Hello everyone. First off, thank you Dr. Abraham Morgentaler, for the excellent and refreshing article. I do not intend to spill my guts about symptoms or values on here as it has already been done so many times over. I will say that I am an RN BSN and have been on HRT for going on 6 yrs. I live in Oklahoma and when I first started noticing symptoms I knew something was wrong and began to do research myself. With an initial level of 241 no doctor here at that time, would even consider HRT as I was only 35ish at the time.
A previous meta-analysis has confirmed that treatment of hypogonadal patients with testosterone improves erections compared to placebo (Jain et al 2000). A number of studies have investigated the effect of testosterone levels on erectile dysfunction in normal young men by inducing a hypogonadal state, for example by using a GnRH analogue, and then replacing testosterone at varying doses to produce levels ranging from low-normal to high (Buena et al 1993; Hirshkowitz et al 1997). These studies have shown no significant effects of testosterone on erectile function. These findings contrast with a similar study conducted in healthy men aged 60–75, showing that free testosterone levels achieved with treatment during the study correlate with overall sexual function, including morning erections, spontaneous erections and libido (Gray et al 2005). This suggests that the men in this older age group are particularly likely to suffer sexual symptoms if their testosterone is low. Furthermore, the severity of erectile dysfunction positively correlates with lower testosterone levels in men with type 2 diabetes (Kapoor, Clarke et al 2007).
Alphamax XT’s testosterone boosting formula is so potent that they had to include an estrogen blocker in the formula. User’s have reported that the product’s effects rivals a hardcore pre-workout in terms of aggression and intensity. When the workout is done user’s have also been reporting accelerated muscle recovery, fat loss, and increased muscle definition.
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:
Zaima, N., Kinoshita, S., Hieda, N., Kugo, H., Narisawa, K., Yamamoto, A., ... Moriyama, T. (2016, September). Effect of dietary fish oil on mouse testosterone level and the distribution of eicosapentaenoic acid-containing phosphatidylcholine in testicular interstitium. Biochemistry and Biophysics Reports, 7, 259–265. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613343/
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.
In the hepatic 17-ketosteroid pathway of testosterone metabolism, testosterone is converted in the liver by 5α-reductase and 5β-reductase into 5α-DHT and the inactive 5β-DHT, respectively.[1][155] Then, 5α-DHT and 5β-DHT are converted by 3α-HSD into 3α-androstanediol and 3α-etiocholanediol, respectively.[1][155] Subsequently, 3α-androstanediol and 3α-etiocholanediol are converted by 17β-HSD into androsterone and etiocholanolone, which is followed by their conjugation and excretion.[1][155] 3β-Androstanediol and 3β-etiocholanediol can also be formed in this pathway when 5α-DHT and 5β-DHT are acted upon by 3β-HSD instead of 3α-HSD, respectively, and they can then be transformed into epiandrosterone and epietiocholanolone, respectively.[157][158] A small portion of approximately 3% of testosterone is reversibly converted in the liver into androstenedione by 17β-HSD.[156]
Popular through the centuries in Ayurvedic healing (a traditional practice of medicine in India) ashwagandha is what is known as an "adaptogen." This means the body may be able to use it to help adapt to stressors. While many people supplement with it for reducing cortisol, anxiety, and fatigue levels, ashwagandha also holds relevance for us here with potential testosterone boosting benefits.[8]
Great product. I'm a 41 yearold and found myself with low energy constantly. Since taking these pills I'm more energized and don't get home from work and just sit around the house anymore. Bonus the wife has been loving the extra benefit that they are giving us. I never thought I had a problem in that area but since I started taking these I've noticed a way longer lasting performance time.
Caffeine. Use caffeine moderately. Too much of the jittery juice increases cortisol, which decreases testosterone. Moreover, consuming caffeine late in the day hurts sleep, which lowers testosterone production. But one recent study indicates that caffeine consumed before working out may boost testosterone levels and help you exercise more efficiently. During my experiment I popped a piece of caffeinated gum five minutes before my workouts. Each piece had 100 mg of caffeine, about the same amount in a cup of coffee. That was usually it for my caffeine intake that day.

