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Sir Steve Redgrave has candidly opened up about his health after being diagnosed with a condition following months of being tired and depressed.

Redgrave, 61, was told his symptoms could be connected to testosterone deficiency just six months ago by a friend.

It comes after Redgrave was diagnosed with type 2 diabetes at the age of 35.

What Ive been noticing is more weight gain, especially around the stomach area, a little bit more tiredness, culminating in depression which I would class as the worst side of it," he told the Mirror as he outlined how his latest health condition had impacted him.

The five-time Olympic gold medalist (second from left) was diagnosed with a testosterone deficiency

PA

Type 2 diabetes, which impacts around 850,000 Britons, is closely linked with testosterone deficiency.

Men who have the deficiency are four times more likely to develop type 2 diabetes and around half of men with type two diabetes will have low testosterone levels.

The five-time Olympic gold medalist rower added: I had a grandfather who was diagnosed with type 2 diabetes in his sixties.

But I never dreamed that I would develop it. It was probably the furthest condition from my mind.

Normally a diabetic would be told to exercise more Im not sure I could have done that!

My first thoughts were that my career was over.

I didnt think you could be a top athlete with that condition.

But my consultant said Why not?

Sir Steve Redgrave confirmed he exercises three times a week on a static bike and also enjoys playing golf.

PA

Despite competing in five consecutive Olympic Games, Redgrave now admits he finds it hard to find motivation to exercise from home.

He confirmed he exercises three times a week on a static bike and also enjoys playing golf.

Redgrave, who won the Golden Sports Personality of the Year in 2003, intends to start testosterone replacement therapy and indicated he hopes to receive an injection rather than gel treatment.

He said: Im hoping for a bit more get up and go.

Redgrave concluded by urging men to consider whether they might be suffering from low testosterone

PA

My eldest daughter is expecting at the moment and Im looking forward to being a grandparent.

I want to be fit and healthy and there are a lot of projects I want to get done around the house.

Redgrave urged men to consider whether they might be suffering from low testosterone.

He suggested men take a simple blood test if they have weight control issues, tiredness, depression or a low libido.

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Sir Steve Redgrave opens up on debilitating private health battle that left him 'tired and depressed' - GB News

By Edmund Willison For The Mail On Sunday 22:30 29 Apr 2023, updated 22:30 29 Apr 2023

Premier League footballers are almost never tested for the banned performance-enhancing drug testosterone, a Mail on Sunday investigation has found. And top-flight stars can expect to be subject to even the most basic drug test as infrequently as once per season.

An FA spokesman told this newspaper that doping in English football is very rare while also refusing to provide any detailed data about how many tests for specific substances are actually undertaken each season.

Instead, the FA told the MoS to ask Britains drug-busters, the UK Anti-Doping Agency, for figures on testing.

And UKAD declined to provide us with any detailed doping test statistics and in the process breached the Freedom of Information Act.

UKAD say they are concerned the data could be misinterpreted and undermine their testing programme.

In reality, UKAD have never sanctioned a Premier League footballer for blood doping or taking testosterone.

We can reveal however that 13 professional footballers in the UK were formally investigated for elevated testosterone levels between 2006 and 2009 but UK Sport, UKADs predecessor, closed every case involving those players without taking any disciplinary action.

A current director of a leading anti-doping agency has told The Mail on Sunday that the Premier Leagues anti-doping programme, run by UKAD, is inadequate, and that synthetic versions of testosterone and blood doping substances would provide great benefit to professional footballers.

The Mail on Sunday can reveal that UKAD, on behalf of the FA, collected an average of 2.5 doping samples from each Premier League footballer during the four seasons between 2017-18 and 2020-21.

But multiple samples (for urine, blood and Athlete Biological Passport sample collections) can be collected during one doping test, therefore it means that some players could have had perhaps a single appointment with testers each season, if any.

In comparison, in 2019, World Athletics collected six times as many samples from track and field athletes as UKAD did from Premier League footballers, despite having 45 fewer athletes in their testing pool.

The extent of doping in athletics, cycling and skiing has been well exposed in recent decades but there has been a dearth of scandals involving footballers despite widespread belief that the problem extends to the beautiful game.

This lack of doping cases in English football is partly explained by the FA and UKADs lax testing programme. Statistics, obtained via a Freedom of Information request, show that doping testing across the game has decreased since 2017.

In the 2017-18 season, UKAD collected 1,923 samples from about 500 first-team players in the Premier League.During 2018-19, 2019-2020 and 2020-21 seasons, the numbers decreased to 1,766, 1,458 and 729 samples respectively.

Testing was impacted by the Covid-19 pandemic but the decrease in testing started before 2020.

UKAD have refused to reveal how often English professional players are tested for blood doping substances.

UKAD claim that to do so would undermine their testing programme despite the fact that UEFA release publicly how many of these tests they perform annually. As of 2004, the FA were not performing EPO testing.

EPO is prohibited for use by the World Anti-Doping Agency and was widely taken by cyclists, such as Lance Armstrong. EPO has a drastic effect on endurance and recovery which would provide substantial benefits to footballers.

When an anti-doping agency collects a doping sample from an athlete, they must choose how rigorously to analyse the sample.

Testing for blood doping substances and banned testosterone, while more expensive, are much more effective than the basic analysis.

This newspaper has now been able to establish that UKAD and the FA are providing footballers with an opportunity to take prohibited testosterone and then go undetected.

UKAD screens footballers for elevated testosterone ratios but a further confirmatory test, called IRMS, is required to confirm the presence of synthetic testosterone.

If the test returns a positive result then the player can be charged with an anti-doping rule violation.

The United States Anti-Doping Agency used this method to catch Justin Gatlin, the former 100m Olympic and world champion, in 2006.

UKAD refused to provide these exact figures but in 2021, the last full year for which figures are available, UKAD performed only 68 of these tests on the 6,943 samples they collected across all sports. The number of those undertaken in the Premier League is therefore minimal.

