Testosterone fluctuates according to age and life circumstance, often plummeting at the onset of parenthood, and spiking (for some) during moments of triumph. Romantic relationships, too, can impact a person’s testosterone production; though the reasons are still not fully understood, entering a relationship tends to increase women’s testosterone levels, while decreasing men’s. Since males produce significantly more testosterone than females—about 20 times more each day—females can be more sensitive to these fluctuations. High levels of testosterone, particularly in men, have been correlated with a greater likelihood of getting divorced or engaging in extramarital affairs, though a causal link has not been established.
Millions of men use testosterone therapy to restore low levels and feel more alert, energetic, mentally sharp, and sexually functional. But it's not that simple. A man's general health also affects his testosterone levels. For instance, being overweight, having diabetes or thyroid problems, and taking certain medications, such as glucocorticoids and other steroids, can affect levels. Therefore, simply having low levels does not always call for taking extra testosterone.
Dr. Martin’s Extra Strength Testosterone Booster made our top spot for budget-friendly enhancers. This is a unique and powerful blend of natural herbs that will help you with your energy levels and raise your stamina. Men will also appreciate better results when it comes to building up lean muscle, and the supplement will give your libido a boost, too.
Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. Nor should men who have severe urinary tract problems, untreated severe sleep apnea or uncontrolled heart failure. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening -- a rectal exam and PSA test -- prior to starting this therapy.
The regular intake of testosterone boosters is known for the high level of safety comparing to the hormone injections and the use of illegal steroids. But still to protect yourself against any possible adverse reactions, you should remember that the supplementation can’t be continuous. The breaks from time to time are required. Such an approach to the use of boosters is healthy and best-working if you aspire to enhance own hormone production without any harm.
Unfortunately, in the modern world, stresses and emotional exhaustion lie in wait for men at every step. Nowadays, burnout is a constant state for many men. Of course, this causes great harm to the men’s health. Stresses drain of vitality and affect emotional state. Besides, they are also very dangerous for the nervous system. The nature is wise. And the body of a man who is not subject to stress can produce more testosterone.
I’m 56 and 5 years ago dropped to 270 with all the side effects listed for low test. After trying shots and not liking the roller coaster effect, I switched to gels. Androgel and Axiron had too low a dosage and far too messy. They need to not call them gels but liquids. If it pours like water it’s a liquid. My doctor recommended a compounding Pharmacy that made a cream and it was perfect. It had a click dispenser that looked like a deoderant that would pre-measure the dosage and I could rub it on my arms and shoulders or on my neck, really anywhere not covered in hair but the thinner the skin the better. It dried instantly so I could get dressed in a couple minutes. My totals never got out of the 400’s until I started the 150mg daily cream dosage, then they hovered around 700. The down side was Insurance didn’t cover it and I had to pay $50 a month vs free shots from the doctors office or $10 for the so-called gels. Bad news is it has now doubled in price due to new Federal production regs on compounding Pharms. Now, I am going back on the shots which I now have to buy the vile for $125 for 10 doses and have to take it to my doctor to administer it every 2wks while I am looking into bioidentical pellet implants.
Androgens may modulate the physiology of vaginal tissue and contribute to female genital sexual arousal. Women's level of testosterone is higher when measured pre-intercourse vs pre-cuddling, as well as post-intercourse vs post-cuddling. There is a time lag effect when testosterone is administered, on genital arousal in women. In addition, a continuous increase in vaginal sexual arousal may result in higher genital sensations and sexual appetitive behaviors.
Statins are some of the most prescribed drugs in the world for reducing cholesterol levels and preventing heart disease. Various studies in the 1990s, including a study published in the ‘European Journal of Clinical Nutrition,’ supported the claim that Fenugreek could help reduce cholesterol levels. One possible explanation is the high fiber content in fenugreek. A fiber-rich diet has been shown to help reduce the levels of LDL (‘bad’ cholesterol) in your blood. (Note: The validity of the various studies from the 1990s have been questioned though because of small sample sizes)
The most commonly used testosterone preparation in the United States — and the one I start almost everyone off with — is a topical gel. There are two brands: AndroGel and Testim. The gel comes in miniature tubes or in a special dispenser, and you rub it on your shoulders or upper arms once a day. Based on my experience, it tends to be absorbed to good levels in about 80% to 85% of men, but that leaves a substantial number who don’t absorb enough for it to have a positive effect. [For specifics on various formulations, see table below.]
