Archive for the ‘Testosterone’ Category

Fromtrendy stubble to neatly trimmed goatee to a lumberjack-worthy beard, the facialhair craze doesnt seem to be going anywhere. But if your beard is more wispythan robust, you might be wondering, What gives?

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Just like there are differences in the shape and texture of the hair on mens heads, the same is true of their beards, says dermatologist John Anthony, MD. Heres why.

Your genes are one of the main factors in how thick or thin your facial hair is. Men have hairs on their face that are programmed to respond to testosterone, and when they get that signal around puberty, they transition from fine hair to thicker hair, Dr. Anthony explains. But how thick it is depends on genetics.

Genetics also affect where facial hair grows and when your beard reaches its full potential.

From ages 18 to 30, most beards continue to develop in thickness and coarseness, he says. So if youre 18 and wondering why you dont have a full beard yet, it just may not be time.

Ethnicity can also play a role. Dr. Anthony notes that people from Mediterranean countries, for example, tend to grow thicker beards.

Ifyoud describe your beard as patchy, it could be more than genes.

Alopecia areata is a condition where hair falls out in round patches. The hair loss can happen both on your scalp and your beard. It occurs when your immune system thinks your hair follicles are the enemy. Doctors arent sure exactly why it happens, but stress could be a factor.

While not dangerous, alopecia areata can worsen. Its not predictable, Dr. Anthony says. It could spontaneously resolve, or it could spread if you dont get treatment.

There are lots of treatment options, but finding aneffective one may take some trial and error. A dermatologist might recommend:

Dr. Anthonys rule of thumb? If a change in yourbeard is new, unusual or asymmetrical, talk to your doctor. Start with yourprimary care doctor, but if there isnt an obvious answer, see adermatologist.

Forthose beards that are more tie-dye than uniform in color (think: reddishpatches when you have brown hair), it could be:

What isntresponsible for a thin beard is your testosterone levels. If you havesufficient testosterone to go through puberty and develop secondary hair inother places, then your testosterone levels are normal, Dr. Anthony says.

Whilethere is little research on proven ways to increase the fullness of your beard,Dr. Anthony suggests a few things that might help:

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Oct 15th, 2019 | Filed under Testosterone

Medical clinics across the country are advertising a treatment some believe is a fountain of youth. They're selling hormone therapy as a way to make people look and feel younger. But a CBS News investigation finds this may be putting patients at risk.

Last year, at the age of 60, Cindy Kinder-Binge was rushed to a hospital in New Albany, Indiana, with a heart rate four times normal. Two months earlier, she had gone to the emergency room with palpitations.

"A cardiologist walks in and he said, 'Who put you on thyroid medicine?'" Kinder-Binge said.

She had been prescribed a thyroid hormone for menopausal symptoms like hot flashes, even though her thyroid blood levels were normal. She says her cardiologist had her stop taking the hormone because he believed it contributed to her irregular heartbeat.

She was treated by a nurse practitioner at a clinic called 25 Again. Hormone therapy is promoted as a way to help patients lose weight and feel younger. But a CBS News investigation found there are clinics across the country prescribing hormones like thyroid and testosterone to people with normal levels and it's not just 25 Again.

Ultrasound technician Leighann Decker is a former employee of an OB-GYN in Owensboro, Kentucky. The doctor Decker worked for prescribed testosterone to patients with normal testosterone levels looking to turn back the clock.

"More and more practitioners have tried to jump on board and when they've seen the profit that's being made from it. Of course, it's cash pay. It's easy money," Decker said.

The doctor in Kentucky and the practitioner in Indiana both attended seminars given by Dr. Neal Rouzier. He has been promoting hormone replacement therapy for decades and said he's trained thousands of clinicians around the world. During a 2016 deposition, he said he gives testosterone to patients even if their levels are normal.

"I don't care about the number. I treat patients. I treat symptoms," Rouzier said.

Some research suggests testosterone therapy may increase the risk of heart attack or stroke. In 2015, Rouzier dismissed that concern.

"There's thousands of articles to show protection against heart attacks," he said.But under oath, in that deposition, he was unable to point to any evidence that would back up his claim that his approach to testosterone therapy is safe.

"The problem is that there is no fountain of youth," said Dr. Steven Nissen, a cardiologist at the Cleveland Clinic. Nissen is leading an FDA-mandated study to see if giving testosterone affects the risk of heart attack or stroke in men with low levels."There's no scientific basis for giving hormone therapy to people whose levels are already normal and there's lots of suggestions that it may actually be harmful," Nissen said.

