Scientists in Italy found that subjects who consumed roughly 3 grams of D-AA for 12 days observed a 42 percent increase in testosterone levels.[12] The researchers also noted that the D-AA group still had 22 percent more testosterone than the placebo group three days after they stopped supplementing. Conversely, a more recent article published in Nutrition Research found no increase in testosterone levels in resistance-trained males after supplementing with 3 grams of D-AA for 28 days.[13]
“I'll be totally honest I tried a different product, and I wasn't happy with the different product and so I've been without any supplement for some time now, and I can really feel the difference. And I had fantastic results with the Andro400 Max. Probably lost 35 pounds. And more impressive than that was the inches I lost off of my belly and my waist. The increased energy is fantastic, and the mood enhancement is really good. I'm very impressed with it. You guys are considerably cheaper than the other brand. I get 2 bottles a month from you guys and that's even $15 less than the GNC product.” 

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.
By passing this bill, the Congress has amended the Controlled Substances Act to include Androstenedione supplements such as 4 Androstenediol, 5 Androstenediol, etc. The original Anabolic Steroid Control Act was passed in 1990 creating a list of anabolic steroids that would be classified as "Schedule III" substances and put in the same category as drugs such as heroin and cocaine. Now, with the passage of Senate Bill 2195 (the Anabolic Steroid Control Act of 2004), they have added Androstenedione supplements to the Controlled Substances Act.

There is a dirty little secret about testosterone cream that almost no one knows, and I’m going to share it here. Please don’t abuse it. If you take a vanishingly small dose of testosterone cream and apply it to your labia and the vulva (or your partner’s), you will witness a form of vasodilation rarely seen no matter how good you are in bed. It has a profound local effect and will produce a night you won’t forget for years.
I am 56 and I have been taking 100 mg of Test Cyp IM once a week for the last 4 months. My total T fluctuates between 500 and 1000 and my E2 has been staying under 30 with the help of Arimidex 0.5 mg every 3.5 days. I do not know what my free T is due to the expense but I feel much better than I did. Not great but much better so I will continue. If you are not feeling good on TRT then you should have your E2 checked because it is probably over 30 which will counteract the effects of your free T.
What is your opinion of using depo-testosterone injections on women? I am 44 and have had a complete hyserectomy. My OB/GYN was injecting the hormone when I complained of low libido. Unfortunately, the doctor was asked to leave the practice and his replacement refuses to use the injections on me. Any thoughts or suggestions would be greatly appreciated.

A meta-analysis of nine randomized controlled trials [31] evaluated effects of ginger on net changes in blood glucose and lipid concentrations (total cholesterol, triglyceride, low-density lipoprotein cholesterol, high density lipoprotein cholesterol).  In a total of 609 adults with T2DM or hyperlipidemia, ginger supplementation led to significant reductions in plasma levels of total cholesterol, triglycerides, and blood glucose, but non-significant reduction in LDL-c levels.
One preliminary study by researchers from Tikrit University showed high statistically significant increase of serum hormones (p< 0.01) in infertile men [9]. After 30 week treatment serum testosterone has increased by 17,7%, serum luteinizing hormone by 43,2% and serum follicle-stimulating hormone by 17,6%; dosage of ginger used was not disclosed [9]. It is suggested that improved testosterone production is because ginger was shown to be effective in decreasing SDF (sperm DNA Fragmentation) in infertile men [22]. SDF is negatively correlated with testosterone levels [23].
I’m telling you all of this because no matter who you are, keeping your testosterone levels balanced is more important now than ever before. Modern living has not been kind to our hormones. In American men, serum testosterone levels have declined by about 1% each year for the past 30 years [5], and you can make a few educated guesses about why. Hormone-disrupting chemicals are more prevalent than ever before, physical activity is less and less common, veganism is popular (I was a raw vegan for a while), and many doctors insist on pushing a low-fat, low-cholesterol diet for health (by the way, the concept of a low-fat diet began in the mid-70s, shortly before the nationwide testosterone decline. It could be a coincidence, but I doubt it).
The information presented on this website is intended to be used for educational purposes only. The statements made have not been evaluated by the Food and Drug Administration (U.S.). Products are not intended to diagnose, treat, cure or prevent any condition or disease. Please consult with your own physician or health care practitioner regarding any suggestions and recommendations made.
Testosterone was first used as a clinical drug as early as 1937, but with little understanding of its mechanisms. The hormone is now widely prescribed to men whose bodies naturally produce low levels. But the levels at which testosterone deficiency become medically relevant still aren’t well understood. Normal testosterone production varies widely in men, so it’s difficult to know what levels have medical significance. The hormone’s mechanisms of action are also unclear.
In summary, low testosterone levels are linked to the presence of numerous cardiovascular risk factors. Testosterone treatment acts to improve some of these factors, but effects may vary according to pre- and post-treatment testosterone levels, as well as other factors. There is little data from trials specific to aging males. Appropriately-powered randomized controlled trials, with cardiovascular disease primary endpoints, are needed to clarify the situation, but in the meantime the balance of evidence is that testosterone has either neutral or beneficial effects on the risk of cardiovascular disease in men. It is particularly important to define the effect of testosterone treatment on cardiovascular disease in view of its potential use as an anti-anginal agent.
I’m afraid I have no super cool “secrets” to share and there are no easy shortcuts to increasing your T. If you were expecting some magical potion or supplement or weird body hack that will instantly and naturally increase your T levels, what follows is bound to disappoint. Despite what some companies or websites might tell you, there’s no single thing that will boost your testosterone naturally for the long term.

