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Testosterone optimization for health in men and women has become popular as well as a hot-button topic over the last 5-10 years. It has become an important factor in hormone optimization but it comes with baggage. There are rumors of benefits as well as risks. I have a heart for optimal health so I've been studying this stuff for years. Also, being a urologist, my specialty has become the leader in hormone optimization, particularly in men. If you want to skip the rest of this article, here's the take away: a normal testosterone is better for your health than a low testosterone - for guys or gals (and they both have different normal levels). And, specific to this article, all studies to date show that testosterone optimization does not increase a mans risk for prostate cancer ... I still want you to keep reading, though!

Testosterone replacement has been around, actually, for quite a while since the 1940s but only recently has it become popular. My first brush with it was when I was a resident (i.e. urologist-in-training) at the University of Virginia. We ran what we called "resident clinic" (don't worry, real doctors backed us up) I pulled a chart out of the door to find a new patient referred by another urologist from two hours south of Charlottesville for "elevated PSA on testosterone replacement." I just blankly stared at the chart. I had no idea what that meant or what I was supposed to do. Getting the background story from the patient, he was on testosterone replacement and had been for several years and now had a PSA (a screening test for prostate cancer) above the normal range. His urologist wasn't sure what to do, so here he was.

I promptly asked my boss (a real urologist not just one in training) what to do. He asked me, "Does testosterone optimization increase his risk for prostate cancer?" Again, blank stare from me. He just smirked but never answered his own question for me. We ended up performing a prostate biopsy and, lo and behold, the guy didn't have prostate cancer. So then the next question was, "Should he stop his testosterone optimization?"

The answers to those questions came months later. We had a visiting professor by the name of Abe Morgantaler. Turns out he was an expert on this testosterone stuff. He showed study after study showing no relationship between any increased risk of prostate cancer and testosterone optimization. Several studies have even shown the opposite that the lower the testosterone level, the higher the chance of having a prostate biopsy showing prostate cancer. On the other end of things, no studies, I repeat none, show an increased risk of getting prostate cancer with an optimization in testosterone levels. So, the short answer on prostate cancer and testosterone optimization is that it doesn't appear to have any relationship in other words, replacing testosterone to a normal level does not appear to increase your risk of developing prostate cancer.

So lets take it to the next level. What if youve had prostate cancer, your PSA level is negligible but you feel miserable because your testosterone level is low. Can you have your level optimized? Lets ask another way. Consider this scenario: Lets say you and your twin brother both get prostate cancer and have it treated. Both of you have negligible PSA levels afterward. Your brothers testosterone level is in the normal range and he feels fine but your level is low and youre tired all the time and moody. You go to your doctor who says you cant have testosterone levels optimized because youve had prostate cancer. But, wait a second, your brothers levels are fine. Does it put him at increased risk for recurrence? All studies point to "no." So, again, I ask, why cant your levels be normal too? Good question. And one you should ask a healthcare provider who specializes in this.

Prostate cancer risk is just one factor in testosterone optimization. Its complicated and, even as health care providers, were still learning. Turns out a normal testosterone has many benefits and very little, if any, risks. That said, guy or girl, you need to see a healthcare provider who specializes in hormones to manage them. They better understand appropriate levels to optimize benefits and minimize risks.

Testosterone optimization can help improve fatigue (i.e. energy), mood, muscle strength, sex drive and (in men) erections. It also does several other things you can't see like improve heart health, better control diabetes, lower cholesterol, improve bone strength and lower risk for dementia. It's no holy grail but it does kill (or severely injure) at least 10 birds with 1 stone.

Dr. Thomas is a board-certified physician who operates Complete Health Integrative Wellness Clinic and Thomas Urology Clinic in Starkville, Mississippi.

This newspaper column is for informational purposes only and is, under no circumstances, intended to constitute medical advice or to create or continue a physician-patient relationship. If you have a medical emergency, you should immediately seek care from your nearest emergency room, and if you have specific health questions, you should consult your own physician.

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Does testosterone optimization cause prostate cancer? - Meridian Star

Next month the CAS is expected to rule on new evidence presented by the IAAF showing that high testosterone levels could shave around 2.5 seconds of an athletes time. There is typically less than two seconds between runners in 800m heats.

However sports science experts believe the court will refuse to take action for fear of opening themselves up to claims over other naturally occurring advantages, and accusations of sexism.

John Brewer, Professor of Applied Sports Science at Queen Mary University in Twickenham, said: There is a reason that testosterone is a banned substance, it has an anaerobic affect and increases muscle strength and power, so someone with more of it is likely to have more speed. And thats clearly an advantage. Its not a level playing field.

But what can you do about it? Do you ban them? Do you have a cut off point? Do you have a separate category? The problem is there will always be athletes who are at the top of a range of physiological values whether it is oxygen uptake, or capillary density, or the ability tolerate high levels of lactic acid.

Do you ban all Kenyan athletes because they train at high altitude and so can use oxygen more efficiently? Testosterone levels is just one of many variables that impact performance. And it can work both ways. Someone with more testosterone generally gains more muscle mass and weighs more, so it can be like running with two extra bags of sugar.