Now, The Mail on Sunday have found 13 footballers in Britain showed elevated testosterone levels between 2006 and 2009.

However, UK Sport, who ran the FAs anti-doping programme at the time, did not perform tests to confirm the presence of synthetic testosterone in the majority of these cases.

UK Sport, by monitoring the players future drug tests, attributed the irregular testosterone values to natural variation and ruled that the footballers had no case to answer. This was consistent with anti-doping rules at the time.

The head of operations at UK Sport during this period was Nicole Sapstead, who became UKAD boss in 2015. Sapstead now runs the International Tennis Federations anti-doping programme.

Since UKAD assumed all anti-doping responsibilities from UK Sport in 2009, any doping cases involving footballers who were cleared of suspected testosterone use is no longer made public. Previously, all doping cases, including those that ended in no sanction, were uploaded to a publicly available database by UK Sport.

Margaret Goodman, the director of the Voluntary Anti-Doping Agency, the body that polices doping in professional boxing, told The Mail on Sunday that the Football Association and UKAD should perform more rigorous drug testing.

From the provided statistics, footballers are unfortunately inadequately tested, she said. What would be more beneficial to a footballer than anabolic steroids and EPO? I strongly believe that if you are going to create a deterrent, the only rationale is to perform the most advanced testing every time.

In contrast to the FA, UKAD and almost all other national anti-doping agencies, Goodmans agency test every sample they collect for both synthetic testosterone and EPO. The agency have a catch rate of four per cent, compared with UKADs 0.2 per cent. This arguably shows how efficient VADAs testing programme has been.

UKAD and other national anti-doping agencies still have not adopted this, albeit more expensive, more effective testing strategy. Goodman says that she was criticised for performing such effective testing.

I believe that national anti-doping agencies and any WADA signatory should include IRMS on every collection, said Goodman. Several years ago, our agency was criticised and almost threatened that we were going to be ostracised for including IRMS on every collection. Bottom line: it was cost-prohibitive.

When the British boxer Ryan Martin was caught doping by VADA in 2018, UKAD had to retest his sample using IRMS testing because he had passed their more basic testing.

Last year, Conor Benn failed two VADA drug tests despite passing all of his UKAD tests. A UKAD spokesperson said that it was not feasible to test all samples for synthetic testosterone, although the agency still only tests one per cent of all samples for the drug.

It is not feasible to analyse all samples using this technique, which is why we strategically use the steroidal module of the Athlete Biological Passport to inform our selection of samples, a UKAD spokesperson told The Mail on Sunday.

It is important to note that IRMS is not a technique used in isolation and is in fact part of a suite of analytical tools available to us to detect prohibited substances.

In response to this story, UKAD told this newspaper: Our football testing programme uses an intelligence-led and risk-based approach to targeting areas of the sport and the individuals who we believe have the potential to dope.

'While it is individual players who are picked out from a team for testing, testers are regularly present at football clubs across the UK, which serves as a deterrent for the whole team.

Testing is conducted with no advance notice and no player is aware if they are to be chosen for testing; this is determined by UKAD alone. The FAs investment into the football testing programme over a number of years is commended by UKAD.

The FA said: We take anti-doping extremely seriously, and we are fully compliant with the Department for Digital, Culture, Media and Sports latest National Anti-Doping Policy.

We fund one of the worlds most comprehensive national anti-doping testing programmes, which is directed by UK Anti-Doping, and is constantly reviewed in order to make improvements wherever possible.

Over the past year, The Mail on Sunday has made numerous attempts, via the Freedom of Information Act, to gain access to these statistics on drug testing in British football but our requests have been refused, on almost every occasion, including on appeal, by UK Anti-Doping. UKAD also refuse to reveal how many British athletes, including footballers, have been investigated for blood doping.

UKAD also breached sections 1, 10 and 17 the Freedom of Information Act by failing to respond to this newspapers requests within the legally mandated time frame.

In 2022, The Mail on Sunday revealed that 15 Premier League footballers failed drugs tests between 2015 and 2020 but none of them were banned by UKAD.

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Does the Premier League have a drugs problem? - Daily Mail

Sir Steve Redgrave has opened up on his health issues after his recent struggles.

The former rower, now 61, has been dealing with several symptoms related to testosterone deficiency in recent months, with knock on effects causing other damaging impacts.

He was diagnosed with type 2 diabetes when he was 35, just years before he retired from rowing.

He also found out he had ulcerative colitis in 1992, a condition which causes an inflammation of ulcers in the colon and rectum.

Speaking to The Mirror, Redgrave admitted his recent battles have resulted in symptoms of tiredness and depression, along with other noticeable feats.

'What Ive been noticing is more weight gain, especially around the stomach area,' he said. 'A little bit more tiredness, culminating in depression, which I would class as the worst side of it.

'At first, I thought it was just getting older,' he said. 'I just accepted it.It just wasnt something I had really considered.'

The five-time Olympic champion also discussed his battle with diabetes and the struggled he had to go through with the condition while still being an elite athlete.

He creditedhis medical team for their help, but it wasn't easy.

'When I was an athlete I was finger pricking my blood 10 times a day,' he revealed. 'Things have come a long way in treatment. The pump has made a big difference and my general health got a little bit better when I was being given a small amount of insulin all the time, 24 hours a day, compared to when you were injecting.

'I had an amazing medical team to help me find the way through.'

'My control is so much better than it was 20 years ago, though my wife Ann, who is a doctor, would say not as good as it should be.'

Redgrave's health appears to be on the decline, but he's determined to be as fit as he can be for the rest of his days.

He also urged more men to keep on top of their health, particularly when it comes to testosterone levels.

'I am starting to notice less feeling in my feet which is another one of the problems, especially being very tall,' he said. 'Youve got all these complications that dont hit you here and now, but will creep up on you sooner or later.

