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Overall, it seems that both estrogen and testosterone are important for normal bone growth and maintenance. Deficiency or failure of action of the sex hormones is associated with osteoporosis and minimal trauma fractures. Estrogen in males is produced via metabolism of testosterone by aromatase and it is therefore important that androgens used for the treatment of hypogonadism be amenable to the action of aromatase to yield maximal positive effects on bone. There is data showing that testosterone treatment increases bone mineral density in aging males but that these benefits are confined to hypogonadal men. The magnitude of this improvement is greater in the spine than in the hip and further studies are warranted to confirm or refute any differential effects of testosterone at these important sites. Improvements seen in randomized controlled trials to date may underestimate true positive effects due to relatively short duration and/or baseline characteristics of the patients involved. There is no data as yet to confirm that the improvement in bone density with testosterone treatment reduces fractures in men and this is an important area for future study.

We scoured the database of the National Center for Biotechnology Information (part of the U.S. National Library of Science) for articles. Of the many ingredients marketed as boosting testosterone levels, we only found four backed by multiple articles based on human testing. For the best chance of boosting testosterone levels, a supplement needs to contain magnesium, fenugreek, and longjack — and some zinc wouldn’t go astray, either.

It's important to understand that your body requires saturated fats from animal and vegetable sources (such as meat, dairy, certain oils, and tropical plants like coconut) for optimal functioning, and if you neglect this important food group in favor of sugar, grains and other starchy carbs, your health and weight are almost guaranteed to suffer. Examples of healthy fats you can eat more of to give your testosterone levels a boost include:
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].

If low T is your initial concern, lifestyle changes may help. “Dietary and exercise changes, particularly limiting sugars, especially fructose, eating healthy saturated fats, and engaging in high-intensity exercises may relieve symptoms of low testosterone," Lucille says. "Strength training, reducing stress, and optimizing vitamin D levels can also be very effective at boosting testosterone levels naturally."
When it comes to testosterone in the body, most of it is bound testosterone. This means it is testosterone that is bound to either the sex hormone globulin or the protein albumin. The problem is this bound up testosterone goes largely unused by the body and does nothing for you in its bound state. It is the free testosterone that is the testosterone you feel and that makes you manly, this is free flowing in your veins and not bound to anything. This is the kind of testosterone you want, the more the better.
Test1fy comes in with one of the most unique formulas containing ingredients that not only support testosterone increases and lean mass gains, but also help in increasing hunger making it the perfect addition to anyone’s natural bulking stack. It is overall a well rounded and potent formula making it perfect for anyone, from newbie to the seasoned veteran.
at 54 testestrone was 135 so started TRH. Huge increase in energy and sex drive on 100mg cypriate every 2 weeks. My PSA rose from 1.13 to 1.63 in two years so Dr. ordered a biopsy. I am now almost 56. Came back with 1 out of 12 cores having adenocarcinoma and graded at 3×3.I am scheduled for a pelvic MRI in 4 weeks. DR wants me stay on testosterone for the time being and wants to add a med to block DHT (as I understand it.I got all this today so kind of confused what to do. Lifestyle-I rarely eat red meat maybe twice a month, run 10ks and half-marathons.how crazy is that?
D-Aspartic acid is a natural amino acid involved in the synthesis and release of testosterone, which research shows can be used as a testosterone booster for infertile men. One 90-day study gave D-Aspartic acid to men with impaired sperm production, and found their sperm count rose from 8.2 million sperm per ml to 16.5 million sperm per ml, more than a 100 per cent increase.
I’ve been on testosterone replacement for over 3 years and at first I did the shots and my mood swings were ridiculous, my skin broke out on my chest and shoulders, and my henatocrit went to 55%. I finally got fed up with doing shots every two weeks and switched to Gel and it’s been so much better. It actually increases my levels which is rare for most men. I do 12.5 mg, three pumps a day, and this keeps My level between 500 and 600. My hematocrit is 48.5 and no mood swings.
Clinical trials of the effect of testosterone on glucose metabolism in men have occurred in diabetic and non-diabetic populations. Data specific to aging males is not available. A series of studies investigated the effects of testosterone or dihydrotestosterone given for 6 weeks or 3 months to middle aged, non-diabetic obese men (Marin, Holmang et al 1992; Marin, Krotkiewski et al 1992; Marin et al 1993). It was found that physiological treatment doses led to improved insulin resistance, as measured by the gold standard technique using a euglycemic clamp and/or serum glucose and insulin responses during glucose tolerance test. These improvements were associated with decreased central obesity, measured by computered tomography (CT) or waist-hip ratio, without reduced total fat mass. Insulin resistance improved more with testosterone than dihydrotestosterone treatment and beneficial effects were greater in men with lower baseline testosterone levels. Increasing testosterone levels into the supraphysiological range lead to decreased glucose tolerance.
I started testosterone therapy on August 25th 2005. I remember this so well because my life pretty much changed after that. I think I’ve had low testosterone my entire life, though I’ve always had a healthy sex drive I was always tired and always sensed something was wrong although I sought out treatment at the doctor’s but just could never quite pinpoint what the problem was. long story short, I’ve had nothing but good things from testosterone therapy. mostly just more vitality and a better outlook on life