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'Intersex' athletes to learn if they will be forced to take drugs to ... - Telegraph.co.uk

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Phenibut high - Nolvadex raise testosterone levels - Bournville Village

Muir, Faith Chepngetich Kipyegon of Kenya and Jennifer Simpson of the United States lead the way in the Women's 1500 metres

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Kenya's Faith Chepngetich Kipyegon celebrates winning the Women's 1500m Final ahead of USA's Jennifer Simpson, South Africa's Caster Semenya and Great Britain's Laura Muir during day four

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Great Britain's Laura Muir reacts after placing fourth in the Women's 1500m final during day four

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Great Britain's Laura Muir reacts after finishing fourth in the Women's 1500m Final during day four

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Great Britain's Daniel Talbot and South Africa's Wayde Van Niekerk in action in the Men's 200m heats during day four

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Jamaica's Omar Mcleod in action during the Men's 110m Hurdles final during day four

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Jamaica's Yohan Blake (right) in action in the Men's 200m heats during day four

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Great Britain's Sophie Hitchon after finishing seventh in the women's hammer throw during day four

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Great Britain's Meghan Beesley in the Women's 400m Hurdles heat five during day four

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Zheng Wang of China, silver, reacts during the Women's Hammer final

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Nethaneel Mitchell-Blake of Great Britain celebrates after competing in the Men's 200 metres heats

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US athlete Erica Bougard competes in the javelin throw of the women's heptathlon athletics event at the 2017 IAAF World Championships at the London Stadium

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Mo Farah celebrates with his children after winning the final of the men's 10,000m athletics event

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Murielle Ahoure of the Ivory Coast falls over Tori Bowie of the United States after Bowie won gold in the Women's 100m Final

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Justin Gatlin (left) of the United States leads the Men's 100 metres final from Christian Coleman of the United States and Usain Bolt of Jamaica (right) during day two of the 16th IAAF World Athletics Championships London 2017 at The London Stadium on August 5, 2017 in London

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Sebastian Martos of Spain falls during the the Men's 3000m Steeplechase

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A streaker is chased by a steward after invading the track

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Luvo Manyonga of South Africa celebrates winning gold in the Men's Long Jump Final

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Jamaica's Omar Mcleod and France's Garfield Darien compete in the semi-finals of the men's 110m Hurdles athletics event

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Tori Bowie of the United States crosses the finish line to win the Women's 100m Final during day three

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US athlete Tori Bowie (C) crosses the finish line next to Ivory Coast's Murielle Ahoure (L) and Jamaica's Elaine Thompson to win the final of the women's 100m

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Anicka Newell of Canada reacts in the Women's Pole Vault Final

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Kenya's Geoffrey Kipkorir Kirui wins the Men's Marathon athletics event

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Luvo Manyonga of South Africa, gold, and Ruswahl Samaai of South Africa, bronze, pose with their medals for the Men's Long Jump during day three

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Spain's Sebastian Martos falls at the water jump in the heats of the men's 3,000m steeplechase athletics event

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Amy Cragg of the U.S., Rose Chelimo of Bahrain and Edna Ngeringwony Kiplagat of Kenya celebrate after the Women's Marathon

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Nafissatou Thiam of Belgium in action during the Women's Heptathlon shot put qualifying round

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Lecabela Quaresma of Portugal competes in the Women's Heptathlon Long Jump during day three

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Katarina Johnson-Thompson of Great Britain (Lane 6) and Carolin Schafer of Germany (Lane 7) and their opponants compete in the Women's Heptathlon 100 metres hurdles during day two

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Katarina Johnson-Thompson of Great Britain looks dejected in the Women's Heptathlon High Jump during day two

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Rose Chelimo of Bahrain celebrates as she crosses the finishline to win the Women's Marathon during day three of the 16th IAAF World Athletics Championships London 2017 at The London Stadium

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South Africa's Caster Semenya, Britain's Laura Muir and Kenya's Faith Chepngetich Kipyegon compete in the semi-finals of the women's 1,500m athletics event

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France's Garfield Darien prepares at the start of the semi-finals of the Men's 110m Hurdles

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A general view in the Men's 800 metres during day two

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Justin Gatlin of the United States raises a finger to his lips to following his win in the Men's 100 metres final in 9.92 seconds during day two

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United States' Justin Gatlin bows to Jamaica's Usain Bolt after winning the Men's 100m Final

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Usain Bolt of Jamaica hugs Justin Gatlin of the United States following Gatlin's win in the Men's 100 metres final in 9.92 seconds during day two of the 16th IAAF World Athletics Championships London 2017 at The London Stadium on August 5, 2017 in London

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Reece Prescod of Great Britain, Justin Gatlin of the United States, (Winner) Yohan Blake of Jamaica, Akani Simbine of South Africa, Christian Coleman of the United States, Usain Bolt of Jamaica, Jimmy Vicaut of France and Bingtian Su of China cross the finish line in the men's 100m final during day two

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Usain Bolt of Jamaica celebrates during a lap of honour following finishing in third place in the mens 100m final during day two

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Usain Bolt of Jamaica celebrates during a lap of honour following finishing in third place in the mens 100m final during day two of the 16th IAAF World Athletics Championships London 2017 at The London Stadium

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Usain Bolt of Jamaica performs the Lightning Bolt pose following his third place finish in the Men's 100 metres final during day two of the 16th IAAF World Athletics Championships London 2017 at The London Stadium on August 5, 2017 in London

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Usain Bolt of Jamaica kneels on the track following his third place finish in the Men's 100m final

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Usain Bolt of Jamaica celebrates during a lap of honour following finishing in third place in the mens 100m final during day two of the 16th IAAF World Athletics Championships London 2017 at The London Stadium on August 5, 2017 in London

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Jamaica's Usain Bolt competes in the final of the men's 100m

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Jamaica's Usain Bolt prepares for the final of the men's 100m athletics event

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Justin Gatlin of the United States, gold, and Usain Bolt of Jamaica, bronze, celebrate during the medal ceremony for the Men's 100m during day three

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Usain Bolt of Jamaica poses with the bronze medal for the Men's 100 metres during day three

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Gold medallist Ethiopia's Almaz Ayana and silver medallist Ethiopia's Tirunesh Dibaba celebrate after the final of the women's 10,000m athletics event at the 2017 IAAF World Championships at the London Stadium in London on August 5, 2017

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Albert Chemutai of Uganda competes in the Men's 3000 metres Steeplechase during day three

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Bianca Perie-Ghelber of Romania in action during the Women's Hammer Throw qualification round

Continued here:
Caster Semenya refuses to be distracted at London 2017 by testosterone debate - Evening Standard

T

his week track and field athletes from all over the world are gathering to compete in the World Championships, an event second only to the Olympics in its level of prestige. Two of the competitors, South African Caster Semenya and Indian Dutee Chand, will represent their countries while on a quest for gold and glory that started last summer in Rio. But their future careers, and those of other women like them, are again in question as the sports governing body attempts to reinstate a limit on female athletes testosterone levels.

