In a previous article I outlined a study showing the effectiveness of testosterone therapy on menopausal symptoms in pre- and post-menopausal women. Here I will present and comment on an insightful study that compared head-to-head the effectiveness of testosterone therapy and estrogen therapy in surgically menopausal women who had their ovaries removed.
Before the surgical removal of both ovaries (bilateral ovariectomy) women were randomly assigned to either a testosterone alone, estrogen alone, or placebo groups. There were 10 patients in each group.
Mean age of the women was 46 years. They had underwent bilateral ovariectomy due to having uterine fibroids (aka myoma), which are non-cancerous (benign) tumors that develop in the womb (uterus).
The testosterone group received injectable testosterone (enanthate); 200 mg/ml.
The estrogen group received injectable estradiol; 10mg/ml.
The testosterone/estrogen group received injectable testosterone (enanthate) 150 mg + 8.5 mg estradiol/ml.
All groups received 1 ml intramuscular injections every 28 days for 3 months.
Testosterone levels in women decline steeply with age during the reproductive years; by the time women reach their late 40, their blood testosterone levels are approximately half what they were in their 20s.[1, 2]
Testosterone deficiency, also known as hypogonadism, is a state with sub-optimal circulating levels of testosterone concomitant with clinical signs and symptoms attributed to low physiological testosterone levels.[1-3]
Sexual dysfunction is the most commonly recognized symptom of testosterone deficiency. However, testosterone also plays a broader role in men's health. A growing body of evidence has established associations between low testosterone levels and multiple risk factors and diseases including the metabolic syndrome, obesity, type-2 diabetes, sarcopenia, frailty, mobility limitations, osteoporosis, cognitive impairment, depression, cardiovascular disease, and reduced longevity.[3-12]
This summary gives an overview of the detrimental impact of testosterone deficiency on a wide range of health outcomes.
Testosterone therapy has been in use for more than 70 years for the treatment of testosterone deficiency, historically called hypogonadism.In the past 30 years there has been a growing body of scientific research demonstrating that testosterone deficiency is associated with increased body weight/adiposity/waist circumference, insulin resistance, type 2 diabetes, hypertension, inflammation, atherosclerosis and cardiovascular disease, erectile dysfunction (ED) and increased risk of mortality [2, 3]. In line with the detrimental health outcomes seen with testosterone deficiency, testosterone therapy has been shown to confer beneficial effects on multiple risk factors and risk biomarkers related to these clinical conditions.
Despite these well-documented health benefits, testosterone therapy is still controversial, in large part due to a few flawed studies and media outcry about potential elevated heart attack risk with testosterone therapy. On July 2, 2014, a study was published which demonstrated that testosterone therapy is not associated with an increased risk of MI, and that is actually may protect against heart attack....
Alleged concerns regarding risk of cardiovascular disease with testosterone replacement therapy (TRT) have been promulgated recently. However, a large and growing number of intervention studies show to the contrary that TRT reduces cardiovascular risk factors and confers multiple beneficial health effects. Thus, fears promoted by some recent flawed studies need to be critically re-evaluated.
This article gives an overview of studies that have investigated health effects and safety of TRT. As outlined here, the position that testosterone deficiency (TD) should be regarded as a risk factor for cardiovascular disease is supported by a rapidly expanding body of evidence.[2-4]
Testosterone deficiency, popularly known as "low T", has entered the center stage in both the lay and medical communities. However, how is testosterone deficiency (a.k.a. hypogonadism) diagnosed? What is the testosterone level threshold below which you can say you have low T? What are the references ranges for healthy men?
Here you will find out what the medical guidelines say, what critical information they are ignoring, what you should point out to your doctor if he/she doesn't think you have low T...
In a previous post I outlined the U-shaped relationship between IGF-1 and all-cause mortality.
A growing body of research shows that IGF-1 has a U-shaped relationship with other health outcomes as well, including cancer. This may come as a surprise, as IGF-1 is well-known to increase cancer risk...
IGF-1 (insulin-like growth factor-1) is a peptide hormone, produced predominantly by the liver in response to pituitary GH (growth hormone). IGF-1 is involved in a wide variety of physiological processes. In adults, IGF-1 has metabolic and anabolic effects, and it mediates many of the effects of GH.[2-4]
GH and IGF-1 levels are reduced with normal aging, a phenomenon called somatopause.[5-7] It has been suggested that somatopause is an age-related GH deficiency state. Somatopause has been considered to contribute to physiological deterioration seen with aging, like reduced muscle mass, reduced exercise tolerance, decreased strength, osteoporosis, increased fat mass, elevated cardiovascular risk, impaired quality of life, cognitive/memory decline and reduced immunity.[7-12] These changes are similar to those seen in classic (non-aging related) GH deficiency (GHD).[13, 14]
A long-held belief is that testosterone stimulates development of prostate cancer and/or accelerates its growth. This fear is the most common reason for doctors' reluctance to prescribe testosterone replacement therapy, even in hypogonadal men [1, 2] , which unnecessarily deprives many hypogonadal men of clinical benefits.
This summary gives an overview of an in-depth review of current literature regarding the relationship of testosterone levels and prostate cancer, and the effect of testosterone replacement therapy on prostate cancer progression and recurrence. Key studies which have refuted the old belief that testosterone has harmful effects on the prostate are presented, along the new testosterone-prostate paradigm known as the saturation model.
Surprisingly, new research provocatively suggests that it is not high testosterone levels that are problematic for prostate cancer, but to the contrary that it is low serum T that is associated with worrisome cancer features and outcomes...and new experimental research has uncovered mechanisms that explain how low testosterone levels may be detrimental for prostate health, and support the new view that testosterone therapy actually may have beneficial effects with regard to prostate cancer...
It is well-documented that maternal food habits and essential nutrient intakes have an important impact on reproductive outcomes.[1, 2] However, there is less information available on the importance of nutrition for paternal reproductive fitness. Evidence is particularly limited for men who habitually
Consume a Western-style unhealthy diet which is lacking in many essential nutrients and omega-3 fatty acids, which are needed for healthy sperm and fertility.[3-13] Omega-3 fatty acids are especially important for proper sperm morphology and function.[5, 6, 8, 9]
Raw unprocessed walnuts are a rich source of essential nutrients and provide an array of health promoting phytochemicals, including carotenoids, phenolic acids, phytosterols and polyphenolic compounds such as flavonoids, proanthocyanidins (PAC) and stilbenes.[14-18] Therefore, a study specifically investigated if in young men (age 21-35 yr old) habitually eating unhealthy, adding 75 g of whole-shelled walnuts per day would have an impact on semen quality...