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.
Ginger rhizome powder was reported to posses an antioxidant and androgenic activity in doses of 50 mg/kg and 100 mg/kg daily [1]. Ginger administration significantly increased serum testosterone levels at 100 mg/kg [1]. There was also an increases in testosterone at 50 mg/kg daily but it failed to reach statistical significance [1]. A study by Kamtchouing et al. [2] also reported significantly increased serum and testicular testosterone levels as well as increase in weight of the testis and testicular cholesterol level in healthy rats. Another study using doses of 500 mg/kg and 1000 mg/kg indicated that extract of Zingiber officinale possesses pro-fertility properties [3]. Compared with the controls there was a dose and duration dependent increases in the serum testosterone levels and seminal quality [3]. At a very high dose (2000 mg/kg for 35 days), ginger led to slightly reduced weights of testes which might be due to negative feedback reaction from androgenic activity [4]. Combination of ginger and zinc appears to further increase testosterone in rats [24].
What makes TestoFuel different from other testosterone boosters on the market is that the company is constantly researching and updating the ingredients. So, you know you are getting a product that has been formulated using the latest clinical studies. Unlike most other companies that formulate a product and update it every 3 – 5 years or never at all.
“Poor lifestyle can mimic the symptoms of low testosterone and can actually cause low testosterone as well,” says Hodzovic. “The main culprits include lack of sleep, excessive stress, too little or too much exercise and too little or too much body fat. Getting healthy and active and eating a balanced nutritious diet along with enough sleep are the most important things to do.
If you take a statin (cholesterol lowering medication) and you follow the 30-Day Heart Tune-Up program, there is a good chance you’ll be able to work with your doctor and over time safely stop your statin medication. Statin medications lower cholesterol, and you need cholesterol to make testosterone. Ask your doctor what you can do with lifestyle changes to not need a statin medication. Improving your cholesterol profile is only part of the answer. Many of the risk calculators doctors use look at tobacco use, body weight, blood pressure, blood sugar, and cholesterol. Improve all your risk factors, and often you won’t qualify for a medication!
Testosterone increases dominance and the desire for power. The link between testosterone and dominance has been demonstrated in numerous studies. T motivates men to gain and maintain social status. The desire for dominance can be a bad thing if it leads to criminal behavior, but it’s also what fuels the climb for success, motivates men to resist oppression and buck authority, and may even help you with the ladies…
“Before taking Andro400, my husband weighed 290 lbs. He's a diabetic and his blood pressure was through the roof. I purchased Andro based on the reviews, and he's lost 60 - 70 lbs! ​It's enhanced him health-wise in a lot of aspects too. He used to be depressed because of his weight. The fact that he was losing weight like crazy gave him a lot of relief. He's not depressed now, he's really happy. He's more loving. And it's so exciting for me as a wife to see him happier -- it made me happier​! ​ So I'm really grateful. Andro400 gave him a lot of ​energy ​ too because of the testosterone boost.​ The 3 main things everybody's noticing are: no more​ depression, a lot more energy and ​the huge weight loss. He went from size 42 to 38, so it's like, oh my God it's WORKING!! Trust me, we've tried a lot of other things that didn't work. And that's why I'm so excited because it's actually, literally changing our lives!”
With ingredients like Fenugreek, Ashwagandha, Shilajit, and Boron Citrate, you can expect to see some increases in lean muscle mass thanks to the hike in free and total testosterone levels as well as its ability to suppress cortisol, a natural hormone that can reduce the body’s ability to use fat stores as energy. True GRIT Test Booster does not contain proprietary blends, so you can actually see the exact dosage you are getting from each ingredient listed.
Then in 2017, Melville carried out another study on DAA.[4] This time he recruited 22 men in a randomized, double-blind fashion and had them consume either a placebo or 6g of DAA. After 12 weeks of supplementation, researchers observed that DAA had no significant impact on resting levels of either free or total testosterone. Any improvements in strength or hypertrophy were similar to those in the placebo group.
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.
