Everytime you add Testosterone to your system, be it naturally through producing in the testis, injected, oral, or dermal you will receive a spike in your blood levels. Estrogen is mainly created in men by an action of an enzyme called Aromatase. Aromatase floats around and binds to Testosterone and converts it to Estrogen. When you spike your T your E will follow in this way. The obvious and detrimental effects to many of the already estrogen dominant hypogonadal men will be inappropriate over stimulation of the estrogen receptors in the body. Gynecomastia, fluid retention, weight gain, brain fog, erratic emotions, depression, ect. Higher levels of Estrogen cause SHBG to be created. SHBG binds to Testosterone and transports it to the liver for disposal. On top of this Estrogen can bind to your androgen receptors causing Testosterone to float around with no where to go. If you are taking shots or gel or cream and feel little to no effect even though it’s technically raised your T blood ranges, you now have an multiple answers for why you little to nothing or feel even worse. This has been known for years that you must be prepared to control Estrogen. An Aromatase Inhibitor (AI) or anti estrogen medication (Clomiphene, Tamoxifen) is needed to stop the estrogen from getting out of control. By taking an Aromatase inhibitor and monitoring your E2 levels you can easily control Estrogen, Aromatase, and SHBG from getting out of hand and free up those blocked androgen receptors so you can now reap the benefits of elevating T to a healthy level. If your Doctor is not testing your E2(aka Estrogen, Estradiol) levels before and during talks and administration of TRT or will never prescribe an AI then you shouldn’t be following his advice at all and will be harmed by Testosterone usage. This may sound complicated but in the end it’s simple. Elevate Testosterone. Control Estrogen. Only two medications needed. Don’t settle.
If you are serious about losing weight, you have got to strictly limit the amount of processed sugar in your diet, as evidence is mounting that excess sugar, and fructose in particular, is the primary driving factor in the obesity epidemic. So cutting soda from your diet is essential, as is limiting fructose found in processed foods, fruit juice, excessive fruit and so-called "healthy" sweeteners like agave.
Smith, R. P., Khanna, A., Coward, R. M., Rajanahally, S., Kovac, J. R., Gonzales, M. A., & Lipshultz, L. I. (2013, September). Factors influencing patient decisions to initiate and discontinue subcutaneous testosterone pellets (Testopel) for treatment of hypogonadism [Abstract]. The Journal of Sexual Medicine, 10(9), 2326–2333. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23859250
Increased testosterone can have an impact on body composition. Possible benefits include gains in lean muscle mass, reduced body fat and increased bone density. Testosterone inhibits uptake of triglycerides and increases lipid mobilization from adipose tissue, and the increase or decrease of testosterone will usually have an inverse effect on fat stores, with higher testosterone generally causing a decrease in body fat. "The Journal of Clinical Endocrinology and Metabolism" published a study in 2007 that showed decreases in body fat and increases in lean mass in HIV-positive obese men given testosterone therapy. In 1989, a study of the effects of testosterone on muscle mass at the University of Rochester School of Medicine and Dentistry suggests that increasing testosterone increases protein synthesis in muscles. Body composition changes from increased testosterone were also demonstrated in a 1999 study at the School of Exercise Science and Sports Management, Southern Cross University in Australia performed on male weight-training subjects, which showed increases in arm girth and body weight and decreased body fat following a 12-week cycle of testosterone enanthate.
The effect excess testosterone has on the body depends on both age and sex. It is unlikely that adult men will develop a disorder in which they produce too much testosterone and it is often difficult to spot that an adult male has too much testosterone. More obviously, young children with too much testosterone may enter a false growth spurt and show signs of early puberty and young girls may experience abnormal changes to their genitalia. In both males and females, too much testosterone can lead to precocious puberty and result in infertility. 

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.