If you have low testosterone and are prescribed testosterone therapy by your doctor, it does not increase your risk for getting prostate cancer. However, in some patients with existing prostate cancer, adding testosterone hormone therapy can make the cancer grow faster. Men with low testosterone levels are actually more likely to get prostate cancer than men with normal prostate levels. You need to discuss these details with your physician and make the best decision for you.
Bikinis, models, nuts … Is there anything Brazilian that’s not sexy? Selenium is a trace mineral found in Brazil nuts that plays an important role in hormone health. You only need a tiny bit for healthy sperm, but a tiny deficiency can be catastrophic for reproductive health. In one study, men who had lower testosterone and were infertile also had significantly lower selenium levels than the fertile group. Supplementing with the mineral improved chances of successful conception by 56 percent. And a second study that included 69 infertile men with low levels of the mineral, found selenium supplementation could significantly improve sub-par sperm motility associated with testosterone deficiency. Moreover, 11 percent of the men successfully impregnated their partners during the trial!
AML Test includes each of the best natural testosterone boosters discussed above as well as red wine polyphenols which function as powerful, all-natural aromatase inhibitors that lower estrogen and increase testosterone levels. These polyphenols also boost nitric oxide production which enhances vasodilation and blood flow to all regions of the body.
Every vitamin, mineral, and ingredient that affects the human body can be taken in enough quantities that they are harmful, or toxic, even the ones that — at lower levels — are beneficial or necessary. Unfortunately, testosterone boosters contain a lot of ingredients that are not well understood. This means in addition to not being able to confirm whether certain ingredients increase testosterone, the scientific and medical communities also don’t know at what levels many ingredients become toxic. On the up side, you might need to eat several pounds of a particular leafy plant before it becomes harmful. On the down side, it could be significantly less that pushes you over your body’s limit. We simply don’t know how little or how much the human body can tolerate. We recommend keeping your doctor in the loop when you add any supplement with unproven ingredients into your diet — they’ll be able to help you find and track any undesired side-effects that these ingredients might cause.
It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.
February 22, 2018 - Since our last review, the manufacturers of two of our top picks have gone out of business, and some new testosterone boosters have entered the arena. We’ve updated this review to evaluate the current field of testosterone supplements, as well as beef up analysis on what kind of results you can expect from t-boosters. Our only current top pick, Beast Sports Nutrition, is a new player in the industry that contains all four of the ingredients with studies showing a positive effect on testosterone.
There are pills in the United States for testosterone supplementation, but their use is strongly discouraged because they cause significant liver toxicity. A safe oral formulation called testosterone undecanoate is available in Canada and in Europe, but not in the United States. What’s quite exciting is that an injectable version of testosterone undecanoate (Nebido) was submitted to the FDA for approval in August 2007. (It’s already approved in many other countries.) It lasts for 12 weeks, so a patient could come in and get a shot about four times a year. [Editor’s note: In December 2009, the brand name of the drug in the United States was changed to Aveed. As of January 2011, it was still awaiting FDA approval.]
An added testosterone benefit of my high fat and balanced protein and carb diet was that it probably helped me lose some body fat (I went from 18% to 12% body fat). Studies show that high fat diets actually contribute to increased body fat loss. And as we discussed earlier, as you lose body fat, your T production ramps up. Virtuous cycle for the win!
The changes in average serum testosterone levels with aging mean that the proportion of men fulfilling a biochemically defined diagnosis of hypogonadism increases with aging. Twenty percent of men aged over 60 have total testosterone levels below the normal range and the figure rises to 50% in those aged over 80. The figures concerning free testosterone are even higher as would be expected in view of the concurrent decrease in SHBG levels (Harman et al 2001).
Leafy green vegetables such as spinach are rich sources of folic acid. Low levels of folate can give rise to distorted sperm shapes such as ones with two heads or two tails. The sperm are also at an increased risk of chromosomal abnormalities. This means that firstly your sperm will find it difficult to reach an egg and even if it does reach an egg, it will not be able to fertilize it. Furthermore, even if these sperms are able to fertilize an egg, the chances of birth defects are quite high in such cases.
Are you getting enough vitamin D? Vitamin D is an essential nutrient, but it can be difficult for people to know if they are getting the right amount. Some people will be able to get enough vitamin D from sunlight. Others may need to make dietary changes or take supplements. Here, we explain how to get vitamin D from sunlight, food, and supplements. Read now
Our bodies make testosterone while we sleep. In one study, men who got five hours of sleep a night had testosterone levels 10 to 15 percent lower than when they got a solid eight hours. The study, conducted by the University of Chicago, found that skimping on sleep reduced the men’s T levels by an amount equivalent to aging 10 or more years. While it can be challenging to change your sleep habits, says Natasha Turner, ND, you can “start going to bed 15 minutes earlier each week until you reach your target time.”