Insulin causes lower Testosterone levels, so go easy on the carbs and eat more protein right? Well you need to be careful with protein consumption – Excess protein without fat can also cause insulin spikes. So go easy on that chicken breast with a side of egg white omelets washed down with a protein shake. From an insulin point of view you may as well drink a can of soda with some aminos acid! So what should you do? Eat more fat.


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]
Ginger is also often found in joint support supplements. There is little well-designed research, however, ginger was reported to have some effectiveness for relieving joint pain of osteoarthritis (OA) and rheumatoid arthritis probably due to its anti-inflammatory [17,18,21] and anti-oxidant activity [17,18]. In a meta-analysis of five trials (593 patients) ginger was found to be modestly efficacious and reasonably safe for treatment of OA and was able to reduce pain and disability [32].
From there, you’ll want to adjust how you train, since certain activities provide an especially powerful stimulus for testosterone. Research published in the journal Sports Medicine found that in order to experience a strong testosterone response from exercise, your workouts should be high in volume and produce a metabolic response. Churn through many exercises, sets, and reps, and focus on intense bursts of exercise with short rest periods.
So much to say, take a look at excelmale.com. it is a resource for men like us that give answers, science and dialogue which addresses our questions. It’s a great resource for men like us. Also, I would say to eliminate blue light before bed from tv and pc screens. Simply use blue light blocking glasses or F.lux from the play store. Also get outside in the sun in the AM. The goal is to restore the circadian rhythm which impacts hormone productiion.

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.
The reason I started the experiment at that point is because I know a lot of guys who live my last-August lifestyle all the time, and I wanted to see what would happen to an “average” guy who turned things around. At the same time, there was no “normal” time in my life which would have been better for me to start the experiment. My stress level and diet fluctuates throughout the year anyway, so at any point, factors in my current lifestyle would have influenced the results. I wanted to begin at “ground zero.”
The normal development of the prostate gland is dependent on the action of testosterone via the androgen receptor, and abnormal biosynthesis of the hormone or inactivating mutations of the androgen receptor are associated with a rudimentary prostate gland. Testosterone also requires conversion to dihydrotestosterone in the prostate gland for full activity. In view of this link between testosterone and prostate development, it is important to consider the impact that testosterone replacement may have on the prevalence and morbidity associated with benign prostatic hypertrophy (BPH) and prostate cancer, which are the common conditions related to pathological growth of the prostate gland.
A testosterone booster is a natural supplement used by people (mostly men) to boost their testosterone levels. They work in a few different ways. First, they often impact the hormones related to testosterone and cause more of the hormones to circulate in the blood. They also can block estrogen production, which is commonly called a female sex hormone.
Unlike women, who experience a rapid drop in hormone levels at menopause, men experience a more gradual decrease of testosterone levels over time. The older the man, the more likely he is to experience below-normal testosterone levels. Men with testosterone levels below 300 ng/dL may experience some degree of low T symptoms. Your doctor can conduct a blood test and recommend treatment if needed. They can discuss the potential benefits and risks of testosterone medication, as well.
My entire presentation was focused on 32 different ways to increase testosterone naturally, with no injections or hormone replacement protocols required. I'm not against bioidentical hormone replacement therapy (BHRT), but I do think one should explore as many natural alternatives as possible first. Or, for even more bang for the buck, pair BHRT with the tactics you'll discover in this episode.

