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Collectively, hormones act as your bodys conductora group of behind-the- scenes powerhouses that influence nearly everything from your energy levels to your appetite. Skin, too, is subject to the whims of these potent chemical messengers (think of that sudden breakout that serves as a reminder to stock up on tampons). Generally, this tight relationship is a good thing: Hormones stimulate oil glands and follicles to lubricate skin and grow hair, says Jessie Cheung, MD, a dermatologist in Chicago. Theyre also necessary to maintain skin health.

But things can go a little haywire because your skin is packed with receptors that react to changes, triggering things like acne, wrinkles, and so forth. Puberty is probably the first time you noticed this (hello, zits, nice to meet you), but the ups and downs keep coming, even when youre fully settled into adulthood. The encouraging news? A few tweaks to your routine help you stay glowy for good.

In the first trimester, youre likely dealing with a spike in progesterone, which preps your uterus for a baby. Progesterone can increase oil production and bouts of acne, says Melissa K. Levin, MD, a dermatologist in New York City. The response can be unpredictable, though, which is why you could be breakout central while your pregnant friend is positively radiant. Estrogen also rises during pregnancy, and that, combined with progesterone, can contribute to the formation of melasma, which appears as dark brown spots or patches.

How to handle it: Treatment options are limited since many classic acne-fighting ingredients, like retinoids, salicylic acid, and benzoyl peroxide, are off-limits. Youre not totally out of solutions, though. If youre dealing with stubborn acne, Dr. Levin recommends azelaic acid, which helps with both breakouts and pigment. Worth a shot as well: lactic acid and sulfur, which help keep pores clear. You can also ask your doctor about topical antibiotics, like clindamycin, which is pregnancy-safe. Melasma is another convo since its both chronic and multifactorial. Long-term management may include Rx options like hydroquinone and oral meds (youll have to wait until youre done breast- feeding). Sun is another major factor in melasma, so load up on SPF.

External stressors (think divorce, moving, living through a worldwide pandemic) trigger a domino effect within the body that contributes to a shift in hormones, says Dr. Levin. Increased chronic stress can up androgens like testosterone, which stimulates production of pore-clogging oil, she says.

How to handle it: Retinoids, including over-the-counter retinol and prescription-strength retinoids, are the gold standard for offsetting acne. They help expedite skin-cell turnover to minimize and prevent clogging buildup, says Dr. Levin. Certain retinoids, like adapalene, can also be anti-inflammatory and help treat post-acne marks. She recommends pairing them with antibacterial agents such as benzoyl peroxide (which kills the acne-causing bacteria) or gentle exfoliants like salicylic acid, to keep dead skin cells from sticking together and potentially forming clogs. Oral medications are also an option. Spironolactone is a popular one; it regulates testosterone sensitivity on the skin by decreasing the amount of a specific type of testosterone, Dr. Levin says. And, of course, good stress-handling habits, like getting enough sleep and exercising regularly, will also help.

This is the transitional time leading up to meno (which is when your estrogen and progesterone officially call it a day) and hormones are fluctuating wildly. That new imbalance can cause dryness, says Dr. Levin. And since estrogen drives the formation of structural proteins like collagen and elastin, dips lead to losses in both, often making for more fine lines. With estrogen AWOL, testosterone will dominate, says WH advisor Mona Gohara, MD, an associate clinical professor of dermatology at Yale University. That may bring on breakouts and rosacea.

How to handle it: Since skin might be at its driest ever, everything you do should be rooted in hydration, says Dr. Gohara, who recommends products with humectant ingredients such as glycerin and hyaluronic acid. To address lines, try a collagen-stimulating retinoid. Topical ingredients that activate estrogen receptors in skin, like methylestradiolpropanoate, or MEP, have been shown in studies to improve dryness, dullness, and laxity.

Three different serumsfor purifying, soothing, and energizingare meant to be used consecutively to help you glide through your monthly cycle.

When pregnancy pimples strike, this serum, with azaleic acid and bakuchiol (a plant-based retinol alternative), will keep you in the clear.

Dryness can be tough during perimenopause. This rich cream is packed with heavy-hitting hydrators like hyaluronic acid and lipids.

Collagen-building peptides are paired with a blend of powerful protective antioxidants (green tea, vitamin E) to firm later-in-life skin.

After menopause, youre no longer dealing with the estrogen and progesterone ups and downs, so youll lose a good amount of collagen, says Dr. Levin. That can cause deeper wrinkles and lax skin. The upside: The chance of breakouts goes way downso if youve dealt with adult acne, this might be your clear, calm moment.