Studies have demonstrated reduced testosterone levels in men with heart failure as well as other endocrine changes (Tappler and Katz 1979; Kontoleon et al 2003). Treatment of cardiac failure with chronic mechanical circulatory support normalizes many of these changes, including testosterone levels (Noirhomme et al 1999). More recently, two double-blind randomized controlled trials of testosterone treatment for men with low or low-normal serum testosterone levels and heart failure have shown improvements in exercise capacity and symptoms (Pugh et al 2004; Malkin et al 2006). The mechanism of these benefits is currently unclear, although a study of the acute effects of buccal testosterone given to men with chronic cardiac failure under invasive monitoring showed that testosterone increased cardiac index and reduced systemic vascular resistance (Pugh et al 2003). Testosterone may prove useful in the management of cardiac failure but further research is needed.
The hypogonadal-obesity-adipocytokine cycle hypothesis. Adipose tissue contains the enzyme aromatase which metabolises testosterone to oestrogen. This results in reduced testosterone levels, which increase the action of lipoprotein lipase and increase fat mass, thus increasing aromatisation of testosterone and completing the cycle. Visceral fat also promotes lower testosterone levels by reducing pituitary LH pulse amplitude via leptin and/or other factors. In vitro studies have shown that leptin also inhibits testosterone production directly at the testes. Visceral adiposity could also provide the link between testosterone and insulin resistance (Jones 2007).
Bisphenol-A also known under the name of BPA is a chemical compound which is very widespread for manufacturing a wide spectrum of plastic items and aluminum cans. Many studies have already proven the fact that even the smallest amount of BPA is very harmful to the human health. This compound causes hormonal imbalance and even may lead to prostate cancer.
Hello there Abraham. My doc and you know each other well. We reside in Richmond, VA. Doc told me to inject my weekly Cypionate into sub fat for longer absorption, with reference you shared this info him with him. I have been his TRT patient for 10 years now. He is the best. I wont mention names. Please point me to a study showing the results of testosterone absorption from fat.
How do you boost testosterone naturally? Testosterone is a male sex hormone. Low levels can cause changes to the distribution of body fat and muscle strength. Testosterone reduces with age, but people can boost it with lifestyle changes, including diet and exercise. Adequate sleep, nutritional supplements, and stress reduction may also help. Learn more here. Read now
Around age 30, men’s testosterone levels begin a long, gradual decline. (According to the FDA, normal T range is between 300 to 1,000 nanograms per deciliter (ng/dl) of blood serum. Anything below 300 ng/dl is considered low.) If a blood test confirms you have low T, your doctor may recommend a prescription testosterone supplement or replacement therapy.
The 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
When looking for a solid natural testosterone booster, you’ll want one that has the ability to increase natural testosterone levels, increase muscular strength, improve performance and stamina, and help pack on lean muscle mass.  With a mix of key ingredients like D-AA, Tribulus, Fenugreek, and DIM, Evlution’s booster aims to take your training to the next level.  It can also help improve your sleep which is vital in allowing the body to recover from intense sessions in the gym.
The reliable measurement of serum free testosterone requires equilibrium dialysis. This is not appropriate for clinical use as it is very time consuming and therefore expensive. The amount of bioavailable testosterone can be measured as a percentage of the total testosterone after precipitation of the SHBG bound fraction using ammonium sulphate. The bioavailable testosterone is then calculated from the total testosterone level. This method has an excellent correlation with free testosterone (Tremblay and Dube 1974) but is not widely available for clinical use. In most clinical situations the available tests are total testosterone and SHBG which are both easily and reliably measured. Total testosterone is appropriate for the diagnosis of overt male hypogonadism where testosterone levels are very low and also in excluding hypogonadism in patients with normal/high-normal testosterone levels. With increasing age, a greater number of men have total testosterone levels just below the normal range or in the low-normal range. In these patients total testosterone can be an unreliable indicator of hypogonadal status. There are a number of formulae that calculate an estimated bioavailable or free testosterone level using the SHBG and total testosterone levels. Some of these have been shown to correlate well with laboratory measures and there is evidence that they more reliably indicate hypogonadism than total testosterone in cases of borderline biochemical hypogonadism (Vermeulen et al 1971; Morris et al 2004). It is important that such tests are validated for use in patient populations relevant to the patient under consideration.
And remember, saturated fats work best (along with monounsaturated fats – olive oil, almonds, avocados etc.). In fact higher intakes of polyunsaturated fats (canola oil, sunflower oil, soybean oil, safflower oil, margarine etc.) are linked to LOWER testosterone levels (14 & 15). I explore the dangers of PUFA's in a lot more detail in this article - PUFA's: The Worst Thing For Your Health That You Eat Everyday.