'My eldest daughter is expecting at the moment and Im looking forward to being a grandparent. I want to be fit and healthy, and there are a lot of projects I want to get done around the house.

'Us blokes dont help ourselves. We think, "Ill ignore that" and we dont tell our mates because theyll take the mickey out of us. I mean, it took me nine years to get help.

'But if you have weight control issues, tiredness, depression or low libido, you can rule things out with a simple blood test. Its about finding things earlier.

'Theres a lot of evidence that testosterone therapy can even help reverse type 2 diabetes.

'Its known that diabetics will probably die earlier than they would have done. If there is a way to improve your health and mortality, why not take it?'

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Sir Steve Redgrave admits he has struggled with depression since discovering low testosterone levels - Daily Mail

A few days ago, producer Chittibabu had criticised Samantha Ruth Prabhu by saying that her career as a star heroine has ended after her recently released film Shaakuntalam underperformed at the box office. Following his remark, Samantha had seemingly taken a dig at Chittibabu in her Instagram stories. Now, the producer has once again targeted Samantha over her cryptic post. In his earlier interview, Chittibabu had said that Samantha was using cheap tactics to promote her movies. He had also mentioned that he was surprised to see her playing the lead role in Shaakuntalam. After his statement, Samantha had taken to her Instagram stories and stated that she was searching How do people have hair growing from ears" on Google and the internet revealed that it happens because of increased testosterone. Many people speculated that it was a jibe at Chittibabu's statement.Responding to Samantha's jibe, Chittibabu said in a new interview, "She has noticed my ear hair and hair grows in many other parts of my body and I have no objection to study and report on it."He also clarified his earlier statement about Samantha and said that all he meant was the actress was not suitable to play young characters anymore. She said that Samantha is not 18-20 years old, which doesn't make her a suitable choice for the role of Shakuntala. He further added that her glamorous days are over and its time to move on to supporting roles. He also mentioned that the actress is not ready to accept the truth. On the work front, Samantha will be next seen in an upcoming romantic film Kushi opposite Vijay Deverakonda and in the action thriller web series Citadel alongside Varun Dhawan. Speaking about the series, Samantha had told IANS, "The Citadel universe, the interconnected storylines between the productions across the globe, and most importantly, the script of the Indian installment really excited me. I am thrilled to be a part of this brilliant universe conceptualised by the Russo Brothers' AGBO." Samantha has already begun shooting for Citadel with Varun Dhawan.Also See: Best Hindi Movies of 2023 | Top 20 Hindi Movies of 2023 | Latest Hindi Movies

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Chittibabu responds to Samantha Ruth Prabhu's 'increased testosterone' jibe: Hair grows in many other par - Times of India

Getting older is an obvious one, but lifestyle choices and chronic conditions are culprits, too.

Discussions around low testosterone often focus on the symptoms of low-T.

Conversely, you sometimes hear exclusively about what you're missing out on due to suboptimal testosterone levels. The conversation immediately shifts toward what testosterone replacement therapy (TRT) may be able to do for you: better energy, improved mood, improved sex drive, better lean muscle-to-fat ratio and better erectile function.

Unfortunately, the modern tendency to look for quick-fix pharmacological solutions leads people to overlook the underlying causes of a medical issue. They get into a big rush to alleviate the symptoms in the quickest, easiest way possible.

That's especially true for the delicate natural hormonal balance in the body. It requires careful calibration to function correctly. It's not like taking an antibiotic for a bacterial infection.

Coming at testosterone with a sledgehammer of clumsy, inexpert or poorly thought-out "treatment" can be disastrous, especially if you don't try anything else first.

For that reason, most reputable men's health specialists don't go directly to TRT. They begin any conversation about potential low-T symptoms with a thorough assessment of the patient's history and lifestyle. They want men to understand they have a great deal of control over their own testosterone levels.

As with any condition, it's important to know the causes of low testosterone and how aging may or may not affect testosterone production. Let's dive into that information and look at a set of possible testosterone-related behaviors that's been dubbed "irritable male syndrome."

On an abstract level, many people realize that modern Western life is unhealthy. The types of food we eat, the level of exercise many of us choose, the type and amount of substances we takehell, the very air we breatheall of these things conspire to compromise our health across a variety of bodily systems.

Look at a typical American man's lifestyle through the lens of testosterone production and it really snaps into focus.

Let's start with one of the biggest impediments to testosterone production and general health in modern life: obesity. As of 2018, more than 42 percent of American adults were obese, and 30.7 percent were overweight. About 1 in 11 adults were severely obese, meaning they had a body mass index (BMI) of 40 or higher, according to the National Institutes of Health (NIH).

Obesity leads to more adipose tissue, or body fat. That excess fat is thought to convert testosterone to estrogen, thereby decreasing testosterone levels. The process itself is more complicated than that, but at its base, excess fat hinders testosterone production.

Multiple studies show a strong link between obesity and low-T. The connection is clear.

One 2017 study featured a man who was morbidly obese and hypogonadal (low-T). He underwent a gastric bypass procedure and his testosterone returned to normal levels so completely that he was taken off exogenous testosterone, according to the researchers.

This study, albeit with a sample size of just one, dovetails with a 2019 review of obesity and low-T. That research suggested that obesity leads to low-T, but the opposite is also true: Low testosterone can cause increased fat accumulation.

Diabetes is closely linked to obesity, and the two of them together are a warning sign of low-T. A certain portion of men with erectile dysfunction (ED) can be expected to have hypogonadism, according to the NIH, but that number increases if those men are obese or have diabetes.

Sleep apnea becomes more common in men as they reach middle age, and this condition may exacerbate the natural drop in testosterone production that occurs with age. Simultaneously treating obstructive sleep apnea and low-T can help, according to the NIH.

Excessive alcohol consumption and chronic use of drugs, particularly opioids, can impact testosterone production in a significant way.