How to handle it: Look for peptides in your skin-care products (scan the ingredient label). Theyre the building blocks of certain proteins that drive an increase in collagen, says Dr. Levin. (In other words, they give your skin the materials to create more of it.) She also recommends antioxidants, which help repair and defend against damage, as well as growth factors, proteins produced by our cells that regulate cell growth, maintain tissue, and contribute to the repair and production of collagen. This might also be a good time to consider in-office treatments such as lasers, radiofrequency, and microneedling. These procedures create controlled, microscopic injuries to skin to trigger new collagen productionand may create a more pronounced effect than products alone, says Dr. Levin.

Deanna Pai is a freelance beauty writer and editor currently based in New York. She has more than 10 years of experience writing about beauty and wellness.

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From Acne To Wrinkles: How Hormones Affect Skin - Women's Health

Participants in this project were given a disposable film camera and a journal. They were asked to chronicle their own lives as transgender and nonbinary young people living in Missouri. From left: Jay, 16, he/him; Zari, 21, she/they/he and Josie, 21, she/her; Miles, 16, he/him; and Peter, 17, they/them. Tristen Rouse/Missourian

On Jan. 31, the Missouri Senates Emerging Issues Committee heard six bills, all seeking to force transgender children to participate in sports that match their sex listed on their birth certificate rather than their gender identity. Those bills likely outnumbered the number of transgender children even seeking to play youth sports. The week prior, a House committee crammed eight anti-LGBTQ bills including those that criminalized drag shows on public property and bills that criminalized gender-affirming health care for minors into a single hearing. Opponents were given less than 25 hours notice.

This session, Missouri has turned into a hotbed of anti-LGBTQ legislation. A database maintained by the American Civil Liberties Union shows that, in 2023, more anti-LGBTQ bills have been filed byMissouri lawmakers than nearly any other state legislature.And, after years of such legislation passing the House and stalling in the Senate, Senate leaderships seems poised to make such bills a priority.

Missouris proposed anti-LGBTQ legislation is part of a national trend. In the last three years, 18 states have banned transgender children from participating in school sports that match their identity. Five states have passed restrictions on gender-affirming health care. Supporters of these bills tend to frame them around the idea of saving womens sports. Critics of these bills often point to existing policies that regulate transgender childrens participation in sports and the importance of gender-affirming health care in decreasing suicide rates among transgender kids.

Participating in sports helps form the stories of people's lives as do things like playing in a marching band, working a first-time job and joining in local activism.

Between March and December 2022, the Columbia Missourian gave disposable cameras and journals to five transgender and nonbinary Missourians, aged 16-21, and asked them to tell their own stories. They gave us these pictures.

"My transness is something that I will always hold dearly, a part of me that has given me an entirely new perspective on the world. Cisgender individuals will never be able to fully understand what it's like to be trans, what it's like to live every day having to deal with such an array of issues. I had been out as transgender for a year and a half before starting my medical transition. Throughout that time, I faced so many issues that cisgender people don't even have to think about. Being followed into the men's bathroom, never knowing if I should group myself with the boys or the girls in class, getting a job for the first time and having to deal with customers constantly misgendering me and calling me maam, having to out myself to people because otherwise they never would have known I was a man, and so many more things I had to deal with every single day.

"I started taking testosterone on April 23, 2022, a day I will never forget. Although I was so happy and excited to have started testosterone, for a few months after, I started feeling hopeless. I was continually misgendered at work and school. I had experienced the misgendering by strangers for two years prior to starting testosterone, but it became different after starting it. I felt like I was injecting testosterone into my thigh every week for nothing. I had no changes for months, my voice didn't change, I didnt grow facial hair, nothing. I had never felt more hatred for my transness, I just wanted to be a boy without having to do so much work. Finally, after over 6 months on testosterone, my voice started dropping and I started seeing so many changes I couldn't even keep up with them. I got gendered correctly at work for the first time and I almost started crying from happiness. Trans joy to me is being gendered correctly, being seen as a man by complete strangers. Ever since Ive started consistently passing, Ive grown to love my transness again. I love connecting with other trans people on a deeper level. I love being a man. I love advocating for myself and my identity. I love the way my transness lets me see the world so much differently. I love being trans."

Jay, 16, he/him

This is the declaration of me.

Escapism that I achieve through poetry.

In God we trust.

In water I rust.

Im drowning in half tales.

Stress causing me to break my nails.

Will I ever be able to live my truth?

I want to harvest this plant right from the root.

I am scared to water it out of fear of judgement.

So my plant will die and be covered by cement.

I can chalk it up but rain will wash it.

This is who I am & I am innocent.