Kinder-Binge is suing 25 Again. The company told CBS News the overall health of their patients is their priority and they make patients aware of any risks. Rouzier declined our request for an interview and did not respond to a list of written questions.

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Oct 15th, 2019 | Filed under Testosterone

Feeling tapped out. Foggy. Just not all that into sex. Gotta be your testosterone, ads would have you believe. And were believing it, too, with the number of T-supplement users tripling from the early 2000s through 2016.

Dont get us wrong: Testosterone is one critical hormone. Babies first encounter it in utero, when it triggers the differentiation of boys from girls. In puberty, it contributes to your bone growth and muscle mass, and continues to affect functions including your red-blood-cell production and mood stability.

But the message those ads are sending plays right into the economic and social anxieties men are facing. Its like when anti-anxiety meds such as Valium first came onto the scene, says urologist and MH advisor Elizabeth Kavaler, M.D. All these middle-aged women were addicted to Valium, because that was the solution to everything. Testosterone has become the new answer for a life of quiet desperation. More and more of us are feeling the exhaustion of uneasiness. We are being asked to do more with less. Were just trying to get through the day alive. Men think, Well, if I just get a little testosterone, Im going to feel great! Dr. Kavaler says. And thats not the case.

Theres so much information out there about Tmuch of it speculation and lorethat leads us to jump to conclusions about it. Men put all kinds of psychological weight on their testosterone numbera low one makes you think youre somehow less manly; a high one means youre basically LeBron Jamesand thats where we get things wrong. Theres little evidence for those stereotypes. Low doesnt automatically imply youre weak or retiring; high doesnt guarantee you muscles, aggressiveness, or MVP athletic performance.

A low number might not even be a low number for very long. It might just indicate that you havent been treating yourself very well. As long as your T is in the normal range, theres nothing about a high number thats better than a low one, or vice versa.

In the name of science and good journalism, I got my testosterone tested twice while writing this story. It put my assumptions up against a pretty big test, too (more on that later).

What do you really know about this famous hormone? Here, we break down the best and latest information to give you the clearest picture yet of what T means for you. And whether, maybe, you should be taking testosterone after all.

As many as 5 million men in the U.S. (generally older men) do actually have low levels of the hormone. To know if your testosterone is low, first see if you have any symptoms, which include: erectile problems, lack of energy (never feeling rested, no matter what you do; having a paunch; an AWOL libido (not just not wanting to have sex on a Thursday night after a crushing week, but lack of the kind of base-level sex drive wherein you get turned on by the sexy person you spot on the street, explains Tobias Kohler, M.D., of the Mayo Clinic).

With testosterone, as with life, normal is nuanced. And fraught (but shouldnt be). To get an accurate reading, you should have at least two tests, since testosterone is constantly in flux. It peaks in the morning, so if youre young and on a typical sleeping schedule, aim to be tested by 10:00 a.m. If youre over 50, it doesnt matter as much.

Be aware that your level can be affected by certain social factors and health habits. In the new book Testosterone: An Unauthorized Biography, scientists Rebecca M. Jordan-Young and Katrina Karkazis point out that T levels even respond to social factors like feedback. For instance, rugby players who watched video of good game plays and got positive feedback had up to a 50 percent increase in T compared with guys who were shown their mistakes and received critical assessments.

Resistance training can also give you a short-term boost in testosterone. Cardio doesnt elevate T levels as much in normal-weight men, says Jesse Mills, M.D., the director of the Mens Clinic at UCLA. But heres the thing: Jordan-Young and Karkazis dug through the research to find that T levels alone dont deserve the credit when it comes to an athletes performance. And cutting sleep short and taking multivitamins with biotin can push testosterone levels down (skip the vitamins for three days before testing).

So get your tests on days that are typical for you. And when you get your number, dont read too much into it. A T level of 264 to 916 nanograms per deciliter of blood is generally considered normal. If you are close to 264 and you feel fine, then youre no less healthy than a guy whose level is 700 and also feels fine. (Theres an exception to that, though: If your T level is below 300 and you have low-T symptoms, then docs would consider you in a low-T category)

Not reading into it is harder than it sounds. I got my first test at the tail end of a busy week. Id slept less than five hours the night before, then scrambled to the phlebotomist in a daze. My number: 287. Thats in the normal range, but just barely. I have no symptoms of low T, but it was hard to shake the feeling that there was something wrong with me, even though I know that normal is normal, no matter where it is in that range. Eleven days later, I was tested again. My number was 429. Why such a dramatic change? It might be because Id slept better and cut out my multivitamins.