Men on long-term testosterone appear to have a higher risk of cardiovascular problems, like heart attacks, strokes, and deaths from heart disease. For example, in 2010, researchers halted the Testosterone in Older Men study when early results showed that men on hormone treatments had noticeably more heart problems. "In older men, theoretical cardiac side effects become a little more immediate," Dr. Pallais says.
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).
Many clinical studies have looked at the effect of testosterone treatment on body composition in hypogonadal men or men with borderline low testosterone levels. Some of these studies specifically examine these changes in older men (Tenover 1992; Morley et al 1993; Urban et al 1995; Sih et al 1997; Snyder et al 1999; Kenny et al 2001; Ferrando et al 2002; Steidle et al 2003; Page et al 2005). The data from studies, on patients from all age groups, are consistent in showing an increase in fat free mass and decrease in fat mass or visceral adiposity with testosterone treatment. A recent meta-analysis of 16 randomized controlled trials of testosterone treatment effects on body composition confirms this pattern (Isidori et al 2005). There have been less consistent results with regard to the effects of testosterone treatment of muscle strength. Some studies have shown an increase in muscle strength (Ferrando et al 2002; Page et al 2005) with testosterone whilst others have not (Snyder et al 1999). Within the same trial some muscle group strengths may improve whilst others do not (Ly et al 2001). It is likely that the differences are partly due to the methodological variations in assessing strength, but it also possible that testosterone has different effects on the various muscle groups. The meta-analysis found trends toward significant improvements in dominant knee and hand grip strength only (Isidori et al 2005).
There are three ways to increase testosterone activity naturally with simple lifestyle choices. The first is to increase total testosterone production. Second is to increase the amount of free and active testosterone that can stimulate testosterone receptors. The third is to unblock testosterone receptors, opening them up for testosterone stimulation.
There are positive correlations between positive orgasm experience in women and testosterone levels where relaxation was a key perception of the experience. There is no correlation between testosterone and men's perceptions of their orgasm experience, and also no correlation between higher testosterone levels and greater sexual assertiveness in either sex.[34]
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.
The oldest form is an injection, which we still use because it’s inexpensive and because we reliably get good testosterone levels in nearly everybody. The disadvantage is that a man needs to come in every few weeks to get a shot. A roller-coaster effect can also occur as blood testosterone levels peak and then return to baseline. [See “Exogenous vs. endogenous testosterone,” above.]
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.
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]
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.
In contrast to steroids, testosterone boosters have a fully different mechanism of action. They are the products which contain the natural ingredients only. These ingredients act by stimulating the man’s body to synthesize own testosterone. So, testosterone levels grow naturally without negative health effects associated with the intake of steroids.

Low Testosterone has a big impact on men. Some males suffer debilitating symptoms when their bodies produce insufficient levels of testosterone, resulting in a condition called hypogonadism. Hypogonadism is the decreased functionality of the testes in producing an adequate amount of testosterone. Hypogonadism is not permanent, and can be treated with hormone replacement therapy, specifically Low Testosterone Therapy.
If you are serious about losing weight, you have got to strictly limit the amount of processed sugar in your diet, as evidence is mounting that excess sugar, and fructose in particular, is the primary driving factor in the obesity epidemic. So cutting soda from your diet is essential, as is limiting fructose found in processed foods, fruit juice, excessive fruit and so-called "healthy" sweeteners like agave.
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]
I’m a low key,thinker-type, after a test I learned my T hormone was so low I should be rigid. TRT sent my drive into negative overdrive: ambition, cunning, entrepreneurial risk, physcal and psychological risks: drugs,you name it. I was lucky it happened after 50 years of memories ’cause I missd and have problems recalling the last seven years that I was on TRT (5 pumps a day of 1.25mgs). If you’re starting, take a pictoral record at the least of your monthly life ( a flick a month).