"The big one for medication is going to be opioids," said Amy Pearlman, M.D., a men's health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida. "Opioids that people use for pain can drastically reduce testosterone levels. I don't know if taking them just for a couple of days can impact testosterone, but I do know that patients who are on them chronically have very low levels, and that's supported by the research."

Men's testosterone production begins to decline by about 1 percent per year after age 30 or so. This sounds like a damning figure, but there's more to unpack here before you rush off to the clinic the day after you turn 30.

"Yeah, testosterone goes down as people get older, but that doesn't mean it's going to be lowif they keep themselves healthy," Pearlman said. "Some of my healthiest patients that come in are in their 80s and 90s and are hoping they have low-T because they have some fatigue or they're not as sharp as they were before. They're hoping their testosterone level is low so I can put them on testosterone and they can go live their best lives.

"I find that the people who are moving and grooving and staying active and treating their bodies well, just because they're 80 or 90 years old doesn't mean they're going to have low testosterone," Pearlman added.

Another important point: That 1 percent drop in testosterone per year may sound like a slow death sentence to your libido, but in the grand scheme of things, it's not a lot.

"One percent is not that much," Pearlman said. "So if someone has total testosterone of 600 nanograms per deciliter, then 1 percent is going to be 6 nanograms per deciliter per year."

Researchers are connecting the dots between the proven scientific phenomenon of lower testosterone production in older men and the anecdotal evidence that some older men become more irritable and depressed and have lower self-confidence and less energy. They're calling it "irritable male syndrome," but it is strongly linked to what's clinically called "andropause" or sometimes "male menopause."

Now, it's safe to say we should take that clickbait-heavy term with a grain of salt.

What is indisputable is that the normal age-related reduction in androgen productionandrogens are "male" hormones, such as testosteroneis linked to moodiness and the other symptoms mentioned above.

One study on irritable male syndrome looked at the end of mating season for a species of ram called the Soay ram. Researchers found the drop in testosterone production at the end of the mating season resulted in the animals appearing to be more fearful and agitated.

What was also striking was that they fought more, resulting in more frequent physical wounding.

Ultimately, testosterone production is something you can control to some degree.

You can't stop aging, but you can get more active, eat healthier, cut drug and alcohol use, and lose excess weight. Doing these simple things can help you stay "moving and grooving" well into old age like one of Pearlman's 80- or 90-year-old, active, healthy patients with great testosterone levels.

Eating better and exercising more may not be a quick fix, but it's a sustainable, healthy way to start your journey to optimal testosterone levels and feeling better in general.

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What Are the Many Potential Causes of Low Testosterone? - Giddy

Singer-songwriter Robbie Williams has opened up about his sex life, revealing how his libido dropped after he stopped taking testosterone.

The 53-year-old said in an interview with The Sun that since coming off hormone replacement therapy, which he was using to treat depression, his incredible sex life with his wife of almost 13 years, Adya Field, had slowed down considerably.

The sex we had when I was on testosterone was incredible, he told the newspaper. It was all the time. We were insatiable. It goes to show how into each other we really are, though, because when I was on it, we couldnt take our hands off each other.

I miss that. That was a fun period. Sometimes now, though, Ayda will turn to me on the sofa and say, We should do sex, and Im sitting there eating a tangerine and just sort of shrug. So, ya know, sometimes we try.

Thankfully, the couple's lack of intimacy in the bedroom hasn't affected their relationship outside of it, Williams said.

Field added they are still always cuddling and kissing.

Everyone knows there is no sex after marriage, Williams continued. Thats just the way it is. I was on testosterone for a while but, because Im an addict, that had to stop. I got these massive square shoulders and started to look like a doorman. It wasnt a good look.

No sex in a marriage is only a problem if youre on different pages, he added. If one person wants it, and the other doesnt, [or] if you have different expectations or requirements.

Field agreed: Intimacy is the important, meaningful side of love. I have friends who feel obliged to have sex with their husbands and that must be awful. Me and Rob are on the same page. We are happy.

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Robbie Williams Opens Up About Sex Life and Low Libido after ... - Men's Health UK

JME and his special guest mates played a relentless set at Bristols Motion, as part of the Boy Better Know co-founders Grime MC FM event series. Whilst grime prides itself on intensity, with no let-ups, the show was only really ever in one gear.

When Drake made a guest appearance at a Section Boyz gig back in 2016, shortly before announcing hed signed to Skepta and JMEs Boy Better Know collective, UK grime had reached a new apex. Even at its most cynical level, the Canadian superstar saw the scene as a gateway toward earning UK cultural kudos.

Yet as with all genres, grime has faced a constant push-and-pull between preserving its core tenets and splintering off into something new. In this instance, the rise of drill (which first emerged in Chicago) has been taken up to give hard-hitting depictions of inner-city life, whilst a more melodious UK rap scene has emerged, no better represented than by Knucks sublime Alpha Place.

JME is still delivering on the same tried and tested grime formula he knows, spitting fast bars over 140bpm garage and jungle influenced basslines. Given the success its brought him, you could hardly blame him.

But at Bristols much-loved Motion this weekend, this often grew wearisome. JME Presents Grime MC FM was a blazing bank holiday bash no doubt, but with little space to breathe both in the set and the sweaty, gun-finger-toting crowd it became stuck in a not-too-distant past.

It would take an hour and a half for an MC to appear, with P Money taking over from a DJ setlist that had riffled through most of the grime classics. Asserting himself with Whos In Charge, P Money would later get the crowd featuring in a music video for his new track Bars n Dat.

This constant hype-athon would be the general gist of the night. The mini-fridge perched near the DJs turntable stacked full of the KSI-endorsed Prime drink tells you all you need to know: this event was all about in-your-face energy.

P Money promised the crowd the night would be grime in its purest element and by the time JME did arrive, flanked one at time by special guests, his words certainly came true.

