been shown to increase your risk of heart disease and diabetes.
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.

Ben has mentioned APOE many times, as in this podcast, with the reference in this transcript as something like 34/44. I’ve always assumed that meant a number of different genes that related to APOE having the homozygous or heterzygous mutations. I’ve only been able to find one rs in my 23andme raw data that seems meaningful to this, rs429358. How do you all figure out your APOE status? Are you getting this from one of the other companies that analyzes part of your raw data for you?
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.
Sergeant Steel ran into trouble here because it contains Shilajit — a type of plant-based resin. Shilajit is banned in Canada because the Canadian government found heavy metal levels when investigating the ingredient. Shilajit is hard to find, and sensitive to water and variations in temperature, so most manufacturers mix it with additives to make it more stable. Research at Boston University School of Medicine found that “nearly 21 percent of 193 ayurvedic herbal supplements [...] contained lead, mercury or arsenic,” and included shilajit on the list of contaminated ingredients. Even though Sergeant Steel lists its shilajit is “purified,” it doesn’t offer any third-party testing to confirm whether or not their shilajit contains heavy metals, and so we cut it.
Your first step should be to see your doctor. If you think you have low testosterone, we cannot stress enough that you should proceed with caution and talk to a medical professional — taking a booster can definitely do more harm than good. Low testosterone can be a symptom of more serious problems, like a pituitary disorder or a side-effect of medication, and a booster can mask the root cause. A doctor will be able to evaluate your testosterone levels with a simple blood test, and if you both decide a booster is the way to go, give the ingredients of any supplement a once-over to make sure that they’re not at risk of making your personal health situation worse.
Most studies support a link between adult criminality and testosterone, although the relationship is modest if examined separately for each sex. Nearly all studies of juvenile delinquency and testosterone are not significant. Most studies have also found testosterone to be associated with behaviors or personality traits linked with criminality such as antisocial behavior and alcoholism. Many studies have also been done on the relationship between more general aggressive behavior/feelings and testosterone. About half the studies have found a relationship and about half no relationship.[66] However, later it was found out that testosterone activates dominant, aggressive behavior if at the same time a person has high testosterone and low levels of cortisol in the blood. Conversely, a high level of testosterone and high levels of cortisol do not stimulate dominant behavior. Because cortisol inhibits the action of testosterone.[67][68][69][70] This is probably why the results of the experiments were inconsistent.
Around age 30, men’s testosterone levels begin a long, gradual decline. (According to the FDA, normal T range is between 300 to 1,000 nanograms per deciliter (ng/dl) of blood serum. Anything below 300 ng/dl is considered low.) If a blood test confirms you have low T, your doctor may recommend a prescription testosterone supplement or replacement therapy.

The other problem researchers run into when studying the benefits of testosterone is distinguishing between “cause” and “effect.” Is it T that’s providing all these great health benefits or does simply being healthy give you optimal levels of testosterone? It’s tricky because in some instances the answer is “both.” Testosterone (like all hormones) often plays a part in a “virtuous cycle” that regulates a whole host of  processes in our bodies — as you increase T, you get healthier; as you get healthier, your T levels rise. It can also play a part in a “vicious cycle” — as your T levels go down, your health suffers; as your health suffers, your T levels decrease even more.
Tongkat ali (a.k.a. Longjack, a.k.a. Eurycoma Longifolia) is a foundational compound of Ayurveda, commonly used as an aphrodisiac. Similar to DHEA, longjack has been found to be effective in both men and women for improving libido, total and free testosterone concentrations as well as muscle mass and strength in men and women! And, unlike many of the other old world herbs commonly touted as natural testosterone boosters, longjack actually has a fair amount of human research denoting its benefits.