“I'm 55 years old and hitting the ball further than I've ever hit, and I'm not getting tired going 18 holes! And when I play softball I'm hitting the ball further. I work for the DWP in LA and it's a very physically demanding job. Andro400 really helps because we work 16 hour days a lot. I was turning down a lot of overtime, but when I started taking Andro400, it got me through the day. I really notice a difference – even my wife did. It really works!”
There are two keys to incorporating fat in your diet: getting enough fat, and getting the right kinds of it. A study from 1984 (done, no doubt, with Big Brother watching) looked at 30 healthy men who switched from eating 40% fat (much of it saturated) to 25% fat (much of it unsaturated), with more protein and carbs to make up the difference in calories. After 6 weeks, their average serum testosterone, free testosterone, and 4-androstenedione (an important hormone for testosterone synthesis) all dropped significantly [6]. I think getting 40% of your calories from fat is too little – I recommend 50-70% of calories from fat, or even more in some cases.
A notable study out of Wayne State University in Indiana found that older men who had a mild zinc deficiency significantly increased their testosterone from 8.3 to 16.0 nmol/L—a 93 percent increase—following six months of zinc supplementation. Researchers of the study concluded that zinc may play an important role in modulating serum testosterone levels in normal healthy men.6
Known as the "male hormone," testosterone is produced primarily by the testicles. "Beginning around age 30, testosterone levels begin to decline naturally and continue to do so as a man ages," says Holly Lucille, ND, RN, a naturopathic doctor, educator, and author, "sometimes leading to low testosterone symptoms such as depressed moods, decreased sex drive, erectile dysfunction, and difficulties with concentration and memory.”
Our bodies need zinc to make testosterone. Zinc also blocks the action of aromatase, the enzyme that converts testosterone to estrogen. Oysters offer the highest amount of zinc per serving of any food. Just six oysters contain about 500 percent of the mineral’s recommended daily allowance (RDA). Other zinc-rich foods include lean meats and spinach.
In this study, an ethical approval No. 20171008 was obtained from Ethical Committee of Qassim province, Ministry of Health, Saudi Arabia. At the beginning, a written informed consent was taken from a 30-year-old man for participation in this study. The patient came to the King Saud Hospital, Unaizah, Qassim, Saudi Arabia, with abdominal pain. He looked pale and hazy, hence, immediately admitted. A battery of lab tests was ordered by the attending physician. Moreover, abdominal ultrasound imaging was performed. The results of the tests showed high levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), indicating liver injury. Other serum parameters, such as total proteins, albumin, and iron, in addition to the levels of kidney and heart enzymes were all found to be in the normal range. A complete blood count showed normal levels of red blood cells, white blood cells, and platelets. The ultrasound images of the man’s abdomen were all found to be normal as well [Figure 2]. The patient, a sportsman, described that he was taking a testosterone commercial booster product called the Universal Nutrition Animal Stak for the purpose of enhancing his testosterone profile to achieve a better performance and body composition. The attending physician decided to admit the man for 1 week. Some medications were prescribed, and the patient was discharged later after having fully recovered.
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.
A study in the European Journal of Clinical Nutrition that showed drops in cholesterol levels also highlighted the benefits of Fenugreek in controlling glucose levels (this is in fact what the trial was intended to test). When you eat, your glucose levels spike. Fenugreek helps stimulate insulin release to slow down the absorption of sugars in your intestinal tract. Fenugreek might help control blood sugar levels in diabetics.  Furthermore, high glucose levels create a poor environment for testosterone production.  This is why Tim Ferris, in his testosterone diet, advises against consuming sweets and simple starches when you are trying to increase T levels.
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In the 2nd study, short-term testosterone treatment in older men significantly increased noncalcified coronary artery plaque volumes, possibly raising their risk of cardiovascular (CV) events,2 according to Matthew J. Budoff, MD, a professor of medicine at the David Geffen School of Medicine at UCLA and the Los Angeles Biomedical Research Institute in Torrance, California, and colleagues. 
Such sort of injuries varies in severity and extent of damage markedly from one person to the other and withdrawal of the drug/supplement coupled with proper medical attention suffice in terms of alleviating the symptoms.[8,12] This was observed in the present case. However, the liver injury observed here may not be confidently linked to product consumption as the subject later reported that the following recovery he consumed two more courses of the booster with no side effects. Tests performed following hospital discharge, and repeated use of the product showed AST and ALT to be slightly high, whereas the rest of the blood parameters tested appeared to be normal. The AST/ALT ratio is considered to be a very important parameter for the evaluation of liver diseases, such as non-alcoholic fatty liver disease,[13] though it is rarely considered alone. Overall, the evidence was inconclusive in the present work in terms of linking the use of a testosterone booster with liver injury. However, even though a single case report cannot establish causality with statistical power.[13] Further research on the usage of a commercial testosterone booster within large populations for a long period is necessary to investigate whether the symptoms shown in the present case were significantly present in other athletes consuming the same commercial product or not. To guarantee an optimal outcome with no severe side effects, further research is warranted to confirm the present findings and determine whether the effects observed in this case report would be statistically significant in larger samples.