A poem from Zari's project journal

"Ive been thinking about activism a lot recently. I really enjoy standing up for trans rights, but there are other things I would rather do. I care so much about the environment and animals and for people with disabilities, and I think these are things I would rather be involved in. I want to be involved with trans rights, but not known for it. Or I would want to be known for it but not that I was trans. Because I feel like if people know Im trans then its like Of course you care about it, you are trans. But I dont want it to be seen that way. I just want to be myself and stand up for trans rights without being seen as trans. Because I dont see myself as trans, really. I just see myself as myself. Like, Im just a boy."

An excerpt from Miles project journal

I live in a small, conservative town. There are few people who are openly queer, and many people are afraid of any scrutiny they will experience if they do come out. I was very aware the queer community in my school was very hidden, and there was not a big support group for them. Because of this, I decided to team up with two of my teachers so I could start my school's GSA (Gender and Sexuality Alliance). The first day we had it, ten to fifteen students showed up. The majority of them were in the schools junior high. Not long after the meeting ended, the superintendent visited one of the teachers involved in the GSA. He told her that we could not have any junior high kids in the group according to district policy. I checked the district policy, and it said nothing about who could be in the club. It said the club had to be started by a student in either eleventh or twelfth grade (I was a junior, so I was not breaking any rules), but there was nothing else about age. The main reason the superintendent got involved was that there was a small uproar about there being a GSA at school. Many parents said it would turn their kids gay and that they did not want that sort of influence on them. If you want to know what it is like being openly queer in a small town, that pretty much sums it up.

Peter, 17, they/them

This project is inspired by the principles of participant photography, a sociological research method intended to empower individuals, through photography, to document and share their own lived experiences.

The Missourian has withheld the last names of those who participated in this project as a safety precaution. Midway through the project, one participant requested their entire name be withheld, as they are preparing to apply to colleges and were concerned their public participation in the project could negatively impact their admissions. Throughout this article, they have been given thepseudonym Peter.

The Missourian thanks those who participated in this project, all of whom generously devoted months of time and energy to it.

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This is who I am: Transgender and nonbinary youth document their own lives - Columbia Missourian

Professional bodybuilding and steroid usage are an open secret at this point. Bodybuilders have become much more transparent about their steroid use in the last two decades. However, the world of celebrity transformations and superhero physiques remains murky. A large part of the internet is convinced actors and influences who drastically transform their bodies do so with the help of steroids. The recent Liver King fiasco has only fanned the flames and also led to fans questioning the natural status of many of the most prominent celebrities like Dwayne Johnson.

Now, bodybuilding legend and four-time Mr. Olympia Jay Cutler has addressed the rumors that The Rock used steroids. Cutler gave his opinion in an interview at the Arnold Classic.

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On March 6, journalist Adam Glyn uploaded an exclusive interview with Cutler on his YouTube channel, Adams Apple. During the interview, Glyn asked the former Mr. Olympia about Hollywood celebrities like Dwayne Johnson, who are not athletes but they get in the same shape. What do these guys take? While he didnt speak about others, Cutler was confident about talking about Johnson.

Ive known Dwayne before he became really big, even in wrestling, the three-time Arnold Classic champion told the interviews. Cutler also said that The Rock has been one of the champions of the fitness community. I see his dedication. I know that dedication, said the champion bodybuilder. He also said that Johnson is among the few individuals who are always in shape.

While addressing Johnsons steroid use, Cutler was confident in saying that The Rock is in shape, and hes cut and lean, but isnt a mass monster. One thing I can honestly say and people may look at me differently for this, but Dwayne isnt that big to me, Cutler said during the interview.

Cutler also said, people say hes gotta be taking this and that, but he believes that the former WWE superstar has immense dedication. He also mentioned that Johnson has the added advantage of working with some of the best experts in the industry. However, Cutler talked about TRT during the interview as well.

While talking to Adam Glyn, the bodybuilding legend talked about why someone his age might consider hopping on TRT or HRT. According to the four-time Mr. Olympia, TRT or HRT is just a special term for medically prescribed testosterone.

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The champion bodybuilder revealed that studies have shown that some people witness a drop in their testosterone levels after a certain age. So, what people are trying to do now, theyre trying to replenish and find the fountain of youth, Cutlker said during the interview.

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Watch this story | Liver Kings $12k Steroids Truth Revealed: Bodybuilding World Reacts

What do you think about Jay Cutlers take on the topic? Do you believe Dwayne Johnson is natural? Write your thoughts in the comments.

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Isnt That Big to Me: Jay Cutler Addresses Steroid Rumors Surrounding Dwayne The Rock Johnsons Physique - EssentiallySports

Chael Sonnen educated people about performance-enhancing drugs and how they made him somewhat of a cheater at one point in his career.