A large number of trials have shown the positive effects of testosterone treatment on markers of bone formation and increased bone density in hypogonadal men treated with testosterone.1,4,6,8,13 Not surprisingly, the effects may take several years to fully develop. At present no data on the role of testosterone in preventing fracture in men with hypogonadism are available.
Amazing this thread is going after 3 years. Very good indeed. I have low cortisol and my doctor decided to check testosterone. It came back at 5! Not 500, but 5! My doctor did not believe this to be correct. She indicated I would not be able to grow facial hair and that my arm hair would have fell out. She retested. It came back at 23. WTH. So she wanted to start me on Clomid. Well of course my insurance would not cover this. Most pharmacies wanted $300-400 for a 30 day supply. Can’t afford that! The 2 pharmacies that were reasonable cannot get it from their suppliers at this time. So my doctor wants to start weekly injections. I do not know what to think but am trying to find all the information I can on the subject as I am quite nervous. So if anyone else is still reading or comes across this please let me know what you think or your story. it would very much be appreciated. i will be 38 next month and am a little “lost” about all of this. Many thanks! 🙂
From there, you’ll want to adjust how you train, since certain activities provide an especially powerful stimulus for testosterone. Research published in the journal Sports Medicine found that in order to experience a strong testosterone response from exercise, your workouts should be high in volume and produce a metabolic response. Churn through many exercises, sets, and reps, and focus on intense bursts of exercise with short rest periods.
Advanced BCAA’s are made from a hydrolyzed whey protein isolate. Its 100% whey protein really. But the amazing thing about this hydrolyzed whey isolate is that it is a whopping 50% BCAA! Incredible really. A pre digested whey protein that is 50% BCAA. Normally hydrolyzed whey protein is only 30% BCAA. Thus for every 10 grams of Advanced BCAA you are getting 5 grams of pre-digested BCAA peptides. NOT free form amino acids from China. Why is this so exciting and valuable to your bodybuilding goals?
Watch out for ingredients that interfere with blood clotting If you are taking any kind of blood medication, take aspirin or ibuprofen, or have any kind of blood-related condition, you’ll want to consult your doctor before taking any of these supplements. Fenugreek, Forskolin, and Acetyl-L-carnitine are just a few of the ingredients that can make these situations worse and increase your chances of bruising and bleeding.
^ David KG, Dingemanse E, Freud JL (May 1935). "Über krystallinisches mannliches Hormon aus Hoden (Testosteron) wirksamer als aus harn oder aus Cholesterin bereitetes Androsteron" [On crystalline male hormone from testicles (testosterone) effective as from urine or from cholesterol]. Hoppe-Seyler's Z Physiol Chem (in German). 233 (5–6): 281–83. doi:10.1515/bchm2.1935.233.5-6.281.
Testosterone is a hormone that is produced primarily in the testicles for men and the ovaries and adrenal glands for women. This hormone is essential to the development of male growth and masculine characteristics. For women, testosterone comes in much smaller amounts. Testosterone production increases about 30 times more during adolescence and early adulthood. After early adulthood, it’s natural for levels to drop slightly each year. Your body may see a one percent decline after you’re 30 years old.
“However, the parallels don’t necessarily follow logically, creating a real need to bring more evidence to this area so that physicians and patients would be able to make more informed decisions based on the best possible evidence,” said Dr. Gill, a professor of medicine and the lead investigator at the Yale study site, the largest site participating in the TTrials, and coauthor of all 4 TTrials.
“I'm a truck driver and for 13 hours a night I sit in my truck and I drive. Out of boredom, I'd stop and eat. That was all until Andro400 – ever since then my life has changed. I started out weighing 341 pounds, and since taking Andro400 I've dropped 85 pounds! There's no cravings – I actually don't even think about food anymore. One thing that Andro400 said on the radio ad is it attacks belly fat – well let me tell you it did – the 2nd month is where I saw a drastic change in the size of my stomach. I've lost 6 inches! I'm sleeping better. My knee pain went away. I've had some lower back issues and that went away, and I can only attribute that to Andro400. It's a Life Changer for me!”