Hormonal Imbalance can affect your personal and work relationships. Some of the most noticeable symptoms prompting patient's to seek out medical care are a complete lack of energy and sheer fatigue, loss of sex drive, erectile dysfunction or soft erections, loss of lean muscle mass and bone strength, rapid weight gain, excessive adipose fatty tissue, disturbed sleep patterns, depression, moodiness, social withdrawal, reduced ability to recover from workouts, flabby muscles, lack of strength and endurance.


The potential downside of this positive feedback loop, Coates argues, is that testosterone levels can eventually surge past optimal levels and have the opposite effect – leading to overconfidence and poor decision-making. When this happens to animals, Coates, observed, they “go out in the open, pick too many fights [and] patrol areas that are too large…Risk taking becomes risky behaviour.”
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.
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.
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.
It’s worth emphasizing that these supplements are totally legit. They’re NOT steroids. Meaning, only the natural and harmless ingredients have been used to make these products, which can help the guys dealing with the low testosterone problems, such as low energy, fatigue, muscle loss, irritability, and similar. Usually, the guys tend to start experience these problems in their late 20s and in some cases in their early 30s.
After various studies in animals had shown anabolic (muscle building) properties among the various Fenugreek benefits, a study was conducted on men undergoing resistance training. During the study the participants trained in a supervised manner 4 times a week for 8 weeks. Although the levels of DHT (Dihydrotestosterone) were reduced in those taking the Fenugreek supplement, other hormonal markers were not affected[4]. Another study further supported those findings, while also reporting that those taking the supplement witnessed an additional 2kg of fat loss and 2kg more muscle mass gain over the same period[5]. Impressive results indeed.
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
I’m 56 and 5 years ago dropped to 270 with all the side effects listed for low test. After trying shots and not liking the roller coaster effect, I switched to gels. Androgel and Axiron had too low a dosage and far too messy. They need to not call them gels but liquids. If it pours like water it’s a liquid. My doctor recommended a compounding Pharmacy that made a cream and it was perfect. It had a click dispenser that looked like a deoderant that would pre-measure the dosage and I could rub it on my arms and shoulders or on my neck, really anywhere not covered in hair but the thinner the skin the better. It dried instantly so I could get dressed in a couple minutes. My totals never got out of the 400’s until I started the 150mg daily cream dosage, then they hovered around 700. The down side was Insurance didn’t cover it and I had to pay $50 a month vs free shots from the doctors office or $10 for the so-called gels. Bad news is it has now doubled in price due to new Federal production regs on compounding Pharms. Now, I am going back on the shots which I now have to buy the vile for $125 for 10 doses and have to take it to my doctor to administer it every 2wks while I am looking into bioidentical pellet implants.

However, testosterone is only one of many factors that aid in adequate erections. Research is inconclusive regarding the role of testosterone replacement in the treatment of erectile dysfunction. In a review of studies that looked at the benefit of testosterone in men with erection difficulties, showed no improvement with testosterone treatment. Many times, other health problems play a role in erectile difficulties. These can include:


Insulin causes lower Testosterone levels, so go easy on the carbs and eat more protein right? Well you need to be careful with protein consumption – Excess protein without fat can also cause insulin spikes. So go easy on that chicken breast with a side of egg white omelets washed down with a protein shake. From an insulin point of view you may as well drink a can of soda with some aminos acid! So what should you do? Eat more fat.
More can be learned from a large, randomized, placebo-controlled trial of finasteride treatment in 18,800 men aged 55 or more. Finasteride is a 5α-reductase inhibitor which acts to prevent the metabolism of testosterone to dihydrotestosterone (DHT) – the most active androgen in the prostate. The trial showed a greater overall incidence of prostate cancer in the control group, but men treated with finasteride were more likely to have high grade tumors (Thompson et al 2003), suggesting that reduced androgen exposure of the prostate may delay the presentation of prostate cancer and/or promote advanced disease in some other way.
My preference is to start men on testosterone, for a couple of reasons. First, if a man has successful return of his own erections, it’s like a home run for him. He doesn’t have to take a pill in anticipation of having sex. He can have sex whenever he wants. Second, the benefits of testosterone-replacement therapy often go way beyond erectile dysfunction. That may be what brought the patient into the office originally, but then he comes back saying how much better he feels in general, how much more energetic and motivated he is, how his drives on the golf course seem to be going farther, and how his mood is better.
This one is another herb that is known to increase semen volume. It has been found that men who consume this herb in the form of a supplement can expect higher sperm count per milliliter of semen, higher semen volume per ejaculation and also better sperm motility. It is also known to have a positive effect on the sex drive and arousal of both men and women.