The limit dates back to 2011, when the International Association of Athletics Federation (IAAF), which oversees track and field events, first created the rule. Naturally produced high testosterone, the group ruled, provided female athletes with an unfair advantage akin to doping and so, to compete, a woman over the limit would have to lower her testosterone, through medication or surgery, or prove that she was not sensitive to its effects.

That rule was put on pause after a challenge was brought in 2015. The arbitrators gave the IAAF a two-year window to provide evidence as to why the rule should persist, or else it would be permanently struck down.

Now, just as the races begin in London, the track authorities have taken their starting positions for a renewed legal fight, filing new evidence with the court that they say supports a testosterone limit and setting up a complicated battle about sex, physiology, and ethics destined to play out on the largest stage in sports.

The case in consideration by the Court of Arbitration for Sport centers on Chand. The 21-year-old runner was a rising 100-meter star in India in 2014, when the Indian affiliate of the IAAF barred her from competing. Blood tests showed that her testosterone was above the 10 nanomoles per liter limit, the level deemed to be the lower end of the male range.

In 2015, she appealed that decision to the Court of Arbitration for Sport an international high court that settles sports-related disputes. The court heard from various ethical and scientific experts. Ultimately, its ruling hinged on whether female athletes with high testosterone a condition called hyperandrogenism experience a boost in performance equivalent to the average athletic performance gap between men and women. It quantified that gap as a 10-12 percent difference.

On July 27, 2015, citing a lack of evidence for that magnitude of performance boost, the court temporarily suspended the policy. However, the arbitrators gave the IAAF two years to submit more evidence to support their claim.

In recent months the IAAF has done just that, according to a recent press release and an expert witness who testified in 2015. Now, both sides will have an opportunity to respond to evidence in a back-and-forth that could drag on for months, and will culminate in the court deciding whether or not to strike down the policy once and for all.

The problematic mapping of gender onto biology is a story as old as sports: Ever since women have been able to participate, athletic organizations such as the IAAF and the International Olympic Committee have struggled with how to define the female category, and how to decide who is eligible to compete in it. Over the years, these organizations have deployed policies requiring female athletes to undergo everything from genital examinations to chromosome testing to prove their eligibility to compete as women, and even mandated that women who failed the tests undergo medical or surgical treatments to regain their eligibility, raising serious ethical questions in the process. And while such widespread sex-testing was officially abandoned in the 1990s, elite female athletes continued to be flagged, often based on physical appearance, and subjected to physical examinations and other medical tests to confirm their eligibility.

The reason for a testosterone policy in the first place centers on the relationship between testosterone and biological sex. Testosterone is a key hormone for the development of male reproductive organs, and also promotes increased muscle and bone mass and the growth of body hair, among other things. Consequently, most testosterone is produced in the testes, and men tend to have a lot of it, generally between 10 and 40 nm/L. But women have testosterone too, typically in the 0.5 to 2 nm/L range, produced by the ovaries and adrenal gland. Testosterone over 2 nm/L is often considered hyperandrogenism, though there is no hard and fast cutoff.

According to Dr. David Cohen, an endocrinologist at Beth Israel Deaconess Medical Center not involved in the case, not all hyperandrogenism is created equal. The most common hyperandrogenism is called polycystic ovary syndrome (PCOS), in which the ovaries produce excess testosterone, and which is unlikely to increase testosterone above the 10 nm/L level. Rather, Cohen said, women above the cutoff who arent doping likely have one of two things going on: a tumor in the ovaries or adrenal gland, or whats called a disorder of sexual differentiation a genetic anomaly. One such anomaly, for instance, is 5 alpha reductase deficiency, a rare genetic condition in which a woman can have XY chromosomes and internal male gonads that produce excess testosterone. Disorders of sexual differentiation, previously known as intersex conditions, highlight the inherent messiness of trying to strictly define biological male and female: Scientifically speaking, not everyone fits neatly into one sex category or the other.

Under the testosterone policy, female athletes over the limit had to lower their testosterone levels to compete, which can generally be accomplished with medication or surgery, depending on the source of the hormone. Semenya continued competing, though the details of if and how she lowered her testosterone are not known. Neither she nor Chand has publicly discussed the cause of her hyperandrogenism.

One of the strongest new pieces of evidence that the IAAF has in its arsenal is a study published just last month. In early July, two IAAF scientists published a paper in the British Journal of Sports Medicine that looked at the testosterone levels in roughly 2,000 elite male and female track athletes who competed in the 2011 and 2013 IAAF World Championships.

The researchers, funded by the IAAF and the World Anti-Doping Agency, divided male and female athletes into low, medium, and high testosterone groups based on results from routine pre-meet blood tests, and compared their athletic performance.

Their main conclusion, touted in an IAAF press release, was that women in the high testosterone group had a significant competitive advantage over women in the low group in a smattering of events, namely the 400 meter, 400-meter hurdles, 800 meter, hammer throw, and pole vault. The advantage ranged from 1.8 to 4.5 percent.

That, the IAAF says, is evidence in support of its assertion that women with high testosterone see a boost in performance. And although 4.5 percent falls well below the 10-12 percent range that the court established, Dr. Angelica Hirschberg, a professor and gynecologist at Karolinska University Hospital who testified for the IAAF in 2015, points out that for elite athletes, even 3 to 4 percent is a big difference that can decide if you will get a medal or not. Additionally, the highest testosterone group of women in the study averaged below the 10 nm/L cutoff, so she said an even higher testosterone level could translate into more of an advantage. We can only speculate that probably if you have a larger group of women with testosterone in the male range, the difference in physical performance would be greater, Hirschberg said.

Cohen, however, sees some problems with the methodology of the study. Perhaps most notably, the study states that some women in the high testosterone group artificially achieved those high levels by doping which he said muddles the findings. What they injected may be a more powerful testosterone or may be a weaker testosterone, or they may have done it yesterday or last week or last month, he said. You cant interpret these numbers as the function of endogenous hormone levels when there are exogenous hormone levels included.