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.

You can browse Drugs A-Z for a specific prescription or over-the-counter drug or look up drugs based on your specific condition. This information is for educational purposes only, and not meant to provide medical advice, treatment, or diagnosis. Remember to always consult your physician or health care provider before starting, stopping, or altering a treatment or health care regimen.
My last injection was November 2017 and i decided to rest for a quarter and see what the impact is. My energy and muscle tone has definitely dropped but I don’t have back acne, sour sweat and I sleep better. In my case anyway I feel like my T is being regulated lower. I turn up the heat and T , my body turns up the aircon which suppresses the T. I can’t find any discussion on correlation between temperature/climate and T anywhere but given that we all live in climate controlled environments now seems worthy of some study.

In addition to conjugation and the 17-ketosteroid pathway, testosterone can also be hydroxylated and oxidized in the liver by cytochrome P450 enzymes, including CYP3A4, CYP3A5, CYP2C9, CYP2C19, and CYP2D6.[159] 6β-Hydroxylation and to a lesser extent 16β-hydroxylation are the major transformations.[159] The 6β-hydroxylation of testosterone is catalyzed mainly by CYP3A4 and to a lesser extent CYP3A5 and is responsible for 75 to 80% of cytochrome P450-mediated testosterone metabolism.[159] In addition to 6β- and 16β-hydroxytestosterone, 1β-, 2α/β-, 11β-, and 15β-hydroxytestosterone are also formed as minor metabolites.[159][160] Certain cytochrome P450 enzymes such as CYP2C9 and CYP2C19 can also oxidize testosterone at the C17 position to form androstenedione.[159]
When I told people that I was doing an experiment to increase my testosterone, the question that people would invariably ask in hushed tones was, “So, did it, you know, improve your sex life?” Honestly, I didn’t see too much change. I had a robust and healthy sex life before the experiment and continued to do so afterwards. I guess I was a bit more randier than usual, but not much. I’d imagine if you had been suffering from low T for a long time and took steps to increase it, you’d likely see improvement in the bedroom department.
I just started TRT gel. On the first day I noticed an improvement in my awareness/energy level. This is now day three and I feel much better. Before I was tired and lacked the mental clarity I now feel. I have not yet noticed and increase in my libido but I think it is improving. Probably need the stimulation from my fiancé and more time to get my T levels up. Before I started the gel, total T levels were 450, and then 500+. I went to an Integrative MD who suggested Free T. That level was low and my SBGH was 100 (high). I then went to an NP who ordered the Free T. She referred me to an Endocrinologist. She along with her Attending interviewed me and decided to prescribe. They asked if I wanted the gel or the injections. I opted for the gel. I will wait and see how the gel works. So far so good.

Another way to look at it is like this: Women are only capable of building a small amount of muscle without the use of performance enhancers, regardless of how hard they train or how rigid their meal plan is. When women reach their physical peak and are unable to move any further than that point, it’s because of their naturally low levels of testosterone.
Epidemiological studies have also assessed links between serum testosterone and non-coronary atherosclerosis. A study of over 1000 people aged 55 years and over found an inverse correlation between serum total and bioavailable testosterone and the amount of aortic atherosclerosis in men, as assessed by radiological methods (Hak et al 2002). Increased intima-media thickness (IMT) is an early sign of atherosclerosis and has also been shown to predict cardiovascular mortality (Murakami et al 2005). Cross-sectional studies have found that testosterone levels are negatively correlated with carotid IMT in independently living men aged 74–93 years (van den Beld et al 2003), diabetic men (Fukui et al 2003) and young obese men (De Pergola et al 2003). A 4-year follow up study of the latter population showed that free testosterone was also inversely correlated with the rate of increase of IMT (Muller et al 2004).
While steroids like DHEA can be used to boost testosterone, if used in the wrong dosages or by people who don’t need them they can raise T-levels far beyond the normal range, which is what causes accelerated muscle gain. According to Dr. Emil Hodzovic, who is a competitive bodybuilder as well as a doctor with Medichecks, steroids come with “a set of risks, including liver damage, hormone imbalance, high blood pressure, and a higher risk of a stroke or heart attack”.
As you can see, the entire workout is only 20 minutes. Twenty minutes! That really is a beautiful thing. And within those 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You're really only working out intensely for four minutes. It's hard to believe if you have never done this that you can actually get that much benefit from four minutes of exercise. That's all it is.
Testosterone is a steroid from the androstane class containing a keto and hydroxyl groups at the three and seventeen positions respectively. It is biosynthesized in several steps from cholesterol and is converted in the liver to inactive metabolites.[5] It exerts its action through binding to and activation of the androgen receptor.[5] In humans and most other vertebrates, testosterone is secreted primarily by the testicles of males and, to a lesser extent, the ovaries of females. On average, in adult males, levels of testosterone are about 7 to 8 times as great as in adult females.[6] As the metabolism of testosterone in males is greater, the daily production is about 20 times greater in men.[7][8] Females are also more sensitive to the hormone.[9]
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).
Finally, there's the question of prostate cancer risk. Research over the past few decades has shown little evidence of a link between testosterone replacement therapy and prostate cancer. However, the question has not been entirely laid to rest. Eisenberg recommends that his testosterone replacement therapy patients get a PSA test once or twice a year to check for possible signs of concern.