I am still on T therapy. But here’s what pisses me off: No one tells you that you will be hooked on the drug virtually forever! Don’t ever stop it abruptly! I did and I had a major crash: physically and emotionally. I went into the darkest depression ever…and I was lacking in energy so much that I had to have 4 naps a day…just to get through the day. I was also robbed of any initiative to do anything.
In addition to these effects, DHEA supplementation also increases FREE testosterone levels. As you may or may not know, testosterone is found in the body in both free and bound forms. Free testosterone is the biologically active kind that we want more of in order to improve energy, strength, recovery, and sexual function. Bound testosterone is biologically inactive, due to serum hormone-binding globulin (SHBG).
Alterations in mood and depression are a symptom of, but not confined to, hypogonadism.1,6 Outcomes in clinical trials of the effect of testosterone treatment on mood have varied. However, there is evidence that testosterone treatment results in improvements in mood, particularly in older men with hypogonadism.7,8Similarly, although there is an established association between measures of cognitive ability and serum levels of testosterone, the benefits of testosterone treatment on cognition are less clearly established, with some studies reporting improvements in some measures of cognitive function and others failing to detect benefits.6,9-11 Although a potential role for testosterone in protecting cognitive function and preventing Alzheimer’s disease has been proposed by some researchers, confirmation from appropriately-designed clinical trials is awaited.
In addition to its role as a natural hormone, testosterone is used as a medication, for instance in the treatment of low testosterone levels in men and breast cancer in women. Since testosterone levels decrease as men age, testosterone is sometimes used in older men to counteract this deficiency. It is also used illicitly to enhance physique and performance, for instance in athletes.
Hormonal Imbalance can affect your personal and work relationships. Some of the most noticeable symptoms prompting patient's to seek out medical care are a complete lack of energy and sheer fatigue, loss of sex drive, erectile dysfunction or soft erections, loss of lean muscle mass and bone strength, rapid weight gain, excessive adipose fatty tissue, disturbed sleep patterns, depression, moodiness, social withdrawal, reduced ability to recover from workouts, flabby muscles, lack of strength and endurance.
This product is to be taken once daily on an empty stomach. Is there a particular time frame when food can be eaten? If I were to take this in the morning right when I wake up and then eat breakfast an hour later, is that fine? Also, mostly the only time of day my stomach is usually empty is right before going to bed. If it is taken at this time, will this affect sleep at all?
We also have epidemiologic studies, like the Physicians’ Health Study, the Baltimore Longitudinal Study of Aging, and the Massachusetts Male Aging Study, that include tens of thousands of men who are followed for 5, 10, 15, or even 20 years. At the end of the study period, the researchers see who developed prostate cancer and who didn’t. They can then look at blood samples taken at the start of the study to see if, for example, the group that got prostate cancer had a higher level of testosterone over all. About 500,000 men have been entered in some 20 trials of this type around the world. Not one of those studies has shown a definitive correlation between prostate cancer and total testosterone. Three or four have shown weak associations, but none of those have been confirmed in subsequent studies.
During the month before my experiment, I was definitely sleep deprived. Some nights I was only getting 4 to 5 hours. Testosterone killer! During my experiment I tried to get 8 to 9 hours of sleep at night as consistently as possible. I had to go to bed earlier, but I was only cutting into time that I would have been using to mindlessly surf the net anyway.
This common kitchen spice can actually play a role in testosterone production. It has been said that through supplementing with ginger, that users have the ability to not only increase testosterone production naturally, but also improve sexual function and drive, improve sperm health, as well as increasing sperm count. This is great for infertile men as well as those looking for another avenue when it comes to boosting natural testosterone levels.
One study looking at alcohol consumption found that increasing alcohol consumption led to a higher level of free & total testosterone compared to a non-drinking control group (20). Drinking did however lower SHBG testosterone levels, though this type of testosterone is bound to a protein meaning our bodies cannot use it to build muscle or increase our mood.
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).
Ashwagandha is shown to be effective at reducing cortisol which in turn helps with testosterone production. There are also numerous studies showing the effects on improving testosterone in infertile men (ref 80). If you are using the Aggressive Strength product you don't need to supplement with ashwagandha as it's included in the test booster formula. Likewise if you're using Tian Chi (my daily herb drink).
In both men and women, imbalances in testosterone result in health issues like diabetes, obesity, metabolic syndrome, and osteoporosis. So testosterone is important for more than just men’s health issues; it crosses gender boundaries and affects all areas of the body. The Providers at New Leaf Wellness are aware of the risks and inconveniences that imbalanced hormone levels bring to the human body, and we are pleased to offer Natural Hormone Therapy to our clients.