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.


Testosterone levels peak by early adulthood and drop as you age—about 1% to 2% a year beginning in the 40s. As men reach their 50s and beyond, this may lead to signs and symptoms, such as impotence or changes in sexual desire, depression or anxiety, reduced muscle mass, less energy, weight gain, anemia, and hot flashes. While falling testosterone levels are a normal part of aging, certain conditions can hasten the decline. These include:

Natural testosterone boosters also help to increase the amount of free testosterone in the body. There are a couple of different ingredients they use that help with this. One of these ingredients is stinging nettle. Stinging nettle is actually able to bind to the globulin in place of testosterone, therefore leaving more free testosterone in the body that is unbound.
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.
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
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]
“I have seen them work for people,” says GP and hormonal therapy expert at Omniya London, Dr Sohere Roked. “I think sometimes people feel that it’s not a good thing to do or they’re just wasting their time taking it, but I have seen people who combine that with a good diet and exercise and have noticed a change in their physique, their energy, their mood, and the sort of things that testosterone would naturally help.”
I’ll be 31 this year and my belly is getting out of hand. I’ve cut way way back on my soda intake to maybe one or two a day most days and I’m drinking way more water than ever. Seems this belly is here to stay lol. I’m working on a better diet and I’m also gonna start back working out. This belly is a serious drag I hate it and I need it gone asap. What’s gonna be my best option in a test booster. I don’t want t to get all crazy buying fat burning pills and other foolery but I thing a test booster will help me all around. I’m high anxiety low energy poor sleeping over eating father of 4 and im currently in barber school. I need to make changes for my family and myself as well as my profession. Please help. (Belly is my only problem area I’m 30yrs olf 6ft 180lbs)