Like some of his fellow former MMA fighters, Sonnen is no stranger to being suspended for banned substances. However, The Bad Guy argued that as a professional athlete competing in a prestigious promotion, he was indeed taking supplements to make him better. Therefore, it shouldnt be labeled as flat out cheating because they didnt know it was illegal until the time commission says so. Otherwise, he wouldnt have taken it in the first place.

Oh, I wasnt clean. Oh, heavens sakes They tricked me. It used to be an IQ test, you used to know when the test was going to be then they come out with something called out of competition testing this is not within the protocol Well they got performance enhancing, those are positive terms then they call it drug at the end to make it negative.. its medicine right? this is legal and appropriate medicine that does make you better. All medicine makes you better like I would never go to a doctor and go, Doc, I feel great can you bring me down a notch? Of course its to make you better. They said that to me, I was in the commission here and they said, Did you know this could give you an advantage? I said, Guys, I wouldnt have taken it. And they sat there, they were dumbfounded, they couldnt believe this response like well, I cant believe your questions. Of course its meant to make you better, Sonnen explained on Flagrant podcast.

Sonnen went on and said that in competitive sports, performance-enhancing drugs are typical, especially Erythropoietin, commonly known as EPO. In fact, Sonnen claimed that NBA superstar LeBron James does EPO as well.

The former UFC title challenger pointed out that EPO increases red blood cells to help athletes perform better for a longer period of time.

If the world understood what LeBron did like other basketball players will hear what LeBron does If you knew what these performance enhancers did, then you would know why it does matter We have the same drug guy. I know exactly what hes doing but theres only one golfer that follows the big three and the big three is EPO, growth hormone, testosterone. Thats the Lance Armstrong diet. Theres one golfer but its Tiger Woods like, yes it does matter trust me that it matters. EPO matters. Its the reason LeBron takes it. It matters and if other basketball players understood what it did, EPO increases your red blood cells which gives you endurance so you can play all game long its the king of performance enhancers EPO is king, he added.

Sonnen has been retired since 2019 but he came clean about still taking some testosterone boosters to this day.

Im currently taking something they call HCG which is human chloronic gynotropin but it just UPS your natural testosterone. Its all about testosterone, he revealed.

Throughout the course of Sonnens MMA career, he tested positive during drug tests three times, most notably in 2014 when the Nevada State Athletic Commission suspended him for two years for testing positive for multiple performance-enhancing drugs, including EPO.

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Chael Sonnen Says Commission 'Tricked' Him To Believing He ... - MiddleEasy

News

By News.com.au

February 22, 2023 | 9:35am

A study has revealed how drinking Coca-Cola and Pepsi can lead to larger testicles and higher testosterone levels.

The Northwest Minzu University in China was attempting to determine the impact of carbonated beverages on fertility and sex organs in men.

The study looked at three groups of mice one that only drank water, another that drank different levels of Coca Cola with another doing the same with Pepsi over 15 days.

Tests on the rodents included weighing their testicles and drawing blood. They were tested on day one, as well as day five, seven, 10 and 15.

It was quickly discovered that the mice drinking Coke and 100 percent Pepsi, compared to a mixture of Pepsi and water, had a significant change.

For instance, the mice that were given pure Coca-Cola had higher levels of the male hormone compared to the group that drank water.

The study concluded: Drinking Coca-Cola and Pepsi-Cola could promote testis development and enhance testosterone secretion [ ] our findings provide the scientific basis for fully understanding carbonated beverages effects and their mechanism on development and reproduction functions of humans, and how they benefit the prevention of prostate dysfunction and cancer.

However, this contradicts previous studies that indicated sugary drinks made men less fertile, instead of more, as the new study suggested.

A previous survey of 2500 men showed those who drank a liter of cola a day had 30 percent fewer sperm than those that drank none.

But some research has shown how caffeine can increase testosterone levels.

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Drinking Coke and Pepsi leads to larger testicles, more testosterone: study - New York Post

Welcome to Testosterone HQMen's Health's guide to the exciting, complicated, and revolutionary world of testosterone. For everything you need to know about T, click here.

IT'S NORMAL for levels of testosterone to change depending on things like age, time of day, sexual and physical activity, and overall health, but consistently high or low levels may cause some unwanted symptoms that could slow you down in the gym and in bed.

Testosterone levels in adult males naturally decline as you age (about 1 to 2 percent each year), but testosterone deficiency in men has become a larger focus of the health community in recent years. Testing your t levels can provide more info on your sexual function and drive, muscle mass development, mood, energy, and even the production of red blood cells. But lab tests can be costly and a pain to schedule, so at-home test kits could be a great starting point for learning more about your T-levels.

Important: not all at-home test kits are created equal. For starters, they're not as reliable as health providers' lab workyour at-home kit's results could vary based on the quality of sample collection, and how you well collected it (yes, you need to read instructions!). Here's the 101 on what to know about at-home kits that are available.