He also explained that a womans testosterone level fluctuates considerably during her menstrual cycle, something the study did not control for. And the paper also double-counted 17.3 percent of the women who competed in both 2011 to 2013, which, according to Cohen, is going to skew the data an incredible amount.

For Cohen, the paper can only suggest an association between hormone levels and physical performance at a single snapshot in time. It doesnt tell me anything about what was going on a week ago, a month ago, a year ago, during training, he said. It doesnt tell me anything about whether its endogenous or exogenous, and it doesnt tell me cause and effect.

Hirschberg has also done research since the testosterone limit was suspended. Her paper, published in late June 2017 and also submitted as evidence for the 2017 hearing, looked at the precursors of testosterone in 106 Swedish women Olympic athletes. It found that, compared to non-athletes, the athletes had higher levels of these testosterone precursors, and also had more muscle mass and better explosive athletic performance.

However, like the IAAF paper, that study can only establish an association between hormone levels and athletic performance, and it cannot determine whether increased hormone levels directly caused this improved performance.

These papers are certainly not the only evidence IAAF has gathered (Hirschberg said other submissions will include individual cases of athletes with testosterone levels over the cutoff), but for Cohen, they are not convincing.

If the goal is to prove that women with endogenous androgen levels have a higher degree of physical performance when compared with women of lower endogenous androgen levels, I dont think these studies prove that, and they definitely dont prove causation, he said. And I definitely dont think they prove that theres an unfair advantage between women.

While the court is choosing to focus on the science, it is impossible to ignore the ethical arguments from both sides, particularly when it comes to defining what is fair.

Much of the IAAF argument hinges on the idea that a policy is needed to make competitions fair for other female athletes, and without it, female sports will decline.

Hirschberg pointed out that several female athletes testified for the IAAF in 2015 (while others have been vocal in the media) and IAAFs goal is to level the playing field for all women so they stay motivated to compete. You can speculate about what will happen with female sport if we dont have any regulation about this, she said. If we can beforehand guess who will win, then perhaps the audience will lose interest. She added that even one or two high-testosterone women in each event could have an effect.

However, Dr. Katrina Karkazis, a medical anthropologist and bioethicist at Stanford University who testified for Chands side in 2015, disagreed. We havent had a regulation for two years and womens sports look just fine to me, she said. Weve got women breaking womens records. I dont think anything blew up in any crazy way. And while Semenya has excelled on the world stage since the policy was suspended, winning 800-meter gold in the 2016 Olympics, Chand has been far from dominant: She goes into the World Championships ranked 103rd in the world in the 100 meter.

Which brings up another question of fairness: is it fair to create a policy that singles out testosterone when so many other factors contribute to overall athletic performance? Hirschberg says yes. Its not all about testosterone, of course not, Hirschberg said. But since we have today two main categories, we have female sport and we have male sport, we have to have regulations about who can compete as a woman and who can compete as a man. Hirschberg and the IAAF believe testosterone is the main factor driving the performance difference between men and women, and should thus be the basis of the policy.

Georgiann Davis, a medical sociologist at the University of Nevada, Las Vegas, who published a 2012 critique of the policy, doesnt buy into this logic. She pointed out that elite athletes have many kinds of extreme physiologies that contribute to their success, and, moreover, athletes in countries like the U.S. have access to top-notch training facilities that dont exist in other places. I understand the desire to create fairness for sports, she said, But at what point do you start saying, wait a second, this is starting to get a little ridiculous? Cohen put it even more simply: You cant say, oh, were not going to allow sumo wrestlers over 300 pounds, or were not going to allow basketball players to be over 66.

Then there is the question of whether it is fair for the policy to only target women. The IAAF argues that there is a scientific basis, namely scientific evidence that indicates women, but not men, with high testosterone levels have a significant performance advantage over their peers. Others, however, believe a policy that targets only female athletes is inherently sexist. I think that the only way it would be fair to regulate athletes [like] Caster and Dutee would be if we also had testosterone testing for men, and men that were in atypically high ranges had to take estrogen to lower their ranges down as well, said Hida Viloria, chairperson of the Organization Intersex International, an intersex advocacy and support group that has supported these athletes since 2010.

Moreover, as much as the IAAF asserts that the policy focuses on testosterone, not sex, Viloria pointed out that it still questions a womans eligibility to compete as a woman, hearkening back to the days of widespread sex testing for female athletes. I think the elephant in the room is that even though on record these sporting bodies keep acknowledging that these athletes are women, they keep trying to make regulations based on the conception that theyre not, s/he said.

Dr. Adrian Dobs, an endocrinologist at Mayo Clinic not involved in the case, can see both sides. If this is biological, if this is what they have, then it may be an advantage, but so are a lot of things an advantage. Good for them, so to speak, she said. But if these women really have a medical problem that they want to ignore because it gives them an advantage on the playing field, then in many ways they should be treated. Conditions that cause hyperandrogenism have been associated with health issues such as infertility, cardiovascular disease, and insulin resistance.

And finally, perhaps the most fundamental question of all: Even if female athletes with hyperandrogenism do have a unique and significant performance advantage, is it automatically unfair? At the end of the day, Karkazis believes that question is a social and cultural one. It really is an open question about whether or not something is fair or unfair, leaving aside the science of it, she said. The science could still say theres a link between [testosterone] and performance and we could still say, and thats fine, it shouldnt be understood as unfair.

The ethics of the situation are complicated to say the least, and while the court wont officially consider ethical arguments as it begins the arduous process of sifting through new evidence, its hard to believe ethics wont come into play especially with the futures of several elite female runners hanging in the balance.

But for this year at least, as athletes take to the track, women will compete as women, men will compete as men, and testosterone will be left on the sidelines.

News Reporting Intern

Catherine Caruso is a news reporting intern at STAT.