Hi I just turned 50 , and for the past 6 years I have been going through depression , low energy , insomnia , but my sex drive was not bad, I really did not know what it was , so last month my family doctor asked that I test my testosterone and the result was 7.2 noml/l (208 ngdl. So I was prescribed 2.5g 1% androgel, after two weeks I did not feel a difference , on the box it says that the recommended dose is 5g 1% , so my doctor prescribed the 5g 1 % , its now a week since I started the 5 g ( all together three weeks since I started androgel ) & now I feel great, my mood and energy level is way better, I never had an issue with my libdo , so no difference there. I asked my family doctor to refer me to an endocrinologist, just to get a second opinion but that appointment will happen only after 5 months, huge wait time. I am not worried about all that is said about side effects like prostate cancer , heart issues etc because otherwise I am very healthy and have family history of cancers and heart issues , but what worries me is , will my testes & p.glands stop producing Testosterone because of this external replacement? Something I would not want to happen at 50, because probably with exercise & diet I could try boosting by my T.Level naturally. More over will I become sterile , I have a young wife and we may have more kids. Also the gel application is very uncomfortable since I have young kids in the house I have o take extreme caution. Last was it worth starting TRT without finding out the level of my free testosterone. appreciate your advise. Thanks.
The prevalence of biochemical testosterone deficiency increases with age. This is partly due to decreasing testosterone levels associated with illness or debility but there is also convincing epidemiological data to show that serum free and total testosterone levels also fall with normal aging (Harman et al 2001; Feldman et al 2002). The symptoms of aging include tiredness, lack of energy, reduced strength, frailty, loss of libido, decreased sexual performance depression and mood change. Men with hypogonadism experience similar symptoms. This raises the question of whether some symptoms of aging could be due to relative androgen deficiency. On the other hand, similarities between normal aging and the symptoms of mild androgen deficiency make the clinical diagnosis of hypogonadism in aging men more challenging.
Let me start out by saying that I didn't notice anything for about the first 10 days. After week 2, I had moderate energy increases buy by far the most noticeable difference for me was in the bedroom. After using this product for over a moth now, I normally run out of energy before I run out of "stamina". This will be a permanent regimen for my daily supplements from now on. I take 4 a day. 2 in the morning and 2 about 5pm. I thought about lowering the dosage to see if it had the same effect, but for the price, why? LOL.
Falling in love decreases men's testosterone levels while increasing women's testosterone levels. There has been speculation that these changes in testosterone result in the temporary reduction of differences in behavior between the sexes.[53] However, it is suggested that after the "honeymoon phase" ends—about four years into a relationship—this change in testosterone levels is no longer apparent.[53] Men who produce less testosterone are more likely to be in a relationship[54] or married,[55] and men who produce more testosterone are more likely to divorce;[55] however, causality cannot be determined in this correlation. Marriage or commitment could cause a decrease in testosterone levels.[56] Single men who have not had relationship experience have lower testosterone levels than single men with experience. It is suggested that these single men with prior experience are in a more competitive state than their non-experienced counterparts.[57] Married men who engage in bond-maintenance activities such as spending the day with their spouse/and or child have no different testosterone levels compared to times when they do not engage in such activities. Collectively, these results suggest that the presence of competitive activities rather than bond-maintenance activities are more relevant to changes in testosterone levels.[58]
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Discussing the clinical utility of these findings, Dr. Budoff told EndocrineWeb, “in the short-term, I am going to check my patients for atherosclerosis before instituting testosterone therapy. We still need a definitive study to show whether or not heart attacks are increased by supplemental testosterone, but advancing atherosclerosis is not a good thing. These results should make us more cautious about whom we treat and what doses we use.”


Most Americans today are sleep deprived, which may be a contributing factor to declining testosterone levels in men. See, our body makes nearly all the testosterone it needs for the day while we’re sleeping. That increased level of T that we experience at night is one of the reasons we wake up with “Morning Wood.” (If you don’t have Morning Wood on a consistent basis, you might have low T).

Early infancy androgen effects are the least understood. In the first weeks of life for male infants, testosterone levels rise. The levels remain in a pubertal range for a few months, but usually reach the barely detectable levels of childhood by 4–7 months of age.[15][16] The function of this rise in humans is unknown. It has been theorized that brain masculinization is occurring since no significant changes have been identified in other parts of the body.[17] The male brain is masculinized by the aromatization of testosterone into estrogen, which crosses the blood–brain barrier and enters the male brain, whereas female fetuses have α-fetoprotein, which binds the estrogen so that female brains are not affected.[18]
I've tried other supplements. Which have basically the same ingredients. They had no effect on me. But taking this one. For a month. Well I can't believe it. I haven't been so horny. Like this. In a long time. My girlfriend sees a big difference. It's almost like I want to have sex every day!! In a way that's great. But she has to calm me down. She loves the attention. But she has to cool my jets!! In other ways

Testosterone, historically believed to be important only for male sexual function, has over the past decades transformed from niche hormone to multi-system player.22 There is increasing recognition of the harmful consequences of hypogonadism (also known as testosterone deficiency) wide spectrum of beneficial health effects of testosterone therapy and.23, 24

Keep more weapons in your arsenal: Occasionally use lifting methods like forced reps, negatives, and dropsets to further stress your body. Personal trainer and fitness journalist Michael Berg explains in "6 Ways to Crank Up Your Testosterone Levels" that going beyond muscular failure with these techniques has been shown to pump up T-levels in study subjects.[16]