Tailor the above recommendations to your personal needs and lifestyle. If you’re a vegetarian drop the bacon and steak, but keep the whey protein and eggs. If you have an injury that prevents you from heavy weightlifting, move as much as you can in the way that you can. There are no studies out there which can tell you exactly what will happen if you do X and Y, but not Z. And I certainly can’t tell you either. Don’t be afraid of self-education – that’s how I learned all this – and embrace the idea of conducting your own experiment and being your own test subject. Incorporate as many of the recommendations above as you’re comfortable with, consult your doctor, and track your results.

Margaret, I’m on Trt, and my wife is 43 going through Peri- (early/pre) menopause. She started trying about a drop a day to see if her libido would improve, and it did, dramatically, and also her moods and patience. After about a month of feeling 30again, she started noticing lite facial hair developing, decreased breast size, and return of all previous symptoms. So she went off it. About a month later, she started St.JohnsWart, and everything improved tenfold. Now she feels 20 instead of just 30 on testosterone. She literally glows with smiles and energy, and has an extremely high libido. Maybe try that first. Good luck.
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.
Cross-sectional studies have not shown raised testosterone levels at the time of diagnosis of prostate cancer, and in fact, low testosterone at the time of diagnosis has been linked with more locally aggressive and malignant tumors (Massengill et al 2003; Imamoto et al 2005; Isom-Batz et al 2005). This may reflect loss of hormone related control of the tumor or the effect of a more aggressive tumor in decreasing testosterone levels. One study found that 14% of hypogonadal men, with normal digital rectal examination and PSA levels, had histological prostate cancer on biopsy. It is possible that low androgen levels masked the usual evidence of prostate cancer in this population (Morgentaler et al 1996). Most longitudinal studies have not shown a correlation between testosterone levels and the future development of prostate cancer (Carter et al 1995; Heikkila et al 1999; Stattin et al 2004) but a recent study did find a positive association (Parsons et al 2005). Interpretation of such data requires care, as the presentation of prostate cancer could be altered or delayed in patients with lower testosterone levels.

This is over simplified but should offer you some clarity to what you are experiencing – If you are getting Testosterone Cypionate injections every 2 weeks, then you are on the roller coaster. I have great results with weekly injections and some folks need bi-weekly injections. It’s all how your body reacts but every 2 weeks is just plain too far apart as the product is relatively ineffective after 10 days. Measurable at 10 days? Somewhat but still ineffective at that point.
A: Testosterone production declines naturally with age. Low testosterone, or testosterone deficiency (TD), may result from disease or damage to the hypothalamus, pituitary gland, or testicles that inhibits hormone secretion and testosterone production. Treatment involves hormone replacement therapy. The method of delivery is determined by age and duration of deficiency. Oral testosterone, Testred (methyltestosterone), is associated with liver toxicity and liver tumors and so is prescribed sparingly. Transdermal delivery with a testosterone patch is becoming the most common method of treatment for testosterone deficiency in adults. A patch is worn, either on the scrotum or elsewhere on the body, and testosterone is released through the skin at controlled intervals. Patches are typically worn for 12 or 24 hours and can be worn during exercise, bathing, and strenuous activity. Two transdermal patches that are available are Androderm (nonscrotal) and Testoderm (scrotal). The Androderm patch is applied to the abdomen, lower back, thigh, or upper arm and should be applied at the same time every evening between 8 p.m. and midnight. If the patch falls off before noon, replace it with a fresh patch until it is time to reapply a new patch that evening. If the patch falls off after noon, do not replace it until you reapply a new patch that evening. The most common side effects associated with transdermal patch therapy include itching, discomfort, and irritation at the site of application. Some men may experience fluid retention, acne, and temporary abnormal breast development (gynecosmastia). AndroGel and Testim are transdermal gels that are applied once daily to the clean dry skin of the upper arms or abdomen. When used properly, these gels deliver testosterone for 24 hours. The gel must be allowed to dry on the skin before dressing and must be applied at least 6 hours before showering or swimming. Gels cannot be applied to the genitals. AndroGel is available in a metered-dose pump, which allows physicians to adjust the dosage of the medication. Side effects of transdermal gels include adverse reactions at the site of application, acne, headache, and hair loss (alopecia). For more specific information on treatments for low testosterone, consult with your doctor or pharmacist for guidance based on current health condition. Kimberly Hotz, PharmD
Testosterone improves not just your sex drive, but it also enhances exercise drive, energy for work, mental sharpness, muscle repair, and revs your metabolism to help with weight control. Although improving testosterone levels has not yet been shown to increase lifespan, having a healthy testosterone level improves quality of life for both men and women.
“I’m a retired firefighter going on 65 and noticed I was getting soft and bigger in the belly even though I do regular exercise (jogging 3-4 miles 4 to 5 times a week). Since using Andro400, I’ve lost 2 inches off my waist and 12-13 pounds. I did not diet, ate what I normally do (here in Vegas, lots of buffets). Started out with a 38 inch waist, now 36; 195 lbs., now in the 182 range.” 