Don’t waste your time with the gel, the Injectable is far superior. Also most will be given 200 mg cypionate per week, you can actually go much higher and feel a lot better and if combined with good resistance training and cardio achieve a very good figure and low fat percentage . There was actually a study overseas that said men could benefit with TRT at 600mg per week, although you will never see that happen with American doctors .
When patients ask about risks, I remind them that they already have testosterone in their system and that the goal of testosterone treatment is to restore its concentration back to what it was 10 or 15 years previously. And the molecule itself that we give is identical to the one that their bodies make naturally, so in theory, everything should be hunky-dory. But in practice, there are always some curveballs.
Most men report being able to lose body fat and gain lean muscle more easily when they take testosterone boosters. These supplements can also raise a man’s mood and make him feel more confident. You might notice that your libido gets a boost, too. They make workouts more effective and, in some cases, easier. Testosterone boosters are also great for men with low testosterone levels, as they will combat the low energy and fatigue that go along with low levels. Other supplements to consider are energy-boosting supplements and pre-workout supplements.
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If you haven’t hit your twenties yet then you probably can’t imagine losing your interest in sex. I feel you, Holmes.  At 26, I have a healthy appetite now (partially because I consciously work on elevating my T) but it’s nowhere near where it was when I was 17.  I imagine that things will only get worse by the time I’m 35 which is why it’s important to learn what gets your motor firing now.
Exercise is the original testosterone booster, and it’s one of the most powerful full-body hacks around. Men see a sharp increase in both testosterone and human growth hormone (HGH) after lifting weights, and the boost is greater with shorter rest time between sets (1 minute rest outperforms 3 minutes rest) [9]. With the shorter rest time, women also get a large boost in HGH.
I have been searching quite a while for a testosterone booster that could help me in a few different ways yet not to be too expensive. Over the years, I have experienced a low irritability tolerance(meaning it doesn’t take much to send me “over the top”) and have moods swings due to negative situations. I would like to be more at peace with myself & around others(without trying to fake it).I don’t usually have a lot of energy at work & rely on energy drinks. I also have a lower sex drive due to what I believe is low blood flow. I am 43 years old and am not over weight, but could stand to tone up and lose a little around the waist. If this site is legit, I would like to know your opinion on what I have disclosed & what you recommend.
Transdermal preparations of testosterone utilize the fact that the skin readily absorbs steroid hormones. Initial transdermal preparations took the form of scrotal patches with testosterone loaded on to a membranous patch. Absorption from the scrotal skin was particularly good and physiological levels of testosterone with diurnal variation were reliably attained. The scrotal patches are now rarely used because they require regular shaving or clipping of scrotal hair and because they produce rather high levels of dihydrotestosterone compared to testosterone (Behre et al 1999). Subsequently, non-scrotal patches were developed but the absorptive capacity of non-scrotal skin is much lower, so these patches contain additional chemicals which enhance absorption. The non-scrotal skin patches produce physiological testosterone levels without supraphysiological dihydrotestosterone levels. Unfortunately, the patches produce a high rate of local skin reactions often leading to discontinuation (Parker and Armitage 1999). In the last few years, transdermal testosterone gel preparations have become available. These require daily application by patients and produce steady state physiological testosterone levels within a few days in most patients (Swerdloff et al 2000; Steidle et al 2003). The advantages compared with testosterone patches include invisibility, reduced skin irritation and the ability to adjust dosage, but concerns about transfer to women and children on close skin contact necessitate showering after application or coverage with clothes.
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14. Volek JS, Volk BM, Gómez AL, Kunces LJ, Kupchak BR, Freidenreich DJ, Aristizabal JC, Saenz C, Dunn-Lewis C, Ballard KD, Quann EE, Kawiecki DL, Flanagan SD, Comstock BA, Fragala MS, Earp JE, Fernandez ML, Bruno RS, Ptolemy AS, Kellogg MD, Maresh CM, Kraemer WJ. Whey protein supplementation during resistance training augments lean body mass. J Am Coll Nutr. 2013;32(2):122-35. PMID: 24015719
A loophole in FDA regulations allows pharmaceutical marketers to urge men to talk to their doctors if they have certain "possible signs" of testosterone deficiency. "Virtually everybody asks about this now because the direct-to-consumer marketing is so aggressive," says Dr. Michael O'Leary, a urologist at Harvard-affiliated Brigham and Women's Hospital. "Tons of men who would never have asked me about it before started to do so when they saw ads that say 'Do you feel tired?'"
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