There is a negative correlation of testosterone levels with plasminogen activator inhibitor-1 (PAI-1) (Glueck et al 1993; Phillips 1993), which is a major prothrombotic factor and known to be associated with progression of atherosclerosis, as well as other prothrombotic factors fibrinogen, α2-antiplasmin and factor VII (Bonithon-Kopp et al 1988; Glueck et al 1993; Phillips 1993; De Pergola et al 1997). There is a positive correlation with tissue plasminogen activator (tPA) which is one of the major fibrinolytic agents (Glueck et al 1993). Interventional trials have shown a neutral effect of physiological testosterone replacement on the major clotting factors (Smith et al 2005) but supraphysiological androgen administration can produce a temporary mild pro-coagulant effect (Anderson et al 1995).
Testosterone is the primary male sex hormone and an anabolic steroid. In male humans, testosterone plays a key role in the development of male reproductive tissues such as testes and prostate, as well as promoting secondary sexual characteristics such as increased muscle and bone mass, and the growth of body hair.[2] In addition, testosterone is involved in health and well-being,[3] and the prevention of osteoporosis.[4] Insufficient levels of testosterone in men may lead to abnormalities including frailty and bone loss.

A number of epidemiological studies have found that bone mineral density in the aging male population is positively associated with endogenous androgen levels (Murphy et al 1993; Ongphiphadhanakul et al 1995; Rucker et al 2004). Testosterone levels in young men have been shown to correlate with bone size, indicating a role in determination of peak bone mass and protection from future osteoporosis (Lorentzon et al 2005). Male hypogonadism has been shown to be a risk factor for hip fracture (Jackson et al 1992) and a recent study showed a high prevalence of hypogonadism in a group of male patients with average age 75 years presenting with minimal trauma fractures compared to stroke victims who acted as controls (Leifke et al 2005). Estrogen is a well known determinant of bone density in women and some investigators have found serum estrogen to be a strong determinant of male bone density (Khosla et al 1998; Khosla et al 2001). Serum estrogen was also found to correlate better than testosterone with peak bone mass (Khosla et al 2001) but this is in contradiction of a more recent study showing a negative correlation of estrogen with peak bone size (Lorentzon et al 2005). Men with aromatase deficiency (Carani et al 1997) or defunctioning estrogen receptor mutations (Smith et al 1994) have been found to have abnormally low bone density despite normal or high testosterone levels which further emphasizes the important influence of estrogen on male bone density.
Grape seed extract is another ingredient with not enough research to suggest a dosage. Grape seed extract can interact with drugs like “blood thinners, NSAID painkillers (like aspirin, Advil, and Aleve), certain heart medicines, cancer treatments, and others.” If this sounds like you (or if you ever pop an Advil to clear off a headache), you’ll need to speak with a doctor to make sure this supplement is safe to take.
Ashwagandha is sometimes included in testosterone supplements because of the hypothesis that it improves fertility. However, we couldn’t find sufficient evidence to support this claim (at best, one study found that ashwagandha might improve cardiorespiratory endurance). WebMD advocates caution when taking this herb, as it may interact with immunosuppressants, sedative medications, and thyroid hormone medications.

I highly recommend using a great essential amino acid mix post-exercise in order to boost testosterone.  These essential amino acids and especially the concentrated branched chain amino acids leucine, isoleucine and valine stimulate muscle protein synthesis.  Getting these amino acids in the post-workout window dramatically boosts testosterone production (14).  I like using our Amino Strong and will often recommend a scoop pre-workout and post-workout for the best muscle building, testosterone boosting benefits.
One study found that men who took 3,332 international units (IU) of vitamin D daily for one year significantly increased their testosterone levels. But vitamin D supplements may only work for men who are severely deficient in this specific vitamin. Another study found that men without a vitamin D deficiency had no increase in testosterone levels after taking vitamin D.