Originally posted here:
Track authorities move to again bar women with naturally high testosterone from competing - STAT

ST. LOUIS (KMOX) Theres a lot of ads out there about low testosterone, prompting local experts to share some advice.

Barnes-Jewish West County Urologist Dr. Christopher Arett at Washington University School of Medicine says theres no real definition of what constitutes low testosterone.

Testosterone typically, for the average population, is around 300 or higher, so 300 to 500 is often given as a normal range, he says. However, if youre below that level, it doesnt mean that you are going to have symptoms, and if youre above that normal, you may still have symptoms of low testosterone [if] at some point in life you had higher testosterone.

What are the symptoms of Low T?

What people may notice is decrease in energy level, decrease in sex drive, over the long-term low testosterone can decrease muscle mass, bone density, and increase truncal obesity, or beer belly, says Washington University urologist Dr. Dane Johnson.

Arett says men have to be tested for Low T no later than 10 a.m., because testosterone production is at its highest when men are asleep. Testosterone levels peak in the early morning, and as the day progresses, testosterone in every person decreases.

When your testosterone is taken during the day completely changes what their value will be, he says.

Arett says it is critical to have a good doctor-patient relationship when talking about whether or not you have low testosterone, because the symptoms are not specific and could be caused by other underlying health conditions.

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Doctors Address Low Testosterone Ads - CBS St. Louis

While there are numerous hormones we may aptly label important in-terms of proper function and health, for men the hormone testosterone is of great importance. Both men and women require testosterone for a well-functioning body but men do so in far higher amounts then their female counterparts. While a very important hormone and largely misunderstood, testosterone is easily one of the most exciting hormones we can discuss, especially as it pertains to performance enhancing; in-fact, we can confidently say it is the most important hormone in the performance enhancing game. Without adequate levels of testosterone our goals will largely not be met and without increased levels you can in many cases wave goodbye to the idea of surpassing these goals to a great degree. As a very important hormone, in order to make the most of exogenous use, meaning in this case testosterone introduced beyond our natural production, we are best served to first have a general understanding the hormone itself and then how best to maximize its use regarding its various forms.

Testosterone belongs to a class of hormones known as androgens; in-fact this is the primary androgenic hormone. A very powerful hormone in its own right, testosterone is largely responsible for testicular and prostate development, as well as the development of muscle tissue, bone density and strength. Beyond these basic functions, testosterone is by-in-large imperative for our overall general health and well-being; low levels of testosterone can not only negatively affect muscle and bone strength but can negatively affect our state of mind.

While a member of the androgenic class of steroidal hormones, testosterone is also highly anabolic. As both androgenic and anabolic, like all steroidal hormones testosterone is derived from cholesterol and is largely regulated in terms of production by luteinizing hormones (LH) and follicle stimulating hormones (FSH). Being regulated by LH and FSH, in order for these hormones to be released the pituitary gland must first be stimulated in order to achieve this purpose; once achieved and LH and FSH are released, testicular stimulation is achieved thereby causing the production of testosterone. As you can easily see, as important as the testicles are in testosterone production, the pituitary gland is of equal importance; without adequate pituitary function natural testosterone production cannot occur.

While a hormone we naturally produce and for centuries athletes of all types have experimented with testicular extract but true synthetic testosterone intended for human use first made its way to the scene in 1935, largely thanks to chemists Adolf Butenandt and Leopold Ruzicka who both received a Nobel Prize for their work. With the testosterone hormone now being isolated and synthesized the first successful injections of testosterone were available in the form of Testosterone-Propionate.

Once the first batches of testosterone were made available, soon after many other forms would be introduced and made ready for human use but there is something important you need to understand. All testosterone in a general sense is the same; it is the ester attached that gives it its own unique function regarding time release and duration of activity but by-in-large all exogenous testosterone is simply the same testosterone. We will explain as we go along and get into understanding half-lives.

- Click on the following link for more info on the [History of Steroids]

There are many benefits to testosterone use and while they are generally the same for anyone who uses they can be largely dose dependent in-terms of the overall effect. Many men who use testosterone simply do so as part of a hormone replacement therapy plan; the idea is to raise testosterone levels to a normal range after they have fallen short. Many other men use testosterone for an entirely different purpose; to increase levels far beyond normal in order to enhance performance. Regardless of your purpose you can expect to receive the following benefits to one degree or another:

These are all positive attributes to supplemental or exogenous testosterone use and the same effects can be achieved regardless of the form of testosterone we use. While these are not the only positive traits these are the most fundamental to our process and essential to our goals revolving around testosterone use.

There are many forms in-which testosterone can be found, as well as application methods. The most common form of application is by way of injection but there are transdermal gels and patches that may be used as well and even orally administered gel caps and tablets. While injectable testosterone is by far the most effective, all forms can be largely found in a hormone replacement plan but for the performance enhancer the injectable administration will prove to be far more efficient and desirable.

Beyond application, ester attachment is the largest difference most testosterones will display and this will be the most important aspect regarding the various types as it pertains to interest and understanding. While there are many types of testosterone, in the grand scheme there are six common forms worth discussing in detail; beyond these six there are other forms included as we will see but the following six will be of the greatest importance to you and they include:

The original testosterone; Testosterone-Propionate is one of the most popularly used forms the world over. This type of testosterone is defined by the fast-acting short ester it has attached known as the Propionate ester. The results and effects caused by this testosterone will largely be identical to all other forms but it is in the half-life it possesses where it differs to the highest degree. Testosterone-Propionate carries with it a half-life of approximately 48 hours; due to this short half-life most users will need to administer the hormone quite frequently; most performance enhancing athletes will inject this testosterone on an every other day schedule in order to maintain stable blood levels.

Milligram for milligram Testosterone-Propionate has been reported to be slightly more potent than many other testosterone forms; however, this difference is very negligible. There is another effect/benefit that is noted by many Test-Prop users as it is commonly called and it revolves around water retention. All testosterones have the ability to cause excess water retention; although very diet dependent, however, many Test-Prop users report less water retention with use as compared to other forms.