Irrational or not, I felt like more of a man. The whole experience was a microcosm of our relationship with T. We act like its destiny, but its just biologyeasily misunderstood and more varied than we think.

The single best thing you can do to improve your level is be healthier. Avoid stress, get more sleep, and lose weightan enzyme in fat tissue converts testosterone to estrogen. Thats one reason flab can lower your T. Its also why overweight guys can develop man boobs, and why bodybuilders who juice can also develop man boobsthey dont have much fat, but theyve jacked their T levels so high that theres a lot of it available to be turned into estrogen. Thinking of T strictly as the male sex hormone oversimplifies the complex hormonal interactions that make our bodies work. Which is also why, if you can avoid it, you dont want to go with the needle-in-the-butt routine to raise your T.

But that might not work. If your level is low enough to warrant more aggressive treatment, your doctor can prescribe a drug that causes your pituitary to tell your gonads to make more testosterone. The typical choice is clomiphene citrate (Clomid), a common fertility drug for women. Using it doesnt exempt you from needing to get healthy, though, as it doesnt diminish the risk of losing T to bad sleep and a beer belly.

Then theres always testosterone-replacement therapy, which should be your last resort. (When you give your body T, it stops making its own, and theres no guarantee it can start again.) If, though, you and your doctor decide its the way to go, youve got options. You can try a testosterone replacement gel, a topical thats easy to use but can rub off on your partner or kids. There are pills, which are even easier to use than the gel and can deliver higher levels. Theres subcutaneous pellets, or rice-sized inserts that live directly under your skin. And then theres that needle in the butt, which can provide a major boost but is generally only used by docs who specialize in testosterone therapies.

Whatever you choose, be glad that weve moved past the early days of replacement therapies, like one in the 1920s that involved transplanting goat testicles into patients. Believe it or not, it didnt work, and it also didnt make anyone feel like more of a man.

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Oct 14th, 2019 | Filed under Testosterone

Gender-affirming hormone therapy is associated with significant differences in body composition and cardiometabolic health between transgender and cisgender youth, according to study results published in The Journal of Clinical Endocrinology & Metabolism.

Previous studies have shown that estradiol treatment for transgender women is associated with a higher incidence of stroke and venous thromboembolism compared with cisgender women and men. The risk for myocardial infarction was found to be higher in both transgender women treated with estrogen and transgender men treated with testosterone compared with cisgender women. Both transgender men and women gained weight on gender-affirming hormone therapy.

As no data are available on adolescents starting gender-affirming hormone therapyand few studies compared the results with cisgender subjects, the goal of the current study was to assess markers of cardiometabolic health in transgender and cisgender adolescents in the United States. The researchers evaluated insulin sensitivity and body composition in adolescent transgender females and males receiving estradiol or testosterone treatment, respectively, matched to cisgender females and males of the same body mass index (BMI) and either age or pubertal stage.

The pilot cross-sectional study ( Identifier: NCT02550431) was conducted between 2016 and 2018 in an academic regional transgender referral center at Childrens Hospital Colorado in Aurora. Transgender youth up to age 21 years were eligible to participate if they had been on either testosterone or estradiol treatment for 3 months.

The study cohort included 19 transgender males matched to 19 cisgender males and 42 cisgender females, 11 transgender females matched to 23 cisgender females, and 13 transgender females matched to 24 cisgender males.

Body composition was measured using dual-energy x-ray absorptiometry in all studies. Insulin sensitivity was estimated by the inverse of the fasting insulin concentration (1/[fasting insulin]), which is correlated with insulin sensitivity measured with a hyperinsulinemic euglycemic clamp.

In transgender males, total body fat was lower compared with cisgender females (29%7% vs 33%7%, respectively; P =.002) and higher compared with cisgender males (28%7% vs 24%9%, respectively; P =.047). Furthermore, they had higher lean body mass compared with cisgender females (68%7% vs 64%7%, respectively; P =.002) and lower compared with cisgender males (69% vs 73%, respectively; P =.029). There were no differences in insulin sensitivity between the groups.

As for transgender females, they had lower BMI compared with cisgender females (31%7% vs 35%8%, respectively; P =.033), and higher lean body mass (66%6% vs 62%7%, respectively; P =.032). Compared with cisgender males, transgender females had higher BMI (28%6% vs 20%10%, respectively; P =.001) and lower lean body mass (69%5% vs 77%9%, respectively; P =.001). Transgender females were more insulin resistant compared with cisgender males (P =.011).

The researchers acknowledged several study limitations, including cross-sectional design, lack of available matched subjects for all patients, and small sample size.