Zaima, N., Kinoshita, S., Hieda, N., Kugo, H., Narisawa, K., Yamamoto, A., ... Moriyama, T. (2016, September). Effect of dietary fish oil on mouse testosterone level and the distribution of eicosapentaenoic acid-containing phosphatidylcholine in testicular interstitium. Biochemistry and Biophysics Reports, 7, 259–265. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613343/


Testosterone replacement therapy is currently only FDA approved for men who have been diagnosed with hypogonadism, but it’s also prescribed off-label for older men who take it in hopes that it will improve their libido. The use of testosterone therapy is increasingly common in the United States, with more than 2 million men receiving the therapy. Not every man benefits from taking testosterone supplements. Testosterone is available in different forms, including topicals such as gels, creams, and patches; injections; and pellets that are surgically placed directly beneath the skin. (7)
“Before taking Andro400, my husband weighed 290 lbs. He's a diabetic and his blood pressure was through the roof. I purchased Andro based on the reviews, and he's lost 60 - 70 lbs! ​It's enhanced him health-wise in a lot of aspects too. He used to be depressed because of his weight. The fact that he was losing weight like crazy gave him a lot of relief. He's not depressed now, he's really happy. He's more loving. And it's so exciting for me as a wife to see him happier -- it made me happier​! ​ So I'm really grateful. Andro400 gave him a lot of ​energy ​ too because of the testosterone boost.​ The 3 main things everybody's noticing are: no more​ depression, a lot more energy and ​the huge weight loss. He went from size 42 to 38, so it's like, oh my God it's WORKING!! Trust me, we've tried a lot of other things that didn't work. And that's why I'm so excited because it's actually, literally changing our lives!”
Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (DHT) by the cytoplasmic enzyme 5α-reductase. DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T.[114] The T-receptor or DHT-receptor complex undergoes a structural change that allows it to move into the cell nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA. The areas of binding are called hormone response elements (HREs), and influence transcriptional activity of certain genes, producing the androgen effects.
If you’re a frequent reader here in AM, you already know that increased dietary fat intake is directly correlated with increased testosterone production. And not only that, but the types of fat that increase T seem to be saturated fats (SFAs) and monounsaturated fats (MUFAs), while polyunsaturated (PUFAs) actually tend to lower testosterone (more here).

My educated opinion would be that it will help, but like I said I want to do some more research on the matter and I will probably end up writing a whole article on this subject, and how to reverse pufy nipples. I too have slightly puffy nipples genetically, so I have learned a lot over the years on how to reduce them and will share in an article shortly. I will message you when it is out.
There is an increased incidence of hypogonadism in men with rheumatoid arthritis. Tengstrand et al (2002) studied hormonal levels in 104 men with rheumatoid arthritis and 99 age-matched healthy men. They divided their subjects into 3 age groups: 30–49, 40–59, 60–69. Mean non-sex hormone binding globulin-bound testosterone (bioavailable testosterone) was lower in men with rheumatoid arthritis for each of the three groups. LH was also found to be lower in the patients with rheumatoid arthritis suggesting a hypothalamic-pituitary cause of the reduced bioavailable testosterone. Of the 104 men with rheumatoid arthritis, 33 had hypogonadism compared to 7 of the 99 healthy controls.
In addition to conjugation and the 17-ketosteroid pathway, testosterone can also be hydroxylated and oxidized in the liver by cytochrome P450 enzymes, including CYP3A4, CYP3A5, CYP2C9, CYP2C19, and CYP2D6.[155] 6β-Hydroxylation and to a lesser extent 16β-hydroxylation are the major transformations.[155] The 6β-hydroxylation of testosterone is catalyzed mainly by CYP3A4 and to a lesser extent CYP3A5 and is responsible for 75 to 80% of cytochrome P450-mediated testosterone metabolism.[155] In addition to 6β- and 16β-hydroxytestosterone, 1β-, 2α/β-, 11β-, and 15β-hydroxytestosterone are also formed as minor metabolites.[155][156] Certain cytochrome P450 enzymes such as CYP2C9 and CYP2C19 can also oxidize testosterone at the C17 position to form androstenedione.[155]