Testosterone HQ | What Testosterone Can and Can't Do | What It's Really Like to Boost Your Testosterone | Low Testosterone Signs and Symptoms | Does Testosterone Increase Penis Size?

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The 4 Best At-Home Testosterone Test Kits of 2023, According to Health Experts - Men's Health

A study has suggested that soda consumption may increase testosterone levels and testicle size in men.

The study, conducted by researchers at the Northwest Minzu University in China and published in the scientific journal Acta Endocrinol, set out to determine the impact carbonated beverages such as Coca-Cola and Pepsi had on fertility.

As noted by the study authors, previous studies have linked soda consumption to harm to reproductive functions, reduced sperm quantity and reduced sperm motility.

The researchers, who relied on animal testing to conduct the study, found the opposite was true when it came to testosterone, the male hormone produced mainly in the testes, and testicle size.

To test their hypothesis, the researchers studied groups of male mice. The first group drank only water, while the remaining groups drank varying levels of Coca-Cola and Pepsi, respectively.

Over the 15-day period, the scientists performed tests on the mice to analyse the effects of the carbonated beverage consumption, which included blood tests and weight and diameter measurements of the testis.

The study found that the testes of the mice that just drank Pepsi or Coca-Cola were significantly increased on day 15.

The outcome demonstrated a high dose of Pepsi or Coca-Cola could promote testis growth and development, the study authors wrote.

In addition to increased testicle size, researchers also found that the concentrations of serum testosterone in all mice were enhanced after the Pepsi-Cola and Coca-Cola treatment, which indicated that high doses of Pepsi and Coca-Cola could improve testosterone secretion of male mice.

In conclusion, drinking Coca-Cola and Pepsi-Cola could promote testis development, enhance testosterone secretion, increase serum EGF concentrations . Our findings provided the scientific basis for fully understanding [carbonated beverages] effects and their mechanism on development and reproduction functions of humans, but also benefit to prevent prostate dysfunction and cancer, the study authors wrote.

Although the study suggested that males may experience increased testicle size and testosterone production as a result of soda consumption, the researchers reiterated that the findings contradict previous studies. One such previous study includes a survey of 2,500 men that suggested sperm quantity was reduced by 30 per cent when a one-litre carbonated beverage was consumed every day.

The researchers also noted that previous studies have suggested links between soda consumption and fertility. One study found that carbonated beverages are associated with alterations in hormones that affect ovulation.

The researchers claimed that, so far, there has been little documentation regarding correlation between carbonated beverage consumption and reproduction function and fertility in humans and animals.

Although the researchers said more research needs to be conducted on the link between soda and fertility, the study acknowledges that carbonated beverage consumption may lead to obesity, cardiovascular diseases and type 2 diabetes, and that previous studies have indicated health damage effects of carbonated beverages on adolescents and children were serious.

The recent study comes after a previous study found that massive consumption of coffee or caffeine increased testosterone production.

As for whether you should consume soda, health experts recommend against consuming the beverages due to the sugar content.

According to the Cleveland Clinic, one can of soda can have as much as 39 grams of sugar, while the American Heart Association recommends no more than 25 grams of sugar per day for women and 36 grams of sugar per day for men.

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Drinking Coke and Pepsi may increase testicle size and testosterone production, study says - The Independent

Testosterone is a hormone produced by testicles in people assigned male at birth. Testosterone can affect many aspects of life, including appearance, sexual development and sex drive (libido). It also helps build bone and muscle mass. A small amount of testosterone is also produced in people assigned female at birth, however this article focuses on low testosterone in males.

Although low testosterone can affect anyone with testicles at any age, low testosterone is more common as people age. Its important to know that it is natural for testosterone production typically to decrease with age. The Endocrine Society considers low blood testosterone to be a morning level of less than 300 nanograms per deciliter in adults. Testosterone levels vary throughout the day, so testing these levels at 8 a.m. is very important.

The symptoms of low testosterone, also known as low T or male hypogonadism, vary based on age and other factors, said Lisal J. Folsom, M.D., adult and pediatric endocrinologist with Norton Community Medical Associates Endocrinology and Norton Childrens Endocrinology, affiliated with University of Louisville School of Medicine. Sometimes when people have symptoms that may signal low testosterone, testing shows normal testosterone levels. That suggests the symptoms are related to something else entirely.

Norton Community Medical Associates Endocrinology offers care for low testosterone at five locations within Greater Louisville. Our fellowship-trained and board-certified endocrinologists provide a comprehensive and inclusive approach.