It also had a purpose. It turns out posing in powerful stances causes your testosterone to increase within 20 minutes [13,14]. In those two studies, power posing for just a few minutes also dropped cortisol and boosted confidence. It’s a great way to start your day, or to give yourself an edge before a job interview or a big presentation. They don’t call it “warrior pose” for nothing!
Bodybuilding.com sells science-backed testosterone support from top brands so you can continue to crush your goals. Our customer reviews will give you a snapshot of how each of these products works on real people living real lives, so you can make the best decision for your body. Ready to feel powerful again? Let’s find the test booster that’s right for you.
The one side effect that no one talks about is psychological for me. Because I am 67 years old and suddenly look, feel and act 37 I only want to be around younger people. I have no use associating with people my own age. I have nothing in common and even look different. This year at my class reunion was a glaring example…..no doubt I looked younger than anyone, but it is sooo much more than just very that. My customers are young, all my girlfriends and associates. This all has a large effect on my mind. It’s hard to grasp suddenly looking and acting 30 years younger than your friends. My mind is so confused about how old I really am. I do a lot of adrenalin sports for my age snow ski, wake-surf, wake-board, scuba dive and it is no doubt just a matter of time till I get hurt doing these wild sports. In my mind I’m 37 so I think it’s all normal. This whole experience has been incredible and very positive with the only one psychological effect and no other physical side effect.
Overall there is evidence that testosterone treatment increases lean body mass and reduces obesity, particularly visceral obesity, in a variety of populations including aging men. With regard to muscle changes, some studies demonstrate improvements in maximal strength but the results are inconsistent and it has not been demonstrated that these changes lead to clinically important improvements in mobility, endurance or quality of life. Studies are needed to clarify this. Changes in abdominal obesity are particularly important as visceral fat is now recognised as predisposing the metabolic syndrome, diabetes and cardiovascular disease.
Epidemiological evidence supports a link between testosterone and glucose metabolism. Studies in non-diabetic men have found an inverse correlation of total or free testosterone with glucose and insulin levels (Simon et al 1992; Haffner et al 1994) and studies show lower testosterone levels in patients with the metabolic syndrome (Laaksonen et al 2003; Muller et al 2005; Kupelian et al 2006) or diabetes (Barrett-Connor 1992; Andersson et al 1994; Rhoden et al 2005). A study of patients with type 2 diabetes using measurement of serum free testosterone by the gold standard method of equilibrium dialysis, found a 33% prevalence of biochemical hypogonadism (Dhindsa et al 2004). The Barnsley study demonstrated a high prevalence of clinical and biochemical hypogonadism with 19% having total testosterone levels below 8 nmol/l and a further 25% between 8–12 nmol/l (Kapoor, Aldred et al 2007). There are also a number longitudinal studies linking low serum testosterone levels to the future development of the metabolic syndrome (Laaksonen et al 2004) or type 2 diabetes (Haffner et al 1996; Tibblin et al 1996; Stellato et al 2000; Oh et al 2002; Laaksonen et al 2004), indicating a possible role of hypogonadism in the pathogenesis of type 2 diabetes in men. Alternatively, it has been postulated that obesity may be the common link between low testosterone levels and insulin resistance, diabetes and cardiovascular disease (Phillips et al 2003; Kapoor et al 2005). With regard to this hypothesis, study findings vary as to whether the association of testosterone with diabetes occurs independently of obesity (Haffner et al 1996; Laaksonen et al 2003; Rhoden et al 2005).
“I'll be totally honest I tried a different product, and I wasn't happy with the different product and so I've been without any supplement for some time now, and I can really feel the difference. And I had fantastic results with the Andro400 Max. Probably lost 35 pounds. And more impressive than that was the inches I lost off of my belly and my waist. The increased energy is fantastic, and the mood enhancement is really good. I'm very impressed with it. You guys are considerably cheaper than the other brand. I get 2 bottles a month from you guys and that's even $15 less than the GNC product.”
Scientists in Italy found that subjects who consumed roughly 3 grams of D-AA for 12 days observed a 42 percent increase in testosterone levels.[12] The researchers also noted that the D-AA group still had 22 percent more testosterone than the placebo group three days after they stopped supplementing. Conversely, a more recent article published in Nutrition Research found no increase in testosterone levels in resistance-trained males after supplementing with 3 grams of D-AA for 28 days.[13]
Pine Pollen is an androgen, meaning in theory it can raise testosterone levels – effectively making it a naturally derived source of testosterone. Read more about this on the links below. But like I said I started taking it for a few weeks and did notice a bit more ‘up and go’ so to speak, but it did only last a few weeks. I have tried cycling it but haven’t noticed the same effects as I had when I initially started with it. I’m still experimenting and will keep this page updated. Therefore I recommend doing your own research.
Let’s do a quick review of what I shared in the introduction to this series. August of last year was a tough month for me, primarily because of a huge and grueling project we were in the midst of here on the site. I was stressed out and my sleeping, healthy eating habits, and workout regimen all suffered. At the end of the month I got my testosterone levels tested and found that my total T was 383 ng/dL and my free T was 7.2 pg/mL – close to the average for an 85-100-year-old man.
Women also feel the effects of testosterone imbalance. Common knowledge holds that testosterone is just for men, but that’s not true. Low testosterone in women results in a wide variety of hard to diagnose symptoms: fatigue, anxiety, sleeplessness, depression, and weight gain are some common symptoms. These effects are commonly seen after menopause, but hormone imbalances can happen at any age. Properly balancing the body’s natural testosterone and estrogen levels prevents these symptoms.
Studies have shown that testosterone-replacement therapy may offer a wide range of benefits for men with hypogonadism, including improved libido, mood, cognition, muscle mass, bone density, and red blood cell production. But little consensus exists on what constitutes low testosterone, when testosterone supplementation makes sense, or what risks patients face. Much of the current debate focuses on the long-held belief that testosterone may stimulate prostate cancer.
Testosterone is included in the World Health Organization's list of essential medicines, which are the most important medications needed in a basic health system.[111] It is available as a generic medication.[10] The price depends on the form of testosterone used.[112] It can be administered as a cream or transdermal patch that is applied to the skin, by injection into a muscle, as a tablet that is placed in the cheek, or by ingestion.[10]