The premise of JMEs Grime MC FM a pirate radio-styled live show built off the back of his 2020 album Grime MC is that its special guests remain a secret until the day. For Bristols entertainment, the list of MCs included Manga Saint Hilare, Tempa T, Shorty, Blay Vision and Flirta D.

Spitting in turns under red lights and a simple Grime MC FM banner, Manga Saint Hilare achieved the most wheel ups (by my reckoning anyhow), whilst Flirta D gave the most memorable moment when he interpolated parts of his Cammy Riddim Freestyle into the set.

The sheer stamina and persistence of the night was impressive, but overall the non-stop bars even for a genre that prides itself on building tracks around a repeated phrase became tedious. This was perhaps most evidenced, too, by the indecisive mosh pits, which ballooned out only to fall in on themselves indecisively when there was no clear drop.

JME left Bristol by previewing something exclusive. In reality, it sounded like a lot that had come before. As he went to biggup the MCs, the DJs, you could certainly admire the Grime MC FM idea, for trying to keep the underground spirit where grime was forged alive.

Grime is by no means dead, but this event did make you wonder whether its now so far removed from the underground that its become a pastiche of its former glory; a victim of its own success, which Drake, for better or worse, has long-since moved on from.

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JME at Motion review | Testosterone-fuelled tribute to times gone by - whynow

Novel research by investigators at the Desai Sethi Urology Institute (DSUI) at the University of Miami Miller School of Medicine was presented at one of the world's most important urology meetings and simultaneously published in one of the highest impact journals in the specialty.

This reflects the quality of research at the DSUI, as this is the first time the Journal of Urology earmarked and simultaneously published American Urological Association (AUA) annual meeting presentations, according to Ranjith Ramasamy, M.D., director of reproductive urology at DSUI.

Two studies, one on a type of short-acting testosterone therapy and another looking at whether platelet-rich plasma (PRP) works to treat erectile dysfunction (ED), were presented during the April 28 to May 1 AUA 2023 meeting in Chicago and published online the day of each presentation in the Journal of Urology.

"These were randomized clinical trials, which offer the best evidence but also are the most challenging and arduous to conduct," Dr. Ramasamy said. "They reflect the primary focus of the DSUI, which is to conduct investigator-initiated clinical trials."

These studies also offer new information for clinicians and patients on common approaches used to treat common conditions, according to Thomas Masterson, M.D., assistant professor of urology.

Traditional treatments for erectile dysfunction focus on pathways that treat ED symptoms without reversing underlying ED causes. The most popular restorative therapies today are shockwave therapy, platelet-rich plasma and stem cell therapy. Restorative therapies have the potential to reverse the underlying pathology of ED.

"All three of these are not FDA approved for ED, and there is not a lot of good research on them," said Dr. Masterson, who was the author of the study.

"While some small studies have shown potential benefits for platelet-rich plasma, popularly called the "P-shot," larger and more rigorous clinical trials are needed to fully evaluate the efficacy and safety of platelet-rich plasma therapy for erectile dysfunction," said Dr. Manuel Molina, a men's health fellow and sub-investigator in the clinical trial.

DSUI investigators are the first to show using PRP was no better than using placebo to treat ED patients.

"This finding may prompt health care providers to reconsider the use of platelet-rich plasma therapy as a viable treatment option for erectile dysfunction until further research provides more conclusive evidence," said Braian Ledesma, a student and study coordinator. Ledesma presented this finding as a late-breaking abstract at the AUA annual meeting.

Patients need to be informed consumers, according to Dr. Masterson.

"This study is the first negative study suggesting PRP, which can be very expensive, may not be any better than a placebo," he said.

There are several forms of testosterone therapy, including those that are injected intramuscularly or subcutaneously, applied to the skin or taken orally as pills, as well as intranasal gel, which is applied on and absorbed into the nasal mucosa.

"Traditional forms of testosterone therapy are known to increase hematocrit, which is the percentage of red blood cells in your blood. That could lead to a risk of cardiovascular events, like heart attacks, blood clots or stroke," said Marco-Jose Rivero, an author on the study and a Miami Andrology Research Scholar at DSUI. "Our objective for this trial was to evaluate and compare intramuscular testosterone therapy versus intranasal testosterone gel, with regards to whether or not they increase hematocrit."

This is the first head-to-head study comparing the two, according to Dr. Ramasamy. Men were randomized to receive either intramuscular testosterone, which is administered every two weeks by injection, or the nasal gel, which is applied two to three times daily.

The researchers found that intramuscular testosterone does increase hematocrit levels, while intranasal testosterone gel does not. And intranasal testosterone gel may be a better option for patients with cardiovascular risk factors and others who want to avoid the potential side effect, according to Rivero.

"This finding is important because we do believe the increased red blood cell count or hematocrit is what puts people at risk of cardiovascular or thrombotic events," said Russell Saltzman, the clinical trial coordinator.

Rivero, a medical student, said that his working on such an impactful randomized clinical trial has allowed him to gain research experience in a rigorous study design, while also further developing his ability to care for patients.

"I am grateful for the opportunity to share my findings with a national audience, through both a poster presentation at the AUA and a publication in the Journal of Urology," Rivero said.

More information:Marco-Jose Rivero et al, Comparison of Hematocrit Change in Testosterone-Deficient Men Treated With Intranasal Testosterone Gel vs Intramuscular Testosterone Cypionate: A Randomized Clinical Trial, Journal of Urology (2023). DOI: 10.1097/JU.0000000000003487

Thomas A. Masterson et al, Platelet-rich Plasma for the Treatment of Erectile Dysfunction: A Prospective, Randomized, Double-blind, Placebo-controlled Clinical Trial, Journal of Urology (2023). DOI: 10.1097/JU.0000000000003481

Provided by University of Miami Health System, Miller School of Medicine

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Clinical trials simultaneously presented at AUA and published in ... - Science X

While the question of transgender and DSD athlete participation in female sporting competitions is undeniably controversial, the history of athletics regulations in the last decade has demonstrated the importance of providing evidence and justification for eligibility restrictions.