Testosterone replacement therapy is considered when testosterone is truly low, Dr. Folsom said. Before beginning treatment its very important to have a thorough evaluation, as many symptoms of low testosterone can overlap with other causes, and treatment with any medication can have risks as well as benefits.

If your health care provider recommends testosterone replacement therapy, there are several treatment options, including:

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What are the symptoms of low testosterone? - Norton Healthcare

Welcome to Testosterone HQMen's Health's guide to the exciting, complicated, and revolutionary world of testosterone. For everything you need to know about T, click here.

TOPICAL TREATMENTS FOR hair loss. Gummy multivitamins. Generic formulations of Viagra. The online market for mens wellness is booming. And in the last couple years, that includes testosterone, which is easier to get than ever before.

Critical for regulating the male sex drive, testosterone plays a number of other key functions in the body. Its required for generating sperm. It helps to increase muscle mass, distribute body fat, and generate red blood cells. For men lacking in testosterone, the symptoms can be debilitating. Severe fatigue and depression. Irritability. No sex drive, brain fog, and anemia. Low-T guys have a harder time putting on muscle, and generally see more fat around their abdomen.

Testosterone levels, which are measured in nanograms per deciliter of blood, naturally wane as we age. The conventional wisdom, as spelled out by the American Urological Association, is that a healthy level is higher than 300 ng/dL; some experts argue that low is a little lower and starts at 264 ng/dL. Either way, doctors who specialize in hormone therapies say they are seeing a glut of guys whose testosterone levels are above 300 and are dealing with all the symptoms associated with a clinical diagnosis of testosterone deficiency.

Various boutique health companies, in response, now offer a spectrum of testosterone therapies, which have been extolled by the likes of Joe Rogan and Sylvester Stallone. There are straight-up replacement therapiesTRT, as its calledthat replenish levels of the hormone via creams, gels, pellets, or injections of either the subcutaneous or intramuscular kind. Tablets and supplements, intended to optimize the testosterone a guys already got, are also increasingly available. And forget in-person visits: The wellness businesses of today sell products that are shipped directly to consumers.

Administering testosterone is not like popping a multivitamin, to be sure. Replacing testosterone exogenously shuts down the bodys own production, which means you have to stay on it to maintain any positive effects. Younger guys should also consider their own fertility, since TRT can hinder or stop sperm production. And there are certainly ways to naturally keep your own testosterone levels at their peak: proper exercise, a good diet, and sufficient sleep are all good places to start. But many men with low or lower-than-average levels notice that their moods, muscles, and movesin the gym and in the bedroomare all improved by boosting or optimizing their T.

We recognize, though, that sifting through the options out there can be a bit daunting. What you need and where to get it are important questions. To say nothing of if you need testosterone therapy at all. So consider this your what-to-know-before-you-go shopping guide to online testosterone therapy.

Roman is a wellness company known for its array of services and its simplicitythat is, ease of use. Part of the reason is how Roman gets you going: a DIY blood test shipped to your home. The kit comes with all the materials required for finger-prick draws on two consecutive days. A smartphone app guides you step-by-step through the draws. The kit also comes with pre-printed postage so you can mail it back for analysis, which is completed in a week.

The other part? Roman has only two offerings. One is a supplement billed as testosterone support for guys with healthy levels. It contains ingredients common in multivitamins, as well as ashwagandha, a plant that has been shown, in some studies, to modestly increase your bodys natural testosterone levels.

Clomiphene citrate is the other, although its better known by its brand name, Clomid. Assume your blood test comes back showing low or lower-than-average T. A call with a doctor or nurse practitioner follows, and theyll help you decide your dosage of Clomid (if signs point to that drug being right for you in the first place, of course). The drug itself is not testosterone replacement at all. Rather, Clomid is a pill that stimulates more natural testosterone production, which it does by blocking estrogen receptors in the brain. (When that happens, the pituitary gland boosts production of luteinizing hormone, which acts on the Leydig cells in the testes to make more testosterone endogenously.)

Clomids main advantage is fewer of the side effects associated with traditional testosterone replacement, which can include testicular shrinkage and, in some cases, infertility. Our approach really has to do with maximizing the interaction between safety and efficacy, says Tzvi Doron, D.O., Romans chief clinical officer.

Costs:

Maximus caters to all men looking to optimize their testosterone, but its an appealing option for young guys who want to maintain their fertility but also need a boost in T.

Founded by clinical psychologist Cameron Sepah, Maximus doesnt offer testosterone replacement therapy at all. He calls it testosterone stimulation rather than replacement. (And his personal view is that TRT should be a last resort.) The company prescribes custom compounds of pure enclomiphene, one of Clomids two ingredients. Sepah says the reason for this is that Clomids other ingredient, zuclomiphene, can have estrogenic side effects. His sales pitch is pretty easy to boil down: The enclomiphene will quickly help your body generate more natural testosterone, minus the side effects that sometimes accompany replenishing with synthetic testosterone or popping Clomid.