Theres no doubt about it; Testosterone-Propionate while a very simple hormonal compound is very effective and a more than solid choice in testosterone for most any athlete. Even so, some users will find this particular form difficult to use; some, the majority will not. Some individuals will find they are very sensitive to the Propionate ester and will find they experience a level of discomfort from the medication. If you fall into this category all hope is not lost; those who experience degrees of pain from Testosterone-Propionate in most all cases will not experience it from other common forms.

- For more info see: Testosterone-Propionate

Testosterone-Enanthate is a pure testosterone with a slow-acting long ester attached and is a testosterone of high popularity. Like the Propionate version it is one of the most common forms used the world over by performance enhancing athletes. As for the functional properties of Testosterone-Enanthate, the same exact results will generally be obtained in comparison to the Propionate version assuming doses are similar.

As a long ester testosterone, commonly known as Test-E, this steroid carries with it a half-life of approximately 15 days. Due to the long half-life, injections will not need to be of a frequent nature, especially if it is used in a hormone replacement plan. However, for the athlete an administration schedule of 2 injections per week is common place and generally accepted as the best form of application. Most athletes will find 2 injections of equal doses to provide them with the results they are looking for. As this protocol is very effective, increasingly many competitive bodybuilders will opt for a more frequent injection schedule, as often as once every other day. Although this is not necessary when we consider the long half-life and duration of drug activity many bodybuilders report more stable blood levels and a general better feeling by keeping testosterone levels at maximum peak levels.

There are many quality brands you may choose from when using Testosterone-Enanthate but there is one brand that is universally accepted as the premier form and that is Testoviron Depot. While there are many other quality pharmaceutical grade brands available, many just as good, Testoviron Depot has for whatever reason developed a grand mystique behind its name, so much so that it may indeed be the most popular brand of Testosterone-Enanthate or any testosterone of all time.

- For more info see: Testosterone-Enanthate

Virtually identical in almost every way to Testosterone-Enanthate, Testosterone-Cypionate is another slow-acting long ester testosterone of high popularity. Absolutely everything that can be said of Testosterone-Enanthate can be said of Testosterone-Cypionate with one minor difference. While generally structurally the same as the Enanthate ester, Test-Cyp or simply Cyp as its commonly known possesses a half-life of approximately 24 hours longer. The very slightly longer half-life is of negligible mention when we consider the total half-life time span, so much so that injection frequency schedules will be the same with Cypionate as they were with Enanthate.

There is however a more or less urban legend regarding Testosterone-Cypionate; for one reason or another this legend has really taken hold in the United States. The common story goes and is believed by many that Testosterone-Cypionate is stronger than Testosterone-Enanthate; the truth is thats a lie. You may absolutely find a more powerful Cyp if youre basing your experience on underground versions but as Human Grade pharmaceutical testosterone goes both Test-E and Cyp are virtually twins and this includes the kick they provide.

- For more info see: Testosterone-Cypionate

While Test-E and Cyp are virtually identical and Test-Prop is close to the same except for the shorter ester, while Testosterone-Suspension is simply testosterone too it has perhaps the most notable differences of all; two of importance. Unlike most forms, Testosterone-Suspension does not have an ester attached. Because of the lack of ester the conversion rate or actual usable and absorbed testosterone from each injection is 100% while other common forms carry with them absorption rates of approximately 75%.

Another important aspect regarding Testosterone-Suspension revolving around its lack of an ester is the frequency in-which it must be administered. As you may or may not understand, the ester attached to a steroid will determine its duration of activity; for example, if we inject 100mg of Testosterone-Propionate with a half-life of 48 hours, at the 24 hour mark after injection we now have 50mg of active testosterone left; after another 48 hours we now have 25mg of active testosterone left and so on until there is none left at all. From one 100mg injection of Testosterone-Suspension in less than 24 hours we will have no active testosterone left. For this reason very frequent injections of this steroid must be administered to have any desired effect; athletes will inject this steroid at minimum once per day and often at least twice.

Testosterone-Suspension further carries the trait of being suspended in water; while almost all testosterones are suspended in oil this gives Testosterone-Suspension an even more potent and fast acting effect. It is important to note, as a water based steroid this testosterone can be very painful to inject; so much so that most athletes cannot tolerate the pain. As this pain can be very intense, it is largely an individualistic type of thing; much of steroid use is largely trial and error and while it may be painful to inject this steroid for you, for another there may be no pain at all.

- For more info see: Testosterone-Suspension

Sustanon-250 is not a testosterone in of itself but a mixture of four different testosterones. Like all testosterone, the four various forms mixed together here are simply testosterone; in that there is no difference. However, each form mixed to comprise Sustanon-250 has a different ester attached to it thereby giving a slow steady release of testosterone for an extended amount of time. The composition of Sustanon-250 is as follows:

While we are familiar with the Propionate ester the remaining three esters that create Sustanon-250 are almost always found as part of a mixture or compounded anabolic androgenic steroid.

Developed by Organon, the original idea behind Sustanon-250 was to provide a testosterone form well-suited for hormone replacement therapy that would only needed to be administered once every few weeks and for all intense purposes the idea was a success. For the performance enhancing athlete Sustanon-250 can be a fine choice but the idea of injecting only once or twice a month is not applicable here. As a performance enhancer this testosterone like all forms will need to be administered on a more frequent basis. This mixture carries with it two fast, short esters, Propionate and Pheylpropionate, a longer more moderate ester Isocaproate and the very slow and long Decanoate ester. In order to keep testosterone levels stable and at their peak most athletes will inject Sustanon-250 at a minimum of every 3 days and more commonly every other day for optimal results.

For more info see: Sustanon-250

Everything that can be said of Sustanon-250 can identically be said of Omnadren. While virtually identical the only difference worth noting is the four esters attached. Like Sustanon-250, Omnadren is comprised of 4 various testosterones each with its own ester, the difference here is in the last ester or longest ester. While the longest ester in Sustanon-250 is that of Decanoate, Omnadrens final ester is Caproate dosed identically at 100mg; beyond this very slight difference there is nothing worth noting regarding Omnadren.