On 24 March 2023, the World Athletics Council (WAC) (previously the International Association of Athletics Federations or IAAF) announced new regulations for transgender athletes or athletes with a Difference of Sexual Development (DSD) (2023 Regulations). These regulations directly impact the eligibility of these athletes to compete in the female category at the international level.

In sum, the WAC:

The decision marks the latest stage in attempts to regulate access to the female category of sporting competition. The last decade or so has seen a particularly contentious debate emerge over regulation of the participation of athletes by reference to testosterone levels, with the Court of Arbitration for Sport (CAS) suspending previous regulations for lack of evidence of an advantage.

As it is unclear on what scientific basis the WAC has made this most recent decision, there is a real question as to whether the 2023 Regulations are similarly vulnerable to challenge by transgender or DSD athletes.

An evolving position

Gatekeeping of the female category can be traced to the beginning of regulated female sport, with the use of testosterone levels as a metric for assessing eligibility a relatively recent development.

Recent history has seen the identification of testosterone as a basis for eligibility, with threshold requirements initially set at 10 nmol/L:

The development of these guidelines provided the basis of what appeared to be an emerging consensus on testosterone levels as an indicator of advantage for transgender and DSD athletes, and as something that should be controlled to ensure a fair competition. However, there has also been a more recent trend towards total bans on male-to-female transgender athletes who have experienced male puberty, as evidenced by the 2023 Regulations released by the WAC. Other bodies that have introduced similar rules include World Aquatics (formerly FINA) and World Rugby, and have cited concerns about unfair advantage and the potential for transgender women to cause serious injuries to cisgender women. Some commentators have questioned the availability of scientific evidence to such policies, stating that "at present, no data suggests safety in women's sport is compromised by including trans women".

By contrast, some domestic codes have sought to develop policies to facilitate the inclusion of transgender and gender-diverse athletes in elite sport. For example, the Football Federation of Australia has announced its commitment to supporting the inclusion of transgender and gender-diverse people in football through the development of a High-Performance Inclusion Policy. The Australian Football League has also sought to codify when a male-to-female transgender athlete may be eligible to participate in the AFLW (although that policy appears, at least. questionable in terms of the metrics used to assess eligibility).

Challenging the consensus

In 2014, Indian sprinter Dutee Chand was subjected to a "gender verification" test by the Athletics Federation of India, after questions were raised about her physique and impressive competition performance. The test identified Chand as having testosterone levels above the 10nml/L level set by the IAAF 2011 Regulations and being an athlete with a DSD. As such, she was deemed ineligible to compete.

Chand challenged the IAAF 2011 Regulations at CAS. In 2015, CAS determined that there was insufficient scientific evidence supporting a link between enhanced testosterone levels and improved athletic performance, and suspended the IAAF 2011 Regulations. The IAAF was given two years to produce relevant evidence, otherwise the IAAF 2011 Regulations were to be declared void.

In 2017, the IAAF produced a report that found elevated testosterone levels advantaged female athletes by margins of between 1.78% and 4.53% in middle distance running, hammer throw and pole vault. No impact was noted in any other competition or in any men's category events.

In 2018, off the back of this report, the IAAF issued new regulations (2018 IAAF Regulations). These stipulated that a DSD athlete was restricted from competing in middle distance (400m-1 mile) running events (Restricted Events) unless they had circulating testosterone levels of 5nmol/L or below and were able to maintain those levels for at least six months prior to competing (and continuously thereafter).

In 2019, Caster Semenya, a middle-distance runner from South Africa and DSD athlete, challenged the 2018 IAAF Regulations on the basis that they were discriminatory, not necessary, and not reasonable and not proportionate. Under the 2018 IAAF Regulations, Semenya was ineligible to compete in the Restricted Events without taking medication or undergoing surgery.

Unlike Chand, however, Semenya's challenge was unsuccessful. CAS upheld the 2018 IAAF Regulations, finding that they were discriminatory but necessary, reasonable and proportionate to achieve fair competition in the female category. Nevertheless, CAS questioned the strength of the evidence in respect of some of the proposed Restricted Events and suggested the IAAF consider withholding implementation of its regulations until further evidence could be obtained. The IAAF rejected this suggestion.

Semenya has sought to appeal this decision, first in the Federal Supreme Court of Switzerland (which was unsuccessful) and now in the European Court of Human Rights (decision pending).

Continuing paucity of evidence

The question of how transgender and DSD female athletes perform against cisgender, non-DSD female athletes has been the subject of increasing debate in recent years. However, that has not corresponded to significant scientific study of the question. As noted above, the IAAF itself declined CAS' recommendation to obtain additional evidence regarding the impact of elevated testosterone on athletic performance.

Perhaps most relevantly, a 2021 study in the British Journal of Sports Medicine suggests that transgender women maintain an athletic advantage over their cisgender peers even after a year of hormone therapy. The study found that prior to taking female hormones, trans women performed 31% more push-ups and 15% more sit-ups in one minute, and ran 1.5 miles 21% faster than their cisgender peers. After two years of hormone therapy, the push-up and sit-up differences disappeared, however the trans women were still 12% faster.

However, the study involved a sample size of only 46 transgender women and focussed on armed forces personnel, as opposed to athletes and sporting performance generally. As such, it is unclear how or whether the findings can be applied to particular sports, or whether the sample size is large enough to draw accurate and broadly applicable conclusions. Similar criticisms can also be raised over a 2019 Swedish study, which found that thigh muscle mass was reduced, albeit marginally, after 12 months of hormone treatment. However, this study followed just 11 transgender women and only assessed muscle mass in the thigh and knee.