Testosterone replacement therapy is currently only FDA approved for men who have been diagnosed with hypogonadism, but it’s also prescribed off-label for older men who take it in hopes that it will improve their libido. The use of testosterone therapy is increasingly common in the United States, with more than 2 million men receiving the therapy. Not every man benefits from taking testosterone supplements. Testosterone is available in different forms, including topicals such as gels, creams, and patches; injections; and pellets that are surgically placed directly beneath the skin. (7)


Testosyn has been the #1 Testosterone Supplement for the 3rd straight year! This testosterone-boosting formula surpasses any product we have reviewed including prescription strength products! Formulated with a powerful set of clinically-proven ingredients, Testosyn can help men everywhere dramatically raise their testosterone levels safely. Testosyn is engineered with the most advanced ingredients and is often considered the most powerful testosterone supplement on the market to help you develop increased athletic performance, improved muscle tone and mass, increased recovery, and enhanced sexual performance.

The same study showed that drinking did, however, lower semen count and quality. And I want to remind you – this is an article  on improving testosterone levels, not general health as there are a lot of studies that show drinking leads to an assortment of health issues. This acute spike in Testosterone could be due to the effect alcohol has on libido, and also the energy influx in the liver?
The hypogonadal-obesity-adipocytokine cycle hypothesis. Adipose tissue contains the enzyme aromatase which metabolises testosterone to oestrogen. This results in reduced testosterone levels, which increase the action of lipoprotein lipase and increase fat mass, thus increasing aromatisation of testosterone and completing the cycle. Visceral fat also promotes lower testosterone levels by reducing pituitary LH pulse amplitude via leptin and/or other factors. In vitro studies have shown that leptin also inhibits testosterone production directly at the testes. Visceral adiposity could also provide the link between testosterone and insulin resistance (Jones 2007).
Topical testosterone, specifically gels, creams and liquids, may transfer to others. Women and children are most at risk of harmful effects from contact with them. You should take care to cover the area and wash your hands well after putting on the medication. Be careful not to let the site with the topical TT touch others because that could transfer the drug.
Beast Sports recommends taking four capsules twice per day. The pills are about the same size as a multivitamin or a Tylenol liquid gel pill — not tiny tablets, unfortunately, but they aren’t horse pills. They smell like the boxes of raisins your Mom packed into your school lunch, but stale, like they were forgotten in the pantry for a few years, and a little spicy, like she sprinkled curry powder on them. If you follow this eight pills per day regime, your $46 bottle will last you twenty-two days, and cost you about $2 per day.
Many studies demonstrate an improvement in mood of hypogonadal men treated with testosterone (Wang et al 1996; Azad et al 2003). The relationship between testosterone status and mood, particularly depression, remains unresolved. Using Beck’s Depression Inventory, Barrett-Connor and colleagues found that the depression score worsened as men aged, exactly at a time when testosterone levels are decreasing (Barrett-Connor et al 1999). Pope and colleagues found that testosterone treatment in men with refractory depression lowered the Hamilton Depression rating scale and the Clinical Global Impression severity rating (Pope et al 2003). The Beck Depression Inventory remained unchanged in Pope’s study.
On the average, you need to sleep at least 8 hours per night to stay healthy. If you want a night sleep to contribute to the maximum testosterone production, it’s important to make your sleep comfortable. Thus, the bedroom temperature shouldn’t exceed 21°C. In addition, you should ventilate your bedroom thoroughly before sleeping. Furthermore, before going to bed, don’t overload your stomach with fatty foods, as well as don’t drink alcohol and caffeinated beverages. Finally, you have to avoid intense physical activity before bedtime.6
In 1927, the University of Chicago's Professor of Physiologic Chemistry, Fred C. Koch, established easy access to a large source of bovine testicles — the Chicago stockyards — and recruited students willing to endure the tedious work of extracting their isolates. In that year, Koch and his student, Lemuel McGee, derived 20 mg of a substance from a supply of 40 pounds of bovine testicles that, when administered to castrated roosters, pigs and rats, remasculinized them.[179] The group of Ernst Laqueur at the University of Amsterdam purified testosterone from bovine testicles in a similar manner in 1934, but isolation of the hormone from animal tissues in amounts permitting serious study in humans was not feasible until three European pharmaceutical giants—Schering (Berlin, Germany), Organon (Oss, Netherlands) and Ciba (Basel, Switzerland)—began full-scale steroid research and development programs in the 1930s.