For more info see: Omnadren

Testosterone use carries with it the possibility of negative side-effects as do all anabolic steroids. As this may sound unpleasant and any side-effect is, keep in mind, all medications, steroidal and non-steroidal alike carry with them the possibility of adverse reactions. The most common possible side-effects include:

Of these side-effects only one is certain and it is testicular atrophy; yes, if you are a male and you use exogenous testosterone your testicles will shrink; however, once you discontinue use they will return to their normal size. There is a very simple explanation for this occurrence; our natural testosterone is produced in the testicles, once outside testosterone is introduced into the body our testicles no longer have a need to produce any testosterone and therefore shrink. Once use is discontinued and natural testosterone production begins again our testicles will return to their previous state.

As for the remainder of the side-effects, these are largely avoidable or reversible if they do occur; a simple breakdown would be as follows:

For the individual who undergoes hormone replacement therapy your doctor will determine your appropriate dose but for the athlete looking for a boost this dose will always be a great deal higher. There is no question, a mere 250mg per week of testosterone can provide a fantastic edge but in most circles 500mg per week is considered the gold standard for optimal results. Yes, doses can range much higher than 500mg per week; it is not uncommon for many athletes to use as much as 1,000mg per week and while less common but certainly not rare even as high as 1,500mg per week. It is important to note, there is a risk to reward ratio highly in effect as it pertains the our testosterone use; the higher the dose the potential for a higher reward but the higher the dose the greater increase of risk in-terms of negative side-effects and risk to our overall health. Most all beginners are advised to never go beyond 500mg per week and many veteran users will find this is all they ever need. If you do desire to chance a higher dose that is a call only you can make but understand the increase in risk is very real.

As for cycles, in this instance were referring to the duration of use, a common minimum length of time is 8 weeks, with 12 weeks being far more optimal for quality results. While a majority of veterans will use at minimum for 16 weeks, although not as common many will use for far extended periods of time; again, greatly increasing the risk to reward ratio. For most athletes, regardless of their level of experience with testosterone use, cycles of 12 weeks to 16 weeks in length will be their best bet and best suited for their long-term overall health.

* This product is not to be used by anyone 18 years of age or younger. Use under a doctors supervision. This product is not a drug and should be used correctly. Use in conjunction with a well balanced diet and an intense bodybuilding or exercise program.

Read more:
Testosterone - Steroid .com

Last month, the I.A.A.F. gave a sneak peek of what it had found in the two years since the courts ruling, publishing a news release that included a study financed by the I.A.A.F. and the World Anti-Doping Agency. The study, a paper published in the British Journal of Sports Medicine, examined the testosterone levels in 2,127 blood samples provided by athletes competing at the 2011 and 2013 world track and field championships. It concluded that some women with high testosterone levels can have a marked advantage over some women with lower levels but only in certain events.

The event that yielded the most glaring advantage was the hammer throw, an edge the paper put at 4.53 percent. The pole vault (2.94 percent), the 400-meter hurdles (2.78 percent), the 400 (2.73 percent) and the 800 (1.78 percent) were found to have smaller, yet significant, advantages for competitors with hyperandrogenism, but all were far below the 10 to 12 percent advantage generally recognized as the performance difference between men and women.

Thats an important point. In 2015, the court said the I.A.A.F. might want to reconsider barring women with hyperandrogenism from the female category if the degree of advantage were well below 12 percent.

For Chand, who competes in races decided by fractions of a second, this focus on numbers and percentages is not merely a theoretical debate. It has made her anxious about her fate.

I do get afraid, but I have faith in my God, Chand told FirstPost, an Indian news site, at a meet in June.

In a statement, Chand and her lawyers contended that the I.A.A.F. study failed to clear the high bar set by the courts ruling two years ago. They appear to be right. On its own, the study is hardly the slam dunk the I.A.A.F. probably hoped it would be.

But nothing about this issue is a slam dunk.

Dr. Eric Vilain, a medical geneticist, helped create the International Olympic Committees hyperandrogenism policy, which requires a competitor with the condition to undergo treatment that lowers her testosterone levels. But he admitted that the policy was not perfect, and that it couldnt be perfect.

Determining whether a single athlete has an advantage over others is basically impossible, Vilain said, because looking at performance through the lens of only one variable, like high levels of testosterone, ignores too many others training regimen, height, limb length, nutrition that can contribute to success.

This issue could be made simpler, according to Dr. Myron Genel, a Yale professor emeritus and longtime consultant to the I.O.C.s medical commission, if the governing bodies would finally listen to the advice that he and others had given them more than two decades ago.

In the 1990s, those experts suggested that athletes born with what is known as a disorder of sex development a biological anomaly that might result in atypically high testosterone production should compete as females if they were raised as females. It is the same advice that Genel and some of his colleagues give today.

Hyperandrogenism can be a natural genetic advantage, Genel argued, in the same way Michael Phelpss flipper-size feet or Usain Bolts uncommonly long stride give those athletes a winning edge.

I think all elite competition at an elite level is unfair, in one form or another, Genel said.

But will it ever be perfectly fair? Could it ever be perfectly fair? Not when so many different qualities come together to make athletes successful. And not when gender distinctions are changing so rapidly.

At its core, the sports world rigidly separating men and women will perpetually struggle to adapt to increasingly nuanced gender distinctions. In June, the District of Columbia became the first jurisdiction in the United States to offer an X gender, signifying a neutral gender, on its drivers licenses. In March, a transgender New Zealand woman crushed her competition in her first international weight-lifting meet, and a transgender boy won a Texas state championship in girls wrestling.

Not every governing body is equipped to rule on these kind of eligibility questions. Not every athlete fits into this box, or that one.

To Chand, though, the issue of hyperandrogenism in sports is clear cut. She grew up as a girl. At 21, she is a proud young woman. She wants to race as one.

On Saturday, she will. But in the coming months, the Court of Arbitration for Sport will decide whether letting her continue to do so is fair.