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).

My genetic make-up is 47XXY. I was diagnosed in September, 1976, and have been on some kind of T-therapy since – injections, pills, gels, patches, pellets, now back on injections. At this time, now, I inject 1/2cc deep IM, every 7-8 days. I suffered a blood clot between my knee and my groin (right leg) in January, 2017. I am now on Eliquis through June, 2017. My blood has always been quick to coagulate. I’ve read through all of this, and only found mention of blood clots sporadically in relation to T-therapy. I’m 70 yoa, have never had a problem before. Can you give me any info I can pass along to my doctor? Thank you.
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.

Attention, memory, and spatial ability are key cognitive functions affected by testosterone in humans. Preliminary evidence suggests that low testosterone levels may be a risk factor for cognitive decline and possibly for dementia of the Alzheimer's type,[104][105][106][107] a key argument in life extension medicine for the use of testosterone in anti-aging therapies. Much of the literature, however, suggests a curvilinear or even quadratic relationship between spatial performance and circulating testosterone,[108] where both hypo- and hypersecretion (deficient- and excessive-secretion) of circulating androgens have negative effects on cognition.
I see this is an older thread, but still very appropriate. After feeling lethargic, gaining weight, and generally having a declining sexual appetite I took some advice from a friend and got the Test check done. Turns out I was around 189, and it explained a lot. Now, I am a bigger guy, and I do hit the gym regularly, and I do push weights a lot. Big arms and chest, kinda flabby gut. Doc recommended Andro Gel. Glad I had insurance, because it is EXPENSIVE!!!!! Noticed after a week of two pumps that energy was coming back, and I could concentrate better at work. A little bit of face acne, some around shoulders, and a little on the chest. I also noticed a little acne on the contact areas on my arms where I applied it. Nothing like a teenager, but I noticed. It did help in the gym a little bit, as I would put on muscle a little faster, and kept it a bit longer. I also noticed some extra water weight gain around my gut.

Tribulus terrestris is an ingredient commonly presented as improving testosterone levels, but has not been found to be more effective than a placebo or possess any testosterone increasing properties. WebMD cautions that it interferes with Lithium and diabetes medications, and in general, not enough is known about tribulus terrestris to recommend a dosage for anyone.

As mentioned earlier, too much protein can negate testosterone production quite a bit. If your protein intake is over 0.85g/lb of body weight a day, then you may not be making full use of each of the nutrients. Consuming these high amounts of protein can cause your cortisol and SHBG levels to increase, which in turn lowers testosterone production. What do you get out of this deal? Increased fat gain and lower testosterone levels.
Fortunately supplementation of Vitamin D3 has been noted to significantly boost testosterone levels up to 20%.[40,41] This occurs via a reduction in sex-hormone binding globulin (SHBG) and aromatase expression, which limits the breakdown of testosterone into estrogen. It’s also worth mentioning that Vitamin D3 has been shown to raise levels of the anabolic hormone IGF-1.[42,43]
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.