Dr. Anthony's Notes: I like Tribulus. It is a VERY common herb in almost all testosterone boosting products – again though, it may be more of a libido enhancer than anything. From my personal experience, it's effective when stacked with the other libido enhancing supplements in this guide. How To Take Tribulus: Take 200-400mg once per day of a 45-60% saponin extract product.
Your body’s circadian rhythm essentially resets itself every night and releases chemicals like cortisol, which contribute to the overall hormone balance that can prevent low T-levels. I have even heard one endocrinologist claim that one hour of sleep between 10 p.m. and 2 a.m. has the same healing effects on your body as two hours of sleep before or after this timeslot!
“I did a lot of research on Andro400 before I ordered it because I've tried other products in the past and they haven't worked. But with this I could not believe the difference within, literally within a month. I'm 62 years old and since I started taking it I have lost 37 lbs. And I have more energy than I've had in 20 years. It's still coming off, but it's coming off slower now. It was the belly fat. I could get weight off but I could never get the tummy off, and now the tummy's coming off. Libido -- everything's better all the way around.“
There are no studies showing its effects on healthy males, but it has been shown to drastically improve testosterone in infertile males (ref 77). It's also packed full of minerals, so is a great superfood nevertheless. I use the Sunfoods brand. Make sure you buy from a quality brand, as there are a lot of poor shilajit products out there, also some have been shown to be high in heavy metals. 
Testosterone is a steroid sex hormone found in both men and women. In men, testosterone is produced primarily by the Leydig (interstitial) cells of the testes when stimulated by luteinizing hormone (LH). It functions to stimulate spermatogenesis, promote physical and functional maturation of spermatozoa, maintain accessory organs of the male reproductive tract, support development of secondary sexual characteristics, stimulate growth and metabolism throughout the body and influence brain development by stimulating sexual behaviors and sexual drive. In women, testosterone is produced by the ovaries (25%), adrenals (25%) and via peripheral conversion from androstenedione (50%). Testerone in women functions to maintain libido and general wellbeing. Testosterone exerts a negative feedback mechanism on pituitary release of LH and follicle-stimulating hormone (FSH). Testosterone may be further converted to dihydrotestosterone or estradiol depending on the tissue.