Of the options here, Maximus is the quickest way to get going on testosterone optimization. You start with a quantitative ADAM, a series of questions on symptoms associated with low testosterone. Within 24 hours, a doctor makes an eligibility decision, and initiates a blood test thats shipped to consumersin this case, a shoulder-mounted device that uses microneedles to remove about a pinky-tips worth of blood. Within a week of shipping your blood sample back, youll have your first bottle of enclomiphene, if you qualify. A follow-up blood test after 30 days determines if your dosage needs any tinkering.

All Maximus patients are assigned a physician; all communication is done asynchronously through text and email. The company also provides health coaching to help guys optimize their diet, exercise, sleep schedules, and stress levels.

Our philosophy is that pharmacology and behavior change are synergistic, says Sepah. One of the biggest benefits of testosterone is increased motivation. We find it helps people make the behavior changes.

Costs:

If youre unclear about whether testosterone therapy is right for you, try Hone Health. According to Jack Jeng, M.D., Hones chief medical officer, the company only accepts patients with lower-than-normal testosterone levels. For guys who are borderline, Hones clinicians might suggest lifestyle changes (sleep, exercise, diet) for three months before jumping into a prescription.

We turn away a lot of patients, Dr. Jeng says. You have to make sure the benefits of treatment outweigh the risks.

You start with a blood test, usually self-administered at home via finger prick, to check biomarkers such as your levels of testosterone and estrogen. A 30-minute telehealth visit follows, and if the doctor deems you a good candidate for testosterone therapy, a second blood test is ordered to confirm the first reading. Within a few weeks, you could be on testosterone replacement, delivered at home in the form of creams, injections, or troches, depending on your preference.

If replacement isnt warranted, Hone can instead send Clomid. Unique to Hone is anastrozole, an inhibitor that blocks the conversion of testosterone to estrogenthat conversion can happen when aromatase, an enzyme contained in fat cells, breaks down testosterone. Whatever the case, patients receive follow-up blood tests and telehealth visits every three months in the first year to check for side effects and titrate dosages if necessary.

Give it at least 10 weeks before deciding whether or not this is working for you, says Dr. Jeng. Thats around the time when people start to notice that the benefits have started to really kick in.

Costs:

Blokes is for anyone who wants doctors controlling their testosterone therapy from start to finish. Every interaction with Blokes begins with a blood test, but these arent self-administered. Instead, Blokes schedules an appointment at a Labcorp or Quest Diagnostics facility. (For a surcharge, a phlebotomist can meet you at your home or workplace.)

These tests are the more conventional CBC, or complete blood count. Testosterone and estrogen levels are assessed, and so are your levels of luteinizing and follicle-stimulating hormonesthe pituitary hormones responsible for testosterone and sperm production, respectivelyas well as your cholesterol and lipids. A one-on-one clinical visit of at least 30 minutes then follows.

You want to know who that patient is before you start prescribing anything, says Amy Killen, M.D., one of Blokes clinicians. You dont want to throw this stuff out like candy.

Once youre in the Blokes system, youre assigned a physician and health coach who guide your therapy and make recommendations on nutrition, exercise, and other lifestyle factors. Testosterone replacement options include creams, injections, and troches, as well as nasal sprays and pellets (inserted into the body via a minor procedure). Clomid is on hand, too, as is pure enclomiphene. After 30 days: another blood test, along with another telehealth appointment. Its usually at this mark that Blokes consults with you to figure out if youre on the right form of testosterone therapy or drug.

We prioritize service over automation, says founder Josh Whalen. Every patient is getting some type of one-on-one follow-up with a provider.

Costs:

If youre as interested in health span and longevity medicine as you are in testosterone, then Opt Health is for you. Graham Simpson, M.D., one of the cofounders, has himself been on testosterone therapy for 27 years; hes 72, but doesnt look much older than 50.

Opt Health starts its prospective patients with a blood draw like all the other companies. These are done at a local Labcorp (or at home, with a visit from a nurse or phlebotomist). The blood test triggers an initial consultation, at which point Simpson, his cofounder Jeremie Walker, M.D., or one of Opts other half-dozen clinicians can take you through their testosterone options, which include creams, injections, and Clomid that are shipped directly in three-month allotments. Chances are that any testosterone treatment you end up taking will be paired with Opts offerings of amino-acid peptides or nutraceuticals.

Testosterone is a big part of our business, says Dr. Walker. But I actually have guys that are not on testosterone. Were focused on lifestyle optimizations.