A notable study out of Wayne State University in Indiana found that older men who had a mild zinc deficiency significantly increased their testosterone from 8.3 to 16.0 nmol/L—a 93 percent increase—following six months of zinc supplementation. Researchers of the study concluded that zinc may play an important role in modulating serum testosterone levels in normal healthy men.6

Garlic is a very effective food that has been used for centuries in treating various physical ailments including heart problems and respiratory infections. What most people don’t know is that it is also a potent aphrodisiac and very effective in boosting sperm volume. It contains a compound called allicin which improves blood flow to the male sexual organs, increasing sperm production and semen volume.


“What on earth do you mean?” Well, I don’t literally mean taking it to the compound. What I mean to say is that you should be incorporating the three most important compound exercises into your routine: bench press, squats, and deadlifts. In case you didn’t know, by training large muscle groups your body releases more testosterone. When you do these three lifts, and perform them properly, then you’ll reap the benefits of not only muscle gains, but also that of an increased release of testosterone and growth hormone.
Magnesium comes with a strict upper cap. Excess magnesium is hard on your kidneys, and can lead to kidney failure. The NIH recommends that men consume 400-420 mg of magnesium daily, but that they should not exceed 350 mg of supplemental magnesium per day. Because while it’s rare for people to chronically overdose on magnesium through diet (you’d have to eat a lot of almonds and spinach, for example), overdose by supplement is far more common.
The sexual hormone can encourage fair behavior. For the study, subjects took part in a behavioral experiment where the distribution of a real amount of money was decided. The rules allowed both fair and unfair offers. The negotiating partner could subsequently accept or decline the offer. The fairer the offer, the less probable a refusal by the negotiating partner. If no agreement was reached, neither party earned anything. Test subjects with an artificially enhanced testosterone level generally made better, fairer offers than those who received placebos, thus reducing the risk of a rejection of their offer to a minimum. Two later studies have empirically confirmed these results.[75][76][77] However men with high testosterone were significantly 27% less generous in an ultimatum game.[78] The Annual NY Academy of Sciences has also found anabolic steroid use which increase testosterone to be higher in teenagers, and this was associated with increased violence.[79] Studies have also found administered testosterone to increase verbal aggression and anger in some participants.[80]
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.
Workouts lasting longer than about an hour may begin to spike cortisol levels and subsequently decrease testosterone. Additionally, research has demonstrated that a shorter rest period between sets (1 minute versus 3 minutes) elicited higher acute hormonal responses following a bout of resistance training.11 To maximize your testosterone response, keep your rest periods short and total workout time to 60 minutes or fewer.
Hooper, D. R., Kraemer, W. J., Saenz, C., Schill, K. E., Focht, B. C., Volek, J. S. … Maresh, C. M. (2017, July). The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition [Abstract]. European Journal of Applied Physiology, 117(7), 1349–1357. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28470410
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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.

Most people associate testosterone with facial hair, gigantic muscles & illegal steroids.  Naturally produced testosterone plays a very important role in male/female metabolic function.  Lowered testosterone is a chronic epidemic that is threatening lives all around the world.  This article will go over 12 ways to boost testosterone levels naturally through healthy lifestyle measures.
Topical testosterone, specifically gels, creams and liquids, may transfer to others. Women and children are most at risk of harmful effects from contact with them. You should take care to cover the area and wash your hands well after putting on the medication. Be careful not to let the site with the topical TT touch others because that could transfer the drug.
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.
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