Opioid substances are in common use both licit and illicit. Opiates are potent analgesics but they are also highly addictive. They are frequently prescribed for both acute and chronic pain and when used chronically, often induce opiate dependence in the user. Pain clinics regularly use narcotic agents in many of their patients. Methadone, in particular, is regularly prescribed to opiate addicts who have entered a program aimed at reducing narcotic dosage and ultimately weaning the patient off it altogether. Most men who are on chronic high doses of an opiate become hypogonadal. This was first recognized in the 1970’s when heroin addicts were found to have suppressed levels of testosterone (Brambilla et al 1977). Also suppressed were LH and FSH pointing to a probable inhibition of GnRH release.
As you cut these dietary troublemakers from your meals, you need to replace them with healthy substitutes like vegetables and healthy fats (including natural saturated fats!). Your body prefers the carbohydrates in micronutrient-dense vegetables rather than grains and sugars because it slows the conversion to simple sugars like glucose, and decreases your insulin level. When you cut grains and sugar from your meals, you typically will need to radically increase the amount of vegetables you eat, as well as make sure you are also consuming protein and healthy fats regularly.
If you still feel the need to supplement, keep in mind that supplemental magnesium is more likely than dietary magnesium to cause adverse effects, which is why the FDA fixed at 350 mg the Tolerable Upper Intake Level for magnesium supplementation in adults. Also, you may want to avoid magnesium oxide: it has poor bioavailability (rats absorbed only 15% in one study,[43] and humans only 4% in another[44]) and can cause intestinal discomfort and diarrhea.
The reliable measurement of serum free testosterone requires equilibrium dialysis. This is not appropriate for clinical use as it is very time consuming and therefore expensive. The amount of bioavailable testosterone can be measured as a percentage of the total testosterone after precipitation of the SHBG bound fraction using ammonium sulphate. The bioavailable testosterone is then calculated from the total testosterone level. This method has an excellent correlation with free testosterone (Tremblay and Dube 1974) but is not widely available for clinical use. In most clinical situations the available tests are total testosterone and SHBG which are both easily and reliably measured. Total testosterone is appropriate for the diagnosis of overt male hypogonadism where testosterone levels are very low and also in excluding hypogonadism in patients with normal/high-normal testosterone levels. With increasing age, a greater number of men have total testosterone levels just below the normal range or in the low-normal range. In these patients total testosterone can be an unreliable indicator of hypogonadal status. There are a number of formulae that calculate an estimated bioavailable or free testosterone level using the SHBG and total testosterone levels. Some of these have been shown to correlate well with laboratory measures and there is evidence that they more reliably indicate hypogonadism than total testosterone in cases of borderline biochemical hypogonadism (Vermeulen et al 1971; Morris et al 2004). It is important that such tests are validated for use in patient populations relevant to the patient under consideration.
The chemical synthesis of testosterone from cholesterol was achieved in August that year by Butenandt and Hanisch.[183] Only a week later, the Ciba group in Zurich, Leopold Ruzicka (1887–1976) and A. Wettstein, published their synthesis of testosterone.[184] These independent partial syntheses of testosterone from a cholesterol base earned both Butenandt and Ruzicka the joint 1939 Nobel Prize in Chemistry.[182][185] Testosterone was identified as 17β-hydroxyandrost-4-en-3-one (C19H28O2), a solid polycyclic alcohol with a hydroxyl group at the 17th carbon atom. This also made it obvious that additional modifications on the synthesized testosterone could be made, i.e., esterification and alkylation.
Mínguez-Alarcón, L., Chavarro, J. E., Mendiola, J., Roca, M., Tanrikut, C., Vioque, J., ... Torres-Cantero, A. M. (2017, March–April). Fatty acid intake in relation to reproductive hormones and testicular volume among young healthy men [Abstract]. Asian Journal of Andrology, 19(2), 184–190. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27834316
The changes in average serum testosterone levels with aging mean that the proportion of men fulfilling a biochemically defined diagnosis of hypogonadism increases with aging. Twenty percent of men aged over 60 have total testosterone levels below the normal range and the figure rises to 50% in those aged over 80. The figures concerning free testosterone are even higher as would be expected in view of the concurrent decrease in SHBG levels (Harman et al 2001).
The maximum hormone concentration in the blood is reported immediately after the workout. And the effect lasts throughout the day. However, it’s important to ensure that your physical activity is moderate. The matter is that too much high-intensity exercise can give an undesirable result. But even if for any reason you can’t attend a gym, it’s not a problem. Just move as much as possible during the day. Even simple walking will be of great benefit.