Thomas M. Gill, MD, Humana Foundation Professor of Medicine at Yale University School of Medicine in New Haven, CT, told EndocrineWeb that these trials were needed because “the pharmaceutical industry did a very good job of promoting testosterone, and there have been suggestions of parallels between age-related decreases in testosterone levels in men, and menopause in older women.”
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.
Started HRT in my early 50’s as I had all the low-T symptoms and Type 2 Diabetes, which was hammering my body. My total T was about 100 (not sure about Free at that point). First started with Androgel, and was getting decent symptomatic improvement, but didn’t like the residue from the cream, and traveling with the creams was a problem. I’ve gone to pellet implants for the past 7 years. Every 4-5 months, very happy with results to date.
TestoRush is a decent natural testosterone booster with decent ingredients. It’s not nearly as potent as some other higher ranked supplements on this site, and, in reading every review we could find from customers, it appears there’s some negativity towards the company. Read this full TestoRush review and find out how it measures up to other boosters we’ve reviewed. READ THE REVIEW
Why the difference? The discrepancy in findings between these studies is likely due to the initial training status and base testosterone levels of the subjects. While more research is warranted on this ingredient, D-AA is one of several ingredients suggested to be effective in boosting test levels, especially for older men whose natural testosterone levels have declined due to the natural course of aging.
The researchers found that men who received hormone treatment experienced an increase in bone strength and density. Strength increases were greater in the spine than they were in the hip. However, as with other T Trials, more research needs to be done. A larger study over many years would need to be performed to determine whether testosterone could decrease risk of bone fracture.
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?
Shilajit in its natural state has no chemical definition. In order to yield a consistent and efficacious form of shilajit, the shilajit is obtained from carefully selected rocks and is put through a patented technology where it is purified and standardized. This form of shilajit is now assured of optimal levels of bioactive components such as fulvic acid and dibenzo-pyrones, and is known as the patented PrimaVie.
Autopsy studies have found histological prostate cancer to be very common, with one series showing a prevalence of greater than fifty percent in men over age sixty (Holund 1980). The majority of histological cancers go undetected so that the clinical incidence of the disease is much lower, but it is still the most prevalent non-skin cancer in men (Jemal et al 2003). Prostate cancer is also unusual in comparison to other adult cancers in that the majority of those with the disease will die of other causes. Treatment of prostate cancer with androgen deprivation is known to be successful and is widely practiced, indicating an important role for testosterone in modifying the behavior of prostate cancer. In view of this, testosterone treatment is absolutely contraindicated in any case of known or suspected prostate cancer. The question of whether testosterone treatment could cause new cases of prostate cancer, or more likely cause progression of undiagnosed histological prostate cancer that would otherwise have remained occult, is an important consideration when treating ageing males with 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.
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