Based on the results of this pilot study, further exploration is needed to understand the impact of starting testosterone or estradiol treatment in adolescence, with or without prior pubertal blockade, on short- and long-term cardiometabolic health, concluded the researchers.

Disclosure: Natalie J. Nokoff disclosed previously consulting for Antares Pharma, Inc.


Nokoff NJ, Scarbro SL, Moreau KL, et al. Body composition and markers of cardiometabolic health in transgender youth compared to cisgender youth [published online September 23, 2019]. J Clin Endocrinol Metab. doi:10.1210/clinem/dgz029

This article originally appeared on Endocrinology Advisor

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Oct 14th, 2019 | Filed under Testosterone

The end of the Oregon Project is the latest development in a stunning downfall for Salazar and a fissure in one of the longest professional relationships of his life. Salazar has had a close relationship with Nike since he migrated to the Pacific Northwest from Massachusetts as a teenager to attend and run for the University of Oregon, alma mater of the Nike co-founder Phil H. Knight. Knight started the company that would become Nike with the famed Oregon coach Bill Bowerman shortly after graduating from Oregon, where he was a member of the track team.

Nike sponsored Salazar as a professional, when he won three consecutive New York City Marathons and became the worlds top distance runner. His running career cratered in the mid-1980s as he battled injuries and depression. Salazar later became a sports marketing executive with Nike, and in 2001 founded the Oregon Project. The venture emulated other elite training groups that were popping up at the time, notably the Mammoth Lakes, Calif.-based Team Running U.S.A., but with far more money, access to Nikes scientific research labs, and with Americas best-known distance runner at the helm.

The biggest stars of the Oregon Project were Galen Rupp, an Oregonian Salazar discovered when he was a teenage soccer star, and later, Mo Farah, the Somali-born Briton, who won four Olympic gold medals and then left the Oregon Project in 2017. Both Rupp and Farah have denied using performance enhancing drugs. Even as those stars succeeded,others left the Oregon Project dispirited, their bodies broken and their minds damaged by Salazars intense workouts and coaching style.

For more than a decade the Oregon Project operated largely in secrecy. The wall of silence began to break 10 years ago, when a Nike scientist called USADA to report suspicious testosterone levels in blood tests of Oregon Project athletes.

Three years later, an Oregon Project scientist and coach, Steve Magness, left and began to speak publicly about experiments with testosterone and L-carnitine infusions that were in excess of antidoping limits.

Kara Goucher, the former Olympian who trained with Salazar for seven years, spoke of how Salazar pushed athletes to take prescription drugs that were unnecessary but had side effects that might prove beneficial to endurance athletes. In testimony at his arbitration hearing, Salazar acknowledged distributing prescription drugs.

I was a part of a culture that was so manipulative and so controlling and so wrong, Goucher said in an interview last week. Your entire life is dependent on the power of this brand.

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Oct 14th, 2019 | Filed under Testosterone

John Richard Schrock


The U.S. Supreme Court recently heard the case of workers who were fired for being gay or transgender. Reference was made to the biological basis of sex being one simple determination: the sex assignment made at birth based on anatomy.

This simple-minded concept was abandoned by biologists by the 1950s. The biological science of what was generalized as sex is today known to involve many factors: anatomy, chromosomes, hormones and hormone levels, and brain differentiation that determines both sexual attraction and gender identity.

Sometimes the doctor in the delivery room cannot proclaim Its a boy! or Its a girl because the anatomy does not always develop properly. Development can be abnormal, as most folks understand in cases of babies with cleft-palate and other deformities. For such rare newborn infants with ambiguous genitals, medical specialists must determine the sex and use corrective surgery.

One important indicator is chromosomes. Generally, among our 23 pair of chromosomes, boys will have an XY pair and girls will have an XX pair that can be seen when cells are treated and placed under the microscope. However, sometimes a person inherits extra chromosomes and is XXY, XXX, XYY, etc. The sex-determining region (SRY) on the Y-chromosome triggers the fetus to develop as a boy. Absent this Y-chromosome, an individual develops as a girl. Thus, a person with only one X-chromosome and lacking the Y, will develop as a female.

Hormones are likewise very important and vary in concentration. While testes in males produce testosterone, so do the adrenal glands that both men and women possess. Ovaries produce estrogens, but so do fat tissues in both men and women. Therefore, normally men have high testosterone and low estrogen levels while women have high estrogens and low testosterone levels.

But the amount of fat tissue varies. Women depend on a base level of estrogen from some fat plus the variations in estrogen from the ovaries in order produce the regular monthly cycles. But in times of starvation, the lack of fat lowers that baseline of estrogens so that eggs are not released and pregnancy does not occuran