As such, it is difficult to say that there is conclusive evidence of widespread or universal advantage resulting from elevated testosterone. Associate Professor Ada Cheung, an endocrinologist at Austin Health who also leads the Trans Health Research Group at the University of Melbourne, has said that when it comes to transgender health there is "not a lot of evidence, but plenty of assumptions". Cheung also says that "no long-term research with adequate comparison groups (adjusted for height) has examined the impact of hormone therapy on strength, fitness and endurance" and that, while larger stature is possibly an advantage for some sports, it's equally possible that a transgender women with a larger stature and smaller muscle mass may actually be at a disadvantage.

Viability of 2023 Regulations

The 2023 Regulations mark a significant shift in the regulation of female eligibility. Firstly, the regulations again lower the testosterone levels permitted, second, they apply to all events (and not just Restricted Events) and third, they exclude transgender athletes completely. A summary of the evolving regulations is illustrated in the table below.

For the past five years, restrictions on eligibility were limited to the Restricted Events, where evidence of an athletic advantage had been accepted by CAS. The absence of such evidence was the reason the 2011 IAAF Regulations were suspended and the 2018 IAAF Regulations were limited in scope.

In its press release of 24 March 2023, announcing the 2023 Regulations, the WAC said:

"World Athletics has more than ten years of research and evidence of the physical advantages that these athletes bring to the female category."

With no reports, studies or specific evidence cited, it's unclear what the WAC has relied to support the shift and, indeed, whether it has the evidence CAS may require.

In relation to the ban of transgender athletes, WAC has acknowledged that:

"there are currently no transgender athletes competing internationally in athletics and consequently no athletics specific evidence of the impact these athletes would have on the fairness of female competition in athletics."

However WAC noted that in the circumstances, it had decided to "prioritise fairness and the integrity of the female competition before inclusion".

The importance of evidence

While the question of transgender and DSD athlete participation in female sporting competitions is undeniably controversial, the history of athletics regulations in the last decade has demonstrated the importance of providing evidence and justification for eligibility restrictions.

It is critical to remember, as sporting federations grapple with the questions of fairness and inclusion when determining whether to allow transgender or DSD athletes to compete while emotive, such decisions need to be made by reference to available evidence, otherwise they are, and will remain, vulnerable to challenge.

Continued here:
Transgender athletes or athletes with a DSD: science and the need ... - Lexology

For actorHeather Mitchell, the #MeToo movement was a long time coming. When women started speaking out, "it immediately resonated,it really did shake me up", she says.

It sent her reflecting down the decades of her own life, all the times she had felt unsafe, uncomfortable and threatened, "not just in my industry, but throughout my life".

"It made me realise that I had minimised experiences," Mitchell tells Australian Story."I was shocked at how I had silenced myself."

There was an actor who was always drunk and took things "much further than was safe", she says. "I felt physically threatened by him and therefore psychologically frightened. But I didn't know anyone to speak to. I felt powerless."

In the 1980s and 90s, she remembers a lotof drugs and alcohol being consumed on some sets. "There were freedoms that were taken, I did feel very uncomfortable."

"The film sets and TV sets were very male dominated.I would go so far as to say very testosterone, cocaine and alcohol-fuelled places."

One time while resting in her van on a set with her eyes closed, she woke to find a man kneeling and kissing her "his tongue in my mouth" and another man watching.

"I did go to a producer and suggest that something should be done. To my knowledge, nothing was done about it.I didn't feel I had a voice," she says. "I was afraid to speak out."

The fear of losing a job or not working again proved all too true when she did make a complaint about another incident, only to be "written out of the show, pretty much".

After that, she retreated to the place she felt safest. "I threw myself into the theatre. I felt in the theatre there was much more of a camaraderie. There was much more of an equality, a feeling of family."

Now in her 60s, in her full power and doing some of the best work of her career,Mitchell is determined that what she lived through doesnot happen to the next generation.

"When I'm working with younger people, I certainly encourage them to speak up if there's anything they're uncomfortable about, and to know who to speak to," she says. "In terms of sexual and emotional safety, I think it's an ongoing discussion that has to just keep happening."

"Heather is a very powerful voice in our industry," says Sydney Theatre Company artistic director Kip Williams. "And she uses that power to advocate for other young women."

The great reckoning has led to the industry being in a much better place than it was five years ago, according to Mitchell. "Now you feel the impact and the input of incredible women, many more female producers, writers, better roles for women, stories about women," she says.

WhatMitchell did with those frightening situations was to "file them away". A part of her would "stand outside of it", she says, and observe. Later, she would draw on it in her acting.

Now, after four decades starring on Australians stages and screens, Mitchellbrings her whole life to her performances, a life that has been lived with love and passion, and one threatened by cancer too.

"She is able," her old friend and co-star Hugo Weaving says, "to tap into a deep well of love and grief, but at the same time being very light and very buoyant."

Last October, her portrayal of Ruth Bader Ginsburg (RBG), the late US Supreme Court judge, at the Sydney Theatre Company, was described by the Sydney Morning Herald as "a performance to live among the greats".

After a lifetime of supporting roles, Kip Williams says:"Here was this pinnacle of acting vehicles for Heather to really be showcased for the genius that she is."

Playwright Suzie Miller had written it specifically with Mitchell in mind. "It was so obvious that it had to be Heather," she says.

"There were so many things in Ruth's life that resonated with me," Mitchellsays. "I was brought up with a Jewish mother. My mother died on my last exam of school. So did her mother."

They even both married a man named Marty.

Performing as RBG, who had fought so hard for equality and the rights of women, gave Mitchell the confidence to write about her own life in her just-published memoir Everything and Nothing; to articulate her own experiences of abuse and inequality.

The one-woman play had been interrupted by her second diagnosis of breast cancer and finishing the season had been a physical and mental feat.

"I don't know how she did it," Williams says, "For Heather to bring that story to life just months after overcoming cancer was a once-in-a-lifetime thing. Heather went to this transcendent place."

Mitchell is a person friends describe as universally loved;a rememberer of birthdays, a bringer of cakes, "Heather will come to rehearsals having learned all her lines," Williams says, "and yet she will have baked three vegan cakes for the entire cast overnight."