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.
On the average, you need to sleep at least 8 hours per night to stay healthy. If you want a night sleep to contribute to the maximum testosterone production, it’s important to make your sleep comfortable. Thus, the bedroom temperature shouldn’t exceed 21°C. In addition, you should ventilate your bedroom thoroughly before sleeping. Furthermore, before going to bed, don’t overload your stomach with fatty foods, as well as don’t drink alcohol and caffeinated beverages. Finally, you have to avoid intense physical activity before bedtime.6
Findings that improvements in serum glucose, serum insulin, insulin resistance or glycemic control, in men treated with testosterone are accompanied by reduced measures of central obesity, are in line with other studies showing a specific effect of testosterone in reducing central or visceral obesity (Rebuffe-Scrive et al 1991; Marin, Holmang et al 1992). Furthermore, studies that have shown neutral effects of testosterone on glucose metabolism have not measured (Corrales et al 2004), or shown neutral effects (Lee et al 2005) (Tripathy et al 1998; Bhasin et al 2005) on central obesity. Given the known association of visceral obesity with insulin resistance, it is possible that testosterone treatment of hypogonadal men acts to improve insulin resistance and diabetes through an effect in reducing central obesity. This effect can be explained by the action of testosterone in inhibiting lipoprotein lipase and thereby reducing triglyceride uptake into adipocytes (Sorva et al 1988), an action which seems to occur preferentially in visceral fat (Marin et al 1995; Marin et al 1996). Visceral fat is thought to be more responsive to hormonal changes due to a greater concentration of androgen receptors and increased vascularity compared with subcutaneous fat (Bjorntorp 1996). Further explanation of the links between hypogonadism and obesity is offered by the hypogonadal-obesity-adipocytokine cycle hypothesis (see Figure 1). In this model, increases in body fat lead to increases in aromatase levels, in addition to insulin resistance, adverse lipid profiles and increased leptin levels. Increased action of aromatase in metabolizing testosterone to estrogen, reduces testosterone levels which induces further accumulation of visceral fat. Higher leptin levels and possibly other factors, act at the pituitary to suppress gonadotrophin release and exacerbate hypogonadism (Cohen 1999; Kapoor et al 2005). Leptin has also been shown to reduce testosterone secretion from rodent testes in vitro (Tena-Sempere et al 1999). A full review of the relationship between testosterone, insulin resistance and diabetes can be found elsewhere (Kapoor et al 2005; Jones 2007).
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I have been on TRT for over 8 years now. I feel GREAT! I read all these studies, hear in the news, and see all these dumb lawsuit commercials about testosterone causing cardiovascular events, blood clots and many other things. If anyone takes the time to do the due diligence and read the studies the picture becomes very clear. Unless you monitor all the other hormones, specifically, Estradiol, DHT, Pregenolone, Total Testosterone, Free Direct Testosterone, and DHEAS you are playing a deadly game. The reason is you must give something to control the pathways of T conversion into estradiol and or DHT. The vast majority of the studies used nothing to control those pathways and they gave men way, way more T than they needed to start with. They also gave forms of T that are not acceptable. Especially the oral version.

The TTrials were funded by the National Institutes of Health, and consist of 7 integrated, placebo-controlled, randomized clinical trials evaluating the short-term efficacy of testosterone treatment in older men with low circulating levels of the hormone. The benefits of testosterone were evaluated in 7 clinically relevant medical concerns and at least preliminary evidence of efficacy in sexual function, physical function, vitality, cognition, anemia, bone health, and cardiovascular health.

The overweight men participated in one German study. The first group of the participants used a placebo for one year. The second group of the participants consumed vitamin D3. All the participants aspired to shed excessive weight. Those men who took this vitamin lost up to 6 kg of unwanted weight. Also, they got the additional bonus; that is, the increase in testosterone production by about 25%.4
I am 31, been on HRT for about 6 months now. Started with Oxandralone (orally, 3 x 10mg tablets per day) and found a 20-30% increase in strength and outlook on life. Stopped taking it and now use Primo Testostin Depot (test enanthate – 1 x 250mg shot every 2 weeks). In the first week I feel a lot stronger, voice deepens etc but these benefits quickly diminish after about 5-7 days
For example, testosterone can increase the hematocrit, the percentage of red blood cells in the bloodstream. If the hematocrit goes up too high, we worry about the blood becoming too viscous or thick, possibly predisposing someone to stroke or clotting events. Although, frankly, in a review that I wrote in the New England Journal of Medicine* where we reviewed as much of this as we could, we found no cases of stroke or severe clotting related to testosterone therapy. Nevertheless, the risk exists, so we want to be careful about giving testosterone to men who already have a high hematocrit, such as those with chronic obstructive pulmonary disease, or those who have a red-blood-cell disorder.
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.
I have been on both pills and gel.While the pills were much more convenient, the gel seems to work better for me. I feel more focused and clear of mind with gel therapy. I’ve also noticed more sexual interest (closer to levels when younger – now 65) and get ‘harder’ when I do get an erection. The therapy has been good for me emotionally and physically. I’ll stay on it until and if negative signs/symptoms arise.