A: Androderm comes in the form of a transdermal patch and is used for testosterone replacement therapy in patients who have insufficient levels of testosterone. Testosterone is a hormone produced in the body that plays a key role in many physiological processes in men. In some men, however, the body does not produce enough of the hormone, resulting in a variety of symptoms including decreased libido, erectile dysfunction, muscle loss, anemia and depression, among others. Androderm helps treat these symptoms and raise low testosterone levels by delivering therapeutic amounts of the hormone, which are absorbed through the skin. According to the prescribing information for Androderm, depression was a reported side effect of the medication. Other common side effects of Androderm include itching and redness at the application site, prostate abnormalities, headache, and burning or hardening of the skin at the application site. Less common side effects of Androderm include reduced libido (sex drive), fatigue, high blood pressure, anxiety, confusion, increased appetite, and body pain. For more specific information, consult with your doctor for guidance based on your health status and current medications, particularly before taking any action. Your physician can determine if your dosage of the medication needs to be adjusted or if an alternative medication should be considered. Lori Poulin, PharmD
One study found that men who took 3,332 international units (IU) of vitamin D daily for one year significantly increased their testosterone levels. But vitamin D supplements may only work for men who are severely deficient in this specific vitamin. Another study found that men without a vitamin D deficiency had no increase in testosterone levels after taking vitamin D.
A: A troche is a small lozenge designed to dissolve in the mouth. Testosterone is available in troche or buccal form. If you are referring to testosterone troche, this product is generally used to treat conditions in men that result from a lack of natural testosterone. Testosterone is vital to maintaining an active and healthy male sex drive. Testosterone deficiency can cause erectile dysfunction. Studies suggest that if erectile dysfunction is associated with a low testosterone level, it can often be treated with prescription testosterone pills. Based on your complete medical history and blood levels of testosterone, your doctor can determine the best treatment option to meet your needs. For more information, please consult with your health care provider and visit //www.everydayhealth.com/drugs/testosterone. Michelle McDermott, PharmD
Here’s a scary thought: You may be less of a man than your father was—at least hormonally. A study in the Journal of Clinical Endocrinology and Metabolism found that, on average, testosterone levels were higher in men of the same age in the ’80s than they were in the 2000s (due, researchers speculate, to higher rates of obesity and the wider use of medication these days).  
Studies also show a consistent negative correlation of testosterone with blood pressure (Barrett-Connor and Khaw 1988; Khaw and Barrett-Connor 1988; Svartberg, von Muhlen, Schirmer et al 2004). Data specific to the ageing male population suggests that this relationship is particularly powerful for systolic hypertension (Fogari et al 2005). Interventional trials have not found a significant effect of testosterone replacement on blood pressure (Kapoor et al 2006).
The reasons for considering such therapy become evident from the many associations, indicated above, that reduced testosterone has with a variety of both physiological functions (bone metabolism, muscle mass, cognitive function, libido, erectile function) and pathophysiological states (metabolic syndrome, diabetes mellitus, obesity, insulin resistance, autoimmune disease). Although a definitive long-term, large scale placebo-controlled double-blind study of testosterone therapy in the aging male has not yet been carried out, multiple shorter-term trials have suggested improvement by testosterone with a resultant enhancement of muscle mass, bone density, libido, erectile function, mood, motivation and general sense of well-being.
Tribulus terrestris is an ingredient commonly presented as improving testosterone levels, but has not been found to be more effective than a placebo or possess any testosterone increasing properties. WebMD cautions that it interferes with Lithium and diabetes medications, and in general, not enough is known about tribulus terrestris to recommend a dosage for anyone.
Erectile dysfunction is a common finding in the aging male. A prevalence of over 70% was found in men older than 70 in a recent cross-sectional study (Ponholzer et al 2005). Treatment with phosphodiesterase-5 (PDE-5) inhibitors is proven to be effective for the majority of men but some do not respond (Shabsigh and Anastasiadis 2003). The condition is multi-factorial, with contributions from emotional, vascular, neurological and pharmacological factors. The concept of erectile dysfunction as a vascular disease is particularly interesting in view of the evidence presented above, linking testosterone to atherosclerosis and describing its action as a vasodilator.