Friend and filmmaker Jocelyn Moorhouse used to call her "Heather Angel". "She is just so gracious and ethereal," she says.

Mitchell has a "warmth and natural empathy", says close friend and former boyfriend Sam Neill, which translates into her work in a "really magical way. A lot of that comes from being a naturally good human being".

When they were both going through cancer last year, she, Neill and the artist Nicholas Harding formed a "cancer club".

Mitchell had T-shirts printed with"F**k off cancer" on them. "And we'd get together occasionally in our T-shirts and drink good wine and have a great time," she says.

Harding died last December. "We miss him terribly," she says.

When she was 11, her "joyous, smart" mother Shirley was diagnosed with leukaemia. "Back in the late 60s you didn't talk about cancer," Mitchellsays. "She kept it an absolute secret."

As her mother got weaker, Mitchell dealt with it by creating characters in her bedroom. They were "to prepare me for grief, for loss," she says. "I suppose I was doing my own therapy."

Shirley died when Mitchell was 17, during her trial exams for the Higher School Certificate. She left behind a letter, "just saying what a gift I'd been and how much she had loved being my mother".

Mitchell had been left "adrift" by her mother's death. But after enrolling at the National Institute of Dramatic Art (NIDA) performing arts school, she soon found her place in the world and her passion.

"I loved being there and I loved doing it," she says. "I loved every class. I didn't care if they were repetitive. I was in heaven."

She and Hugo Weaving were some of the early recruits to the burgeoning Sydney Theatre company.

Mitchell's first big-screen break was with Weaving in the 1983 TV series Bodyline, about "the" famous cricket clash between Australia and England in the 1930s.

But after it aired, she found it difficult to get auditions. For a time, she was living in her girlfriend's yellow Mini and doing house-sitting.

A casting agent stunned her by telling her she didn't have "it", "that elusive thing". Mitchell was shocked, but quickly learned that "in this industry, resilience is your best friend".

In 1989, Mitchell had to fly to Broken Hill on a last-minute job. The day before leaving she had been to a clairvoyant who told her she would meet "my guardian angel and it would make itself known to me".

She was picked up at the airport by cinematographer Martin McGrath. Three nights later, walking home from the pub, they had taken shelter from the rain under an awning. "And then," Martin says, "we just kissed. That was it, it was on."

When they moved in together, Mitchell says:"Every time I'd come back to where we lived, as I turned the corner, I thought, 'I'm going home.' Being with him was like being home." In 1992, they were married.

After six years of trying, at the age of 42, Mitchell had her first child, Finn.

Two years later, Seamus arrived. When he was five weeks old, Heather woke up to find him "boiling hot". He was critically ill with meningitis. "He was very lucky to live," Martin says.

There were distressing weeks in and out of hospital. "I don't think there is anything scarier than your child being in trouble," Mitchell says."It's the most frightening thing."

There were months of trying to work out the effects on his development, months of a screaming child.

"It really did have a huge impact on all of our lives," Mitchell says.

For three years, Mitchell had a lump on her breast. "My left hand travelled to it at least 10 times a day," she writes in her memoir. But she was told, after mammograms, that it was benign.

Still, she was worried that it was too high up for the mammogram to see and asked for an ultrasound. "And that was when I found out I had grade 3 breast cancer." She was 46.

After they had both cried, Mitchell, Martin says, "grabbed the lance and rode into battle like Joan of Arc. She's made of very, very tough stuff." There would be two years of gruelling surgery, chemotherapy, radiotherapy.

"The cancer really took her to within a whisper of life," close friend Joanne Corrigan says.

"She was skeletal. There was a day when I went over to visit her where I honestly thought, you know, this is the last time I'm going to be with my friend.

"And she just slowly and surely came back to life."

Mitchellwanted desperately to work during that time, but the jobs dried up altogether for both her and Martin.

"Basically, we seemed to be unemployable," Martin says. "I could see what was coming was like a slow-approaching train smash, that we really needed to sell the house and regroup. It was a very confronting time."

But in the middle of all that, they received an anonymous letter with a bank cheque for $30,000. The letter said:"I am writing to you because over the years I have so much enjoyed your performances. It gives me pleasure to say thank you in a tangible way to artists whose work I have admired."

They still don't know who sent it, but it was a "godsend" and kept them going for a year.

The Sydney Theatre company was about to announce the 2022 season last January, which included RBG:Of Many, One, when Mitchell received another cancer diagnosis. "The return that everyone dreads," Martin says.

It had been 17 years since the last diagnosis. This time it had been caught early and hadn't spread.

"It felt completely different," Mitchell says. "A little stumble, a trip and I straightened up again. I had a mastectomy with reconstruction. I was so thrilled I didn't have to do chemo."

And the second time around, cancer was not going to stop Mitchell. She had the surgery in March and was rehearsing three months later, as well as travelling to Melbourne for a role in the TV series Love Me.

"She never breaks into a sweat," Sam Neill says. "How is that possible? She's doing three things at once."

Neill watched her performance in RBG "with my jaw on the floor. At the end of it, I found myself not just on my feet, but in floods of tears. And I thought all those struggles, all those adversities, all the health issues, all the rest of it, paid off in a way that I could never have dreamt was possible".

Heather Mitchell doesn't fear ageing in the way some actresses do. "I love acting more than ever now. It's given me so much in my life and I just feel as I get older acting is about growing in your life. I love getting old because I love seeing my kids growing up. I feel so blessed that I've lived long enough to see them in their 20s."

Mitchelllives every day as if it is her first. "I can go for a walk in the morning and see things fresh and see new colours and talk to people and find something new in them."

Basically, she says, "getting old is fantastic".

Watch Australian Story's Taking the Lead onABC iview.

See the original post:
How Heather Mitchell stood into her power during the #MeToo movement - ABC News

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