Every three to four months, Opt Health repeats a blood draw followed by a consult with your clinician. A personalized online dashboard helps you track your progress, side effects, symptoms, and something Dr. Simpson calls your DNA age. (Theres your chronological ageyour birthdayand your biological age, he says.) In Opts view, fighting insulin resistance and inflammation is just as important to Opt as prescribing the right form of testosterone treatment.

Were very focused on reversing biological age, Dr. Simpson says. We look at nutrition, we look at exercise, we look at hormones, we look at stress, we look at sleep. We look at many, many things that optimize mens health.

Costs:

Andrew Zaleski, a writer based near Washington, D.C., covers science, technology, and business.

Continue reading here:
5 Best Testosterone Replacement Therapy Services 2023 - Men's Health

February 22, 2023

3 min read

Disclosures: Healio could not confirm relevant financial disclosures at the time of publication.

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Testosterone replacement therapy combined with lifestyle modification may contribute to improved metabolic and glucose profiles for men with hypogonadism and prediabetes, according to a review article.

In findings published in Andrology, Giovanni Corona, MD, PhD, an endocrinologist and andrologist at Maggiore-Bellaria Hospital in Bologna, Italy, and colleagues reviewed data from multiple studies and meta-analyses on the role testosterone plays in the development of diabetes. The researchers found people with impaired fasting glucose tended to have lower total and free testosterone levels than controls, and testosterone replacement may improve body composition and insulin resistance. However, they concluded more research is needed to analyze whether testosterone replacement can help men lose weight or prevent the development of type 2 diabetes.

Experimental and clinical evidence clearly indicates that metabolic derangements even in preclinical stages are characterized by significantly lower testosterone circulating levels, the researchers wrote. In the latter circumstances, testosterone replacement therapy can improve body composition, metabolic profiles and insulin resistance, whereas the data on body weight are more conflicting.

Researchers conducted a systematic review using studies and meta-analyses available in the Medline, Embase and Cochrane databases from 1969 to April 2022. Meta-analyses were preferred over individual studies. Searchers were conducted for papers analyzing the relationships between testosterone, diabetes and prediabetes. Researchers also analyzed data from a study of 4,682 patients who received care for sexual dysfunction at the University of Florence.

In the cohort with low testosterone from the University of Florence, 16.9% had IFG. Among men with IFG, the prevalence of secondary hypogonadism was two times higher than the prevalence observed in the general population. After adjusting for age, BMI and waist circumference were the best predictors for IFG-related low testosterone. Researchers also analyzed findings from eight similar studies, of which 3,625 participants had IFG and 6,205 had normal glucose. Men with IFG had a 3 nmol/L lower total testosterone and a 1.8 times higher risk for hypogonadism compared with controls. Waist circumference and BMI were again the strongest predictors for low testosterone.

Researchers found three meta-analyses investigating the effects of low testosterone among men with type 2 diabetes. Men with type 2 diabetes had lower total and free testosterone than controls without diabetes. Additionally, men who developed type 2 diabetes during follow-up had lower total testosterone at baseline than those who never developed diabetes.

Researchers found two studies evaluating the use of testosterone replacement in people with hypogonadism and prediabetes. In an open-label observational study, 90% of men with low testosterone and prediabetes treated with injectable testosterone undecanoate (Nebido, Grnenthal) for up to 8 years achieved an HbA1c of less than 5.7% at follow-up. Those receiving testosterone replacement also had greater improvements in body composition, lipid profile and fasting glucose compared with controls. In a randomized controlled trial where men with low testosterone and prediabetes were randomly assigned to an intramuscular injection of testosterone undecanoate or placebo, participants in the testosterone group had greater improvements in fat mass, lean mass and waist circumference, but not body weight, compared with controls. Testosterone replacement was also associated with a greater reduction in fasting glucose, but not HbA1c.

Researchers analyzed data from four meta-analyses investigating the effect of testosterone replacement in people with type 2 diabetes. Testosterone replacement was associated with greater improvements in fasting glucose, HbA1c, fasting insulin and insulin resistance compared with placebo. However, data between the meta-analyses were conflicting for body composition. None of the meta-analyses found a change in BMI with testosterone replacement and only one found testosterone replacement reduced fat mass. For lipids, all of the meta-analyses found an improvement in triglycerides for men receiving testosterone compared with placebo, but findings varied for all remaining lipid parameters.

It is our opinion that the combined approach of testosterone replacement therapy and lifestyle changes should be used in symptomatic hypogonadal men to better motivate patients to perform physical activity eventually resulting in weight loss and sexual function improvement, the researchers wrote. Whether or not these approaches can prevent the development of type 2 diabetes from preclinical conditions require more longitudinal well-performed studies.

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