Professional-athlete-turned-biohacker Maximilian Gotzler gave a speech about boosting testosterone at the 2015 Bulletproof Conference. He started by leading the room through the Haka, a Maori war dance that New Zealand’s pro rugby team has made popular. The Pasadena Conference Center trembled as over 100 people shouted and stomped in unison. It was awesome.


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.
Short bursts of timed intense activity — known as high-intensity interval training or HIIT — trigger the body to make more testosterone than less-than-intense aerobic or endurance exercise, says La Puma. Spurts of activity stimulate androgen-sensitive tissue, he explains, which tells the body to make more testosterone. Strength training has also been shown to increase testosterone.
^ 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.
Grape seed extract is another ingredient with not enough research to suggest a dosage. Grape seed extract can interact with drugs like “blood thinners, NSAID painkillers (like aspirin, Advil, and Aleve), certain heart medicines, cancer treatments, and others.” If this sounds like you (or if you ever pop an Advil to clear off a headache), you’ll need to speak with a doctor to make sure this supplement is safe to take.

Not exactly. There are a number of drugs that may lessen sex drive, including the BPH drugs finasteride (Proscar) and dutasteride (Avodart). Those drugs can also decrease the amount of the ejaculatory fluid, no question. But a reduction in orgasm intensity usually does not go along with treatment for BPH. Erectile dysfunction does not usually go along with it either, though certainly if somebody has less sex drive or less interest, it’s more of a challenge to get a good erection.
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.
Your diet is the best source of zinc; along with protein-rich foods like meats and fish, other good dietary sources of zinc include raw milk, raw cheese, beans, and yogurt or kefir made from raw milk. It can be difficult to obtain enough dietary zinc if you're a vegetarian, and also for meat-eaters as well, largely because of conventional farming methods that rely heavily on chemical fertilizers and pesticides. These chemicals deplete the soil of nutrients ... nutrients like zinc that must be absorbed by plants in order to be passed on to you.
This is because your body is really good at self-regulating your hormone levels. So if you have normal testosterone levels, boosting above your natural base level may at best give you a few hours while your body makes, and then immediately processes out, the excess testosterone. This means you might experience higher than your average testosterone levels, but not by much, and only for a little while.
Looking purely at the biochemical numbers, The Endocrine Society* considers low testosterone to be a total testosterone level of less than 300 ng/dl, and I think that’s a reasonable guide. But no one quite agrees on a number. It’s not like diabetes, where if your fasting glucose is above a certain level, they’ll say, “Okay, you’ve got it.” With testosterone, that break point is not quite as clear.
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!
Aromatase inhibitors can boost testosterone on their own, but they can also complement other testosterone boosters. If you take a supplement that increases testosterone without inhibiting the aromatase enzyme (through hypothalamic stimulation, for instance), you may find yourself with more estradiol than you need, a situation that taking an aromatase inhibitor may remedy.
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]

The mechanism of age related decreases in serum testosterone levels has also been the subject of investigation. Metabolic clearance declines with age but this effect is less pronounced than a reduction in testosterone production, so the overall effect is to reduce serum testosterone levels. Gonadotrophin levels rise during aging (Feldman et al 2002) and testicular secretory responses to recombinant human chorionic gonadotrophin (hCG) are reduced (Mulligan et al 1999, 2001). This implies that the reduced production may be caused by primary testicular failure but in fact these changes are not adequate to fully explain the fall in testosterone levels. There are changes in the lutenising hormone (LH) production which consist of decreased LH pulse frequency and amplitude, (Veldhuis et al 1992; Pincus et al 1997) although pituitary production of LH in response to pharmacological stimulation with exogenous GnRH analogues is preserved (Mulligan et al 1999). It therefore seems likely that there are changes in endogenous production of GnRH which underlie the changes in LH secretion and have a role in the age related decline in testosterone. Thus the decreases in testosterone levels with aging seem to reflect changes at all levels of the hypothalamic-pituitary-testicular axis. With advancing age there is also a reduction in androgen receptor concentration in some target tissues and this may contribute to the clinical syndrome of LOH (Ono et al 1988; Gallon et al 1989).

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