TestoGen USA stood head and shoulders above the rest, which is why it earned the top spot on our list. This testosterone supplement will help keep men on a more even keel when it comes to both stamina and temperament. You won’t feel wiped out at the end of the day and you’ll be less likely to feel your tension levels rising as you deal with everyday annoyances. In addition, it will stimulate your libido and can even help you lose excess body fat.
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."
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'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
The steroid hormone known as dehydroepiandrosterone, DHEA, plays an important role in sexual behavior, mental health and muscle growth. Your body uses this hormone to make sex steroids. Thus, taking a DHEA supplement should increase your circulating testosterone. A 2018 paper in the International Journal of Sports Medicine explored this possibility in athletic women.
There is a dirty little secret about testosterone cream that almost no one knows, and I’m going to share it here. Please don’t abuse it. If you take a vanishingly small dose of testosterone cream and apply it to your labia and the vulva (or your partner’s), you will witness a form of vasodilation rarely seen no matter how good you are in bed. It has a profound local effect and will produce a night you won’t forget for years.
Also, due to the intake of these synthetic substances, men start behaving in a very excited way, as well as demonstrate high levels of aggression and even violence. So, the men’s behavior may be antisocial. In addition, the men will experience breast enlargement and testicular shrinkage. The other adverse effects include hypertension, tumor growth, heart attacks and strokes, as well as development of liver disorders. It’s obvious that the numerous dangers of steroid use far outweigh a few benefits which they bring.
Bodybuilding.com sells science-backed testosterone support from top brands so you can continue to crush your goals. Our customer reviews will give you a snapshot of how each of these products works on real people living real lives, so you can make the best decision for your body. Ready to feel powerful again? Let’s find the test booster that’s right for you.
The use of these supplements can help to burn fat and build muscles. As a result, the health and strength of your muscles and bones improve that ultimately leads to a strong and healthy body. Another prominent feature of Testosterone Booster is that it can help to elevate mood and energy. These supplements contains a powerful blend of natural herbs. These natural herbs have healthful properties. Thus, you can have the energy and stamina to perform your best in the gym. Furthermore, these supplements will also help you to increase your productivity at work because of your improved energy levels.
Hallie Levine is an award-winning magazine and freelance writer who contributes to Consumer Reports on health and fitness topics. Her work has been published in Health, Prevention, Reader's Digest, and Parents, among others. She's a mom to three kids and a fat but feisty black Labrador retriever named Ivry. In her (nonexistent) spare time, she likes to read, swim, and run marathons.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
The other problem researchers run into when studying the benefits of testosterone is distinguishing between “cause” and “effect.” Is it T that’s providing all these great health benefits or does simply being healthy give you optimal levels of testosterone? It’s tricky because in some instances the answer is “both.” Testosterone (like all hormones) often plays a part in a “virtuous cycle” that regulates a whole host of processes in our bodies — as you increase T, you get healthier; as you get healthier, your T levels rise. It can also play a part in a “vicious cycle” — as your T levels go down, your health suffers; as your health suffers, your T levels decrease even more.
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.
"I went from 230 pounds down to 192. When my son got married, I went for the suit fitting, and I was a size 48. When I went back to do the final fitting, I was a 44! I want to keep getting it for the weight loss; I lost 4 inches around my belly, and I want to get rid of the rest of the weight around my belly. I’m 57, and my wife says I look like I’m back in my 30s. I have more energy for sure, and I’m going to participate in one of those Savage races where they have the obstacle courses with one of our kids."
My entire presentation was focused on 32 different ways to increase testosterone naturally, with no injections or hormone replacement protocols required. I'm not against bioidentical hormone replacement therapy (BHRT), but I do think one should explore as many natural alternatives as possible first. Or, for even more bang for the buck, pair BHRT with the tactics you'll discover in this episode.
Joe Costello is a Nutrition & Wellness Consultant, certified by the American Fitness Professionals & Associates (AFPA), author, and internet blogger. Joe has more than 9 years of experience in the sports nutrition industry and over 3 years of experience as a supplement and nutrition blogger. As a certified NWC who specializes in dietary supplements, Joe strives to deliver accurate, comprehensive, and research-backed information to his readers. You can find more of Joe’s work including his E-Books about fitness and nutrition at his official website joecostellonwc.com, or connect with him on LinkedIn, Facebook, Instagram, Vimeo, or YouTube.
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.