What if it gets it wrong?

Read the original here:
What Qualifies a Woman to Compete as a Woman? The Ugly Fight Is Here Again - New York Times

How is it used?

Testosterone testing is used to diagnose several conditions in men, women, girls, and boys. Testosterone is the main sex hormone in men, produced mainly by the testicles, and is responsible for male physical characteristics. Although it is considered to be a "male" sex hormone, it is present in the blood of both males and females. (See the "What is being tested?" section for more.)

The testosterone test may be used to help evaluate conditions such as:

Typically, a test for total testosterone is used for diagnosis. The total testosterone test measures testosterone that is bound to proteins in the blood (e.g., albumin and sex-hormone binding globulin [SHBG]) as well as testosterone that is not bound (free testosterone).

About two-thirds of testosterone circulates in the blood bound to SHBG and slightly less than one-third bound to albumin. A small percent (less than 4%) circulates as free testosterone. Free testosterone plus the testosterone bound to albumin is the bioavailable testosterone, which can act on target tissues.

In many cases, the total testosterone test provides adequate information. However, in certain cases, for example when the level of SHBG is abnormal, a test for free or bioavailable testosterone may be performed as it may more accurately reflect the presence of a medical condition. (For more on this, see Common Questions #4.)

Depending on the reason for testing, other tests and hormone levels may be done in conjunction with testosterone testing. Some examples include:

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In men, the test may be ordered when infertility is suspected or when a man has a decreased sex drive or . Some other symptoms include lack of beard and body hair, decreased muscle mass, and development of breast tissue (). Low levels of total and bioavailable testosterone have also been associated with, or caused by, a greater presence of visceral fat (midriff or organ fat), insulin resistance, and increased risk of coronary artery disease.

In boys with delayed or slowly progressing puberty, the test is often ordered with the FSH and LH tests. Although there are differences from individual to individual as to when puberty begins, it is generally by the age of 10 years. Some symptoms of delayed puberty may include:

The test also can be ordered when a young boy seems to be undergoing a very early (precocious) puberty with obvious secondary sex characteristics. Causes of precocious puberty in boys, due to increased testosterone, include various tumors and congenital adrenal hyperplasia.

In females, testosterone testing may be done when a woman has irregular or no menstrual periods (), is having difficulty getting pregnant, or appears to have masculine features, such as excessive facial and body hair, male pattern baldness, and/or a low voice. Testosterone levels can rise because of tumors that develop in either the ovary or or because of other conditions, such as polycystic ovarian syndrome (PCOS).

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Males: The normal range for testosterone levels in men is broad and varies by stage of maturity and age. It is normal for testosterone levels to slowly decline, usually after age 30. Testosterone may decrease more in men who are obese or chronically ill and with the use of certain medications.

A low testosterone level (hypogonadism) may be due to:

Men who are diagnosed with consistently low testosterone levels and have related signs and symptoms may be prescribed testosterone replacement therapy by their healthcare providers. However, testosterone supplements are not approved by the Food and Drug Administration to boost strength, athletic performance, or prevent problems from aging. Use for these purposes may be harmful. For more information, see the Hormone Health Network's article: The Truth about Testosterone Treatments.

Increased testosterone levels in males can indicate:

Females: In women, testosterone levels are normally low. Increased testosterone levels can indicate:

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Alcoholism and liver disease in males can decrease testosterone levels. Drugs, including androgens other than testosterone and steroids, can also decrease testosterone levels.

Prostate cancer responds to androgens, so many men with advanced prostate cancer receive drugs that lower testosterone levels.

Drugs such as anticonvulsants, barbiturates, and clomiphene can cause testosterone levels to rise. Women taking estrogen therapy may have increased total testosterone levels.

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Expert Reviewed

Six Methods:Managing Your Diet and NutritionExercising RegularlyChanging Your LifestyleUsing Vitamins, Minerals, and HerbsDiagnosing Low TestosteroneWhen Should You Try This?Community Q&A

Testosterone is a hormone that regulates the sex organs, metabolism, bone loss, and other bodily functions. Though affecting primarily men, both sexes can experience low testosterone or Low T. Studies have shown that lifestyle choices play the biggest part in testosterone levels. Exercise, sleep, stress, and obesity can all affect hormone levels. Find out how to increase testosterone levels naturally.

Additionally, check out When Should You Try This? to learn more about when you may wish to consider trying natural methods of increasing your testosterone levels.

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Increase healthy fats. Omega-3 fats are healthy fats found in a variety of foods. These include those found in eggs, algae, fish, and mussels, but also plant oils like flaxseed, hemp and walnut oil. Healthy fats actually help to build a healthier body.

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Drink plenty of water. Lots of water is essential to any healthy diet. In addition to hydrating you, water can also stop you from feeling hungry.

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Eat only when hungry. Cut down on snacking, eating when bored, and other sneaky calories. Try to eat only when you are hungry.

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Eat following a workout. Meat, high-protein yogurt, and some vegetables can help build muscle. Increasing muscle will help burn fat and increase testosterone.

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Consider including sexual activity in the morning. If low testosterone has affected your sex life, then consider changing sexual activity to the morning. Testosterone levels are naturally higher in the morning.

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We are past 50 and in good health. Since my wife and I eat together, what effect on HER body as a woman will our "eating better for increased testosterone" likely produce?

The dietary recommendations will not likely increase your wife's testosterone levels beyond what is normal for her because the diet just provides the "raw materials" that any body needs to make the hormones it needs...it doesn''t "force" any more testosterone production than is needed.

My body and face look younger than I am. I am in perfect shape. I want to gain weight and increase metabolism in my body. I do regular workouts and am over 30. Could you please suggest how to gain weight and look matured?

Strength and endurance exercises tend to increase muscle mass most efficiently. You should also include high quality lean protein in your diet. You may appreciate how young you look the older you get, but you should also be careful not to gain too much weight too quickly.

Does this work for women too?

wikiHow Contributor

Not to any significant extent for most women.

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