Another recent development is the production of adhesive tablets which are applied twice daily to the buccal mucosa on the gum above the incisor teeth. The tablets gradually release testosterone into the systemic venous circulation and steady state physiological concentrations are achieved in most patients within two days (Ross et al 2004). Some patients do not like the feeling of the tablet in the mouth or find that there is an abnormal taste in the mouth, but local adverse effects are usually mild and transient (Wang, Swerdloff et al 2004).


BSN's Evotest is a top of the line testosterone powder designed by award BSN. While taste of this product has been suspect, Evotest aims to help pump you with naturally produced testosterone by improving your own testosterone production. Most people like the convenience of pills, but for those that can’t take pills, this powder might be a good alternative. If you want to avoid swallowing pills and boost testosterone levels, Evotest may be for you. Click To Read More...
A: Testosterone is the male androgen, or sex hormone. It controls too many things to list here. While it does help regulate mood, sex drive, and metabolism, it does this by working in tandem with other hormones in your body. It's produced by the male testes and the adrenal glands. For more information, go to //www.everydayhealth.com/drugs/testosterone. Matt Curley, PharmD
The normal development of the prostate gland is dependent on the action of testosterone via the androgen receptor, and abnormal biosynthesis of the hormone or inactivating mutations of the androgen receptor are associated with a rudimentary prostate gland. Testosterone also requires conversion to dihydrotestosterone in the prostate gland for full activity. In view of this link between testosterone and prostate development, it is important to consider the impact that testosterone replacement may have on the prevalence and morbidity associated with benign prostatic hypertrophy (BPH) and prostate cancer, which are the common conditions related to pathological growth of the prostate gland.

There is a polymorphic CAG repeat sequence in the androgen receptor gene, which codes for a variable number of glutamine amino acids in the part of the receptor affecting gene transcription. A receptor with a short CAG sequence produces greater activity when androgens attach, and men with shorter CAG polymorphisms exhibit androgenic traits, such as preserved bone density (Zitzmann et al 2001) and prostate growth during testosterone treatment (Zitzmann et al 2003). Indirect evidence of the importance of androgens in the development of prostate cancer is provided by case control study findings of a shorter, more active CAG repeat sequence in the androgen receptor gene of patients with prostate cancer compared with controls (Hsing et al 2000, 2002).


Falling in love decreases men's testosterone levels while increasing women's testosterone levels. There has been speculation that these changes in testosterone result in the temporary reduction of differences in behavior between the sexes.[53] However, it is suggested that after the "honeymoon phase" ends—about four years into a relationship—this change in testosterone levels is no longer apparent.[53] Men who produce less testosterone are more likely to be in a relationship[54] or married,[55] and men who produce more testosterone are more likely to divorce;[55] however, causality cannot be determined in this correlation. Marriage or commitment could cause a decrease in testosterone levels.[56] Single men who have not had relationship experience have lower testosterone levels than single men with experience. It is suggested that these single men with prior experience are in a more competitive state than their non-experienced counterparts.[57] Married men who engage in bond-maintenance activities such as spending the day with their spouse/and or child have no different testosterone levels compared to times when they do not engage in such activities. Collectively, these results suggest that the presence of competitive activities rather than bond-maintenance activities are more relevant to changes in testosterone levels.[58]
At the present time, it is suggested that androgen replacement should take the form of natural testosterone. Some of the effects of testosterone are mediated after conversion to estrogen or dihydrotestosterone by the enzymes aromatase and 5a-reductase enzymes respectively. Other effects occur independently of the traditional action of testosterone via the classical androgen receptor- for example, its action as a vasodilator via a cell membrane action as described previously. It is therefore important that the androgen used to treat hypogonadism is amenable to the action of these metabolizing enzymes and can also mediate the non-androgen receptor actions of testosterone. Use of natural testosterone ensures this and reduces the chance of non-testosterone mediated adverse effects. There are now a number of testosterone preparations which can meet these recommendations and the main factor in deciding between them is patient choice.

Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).
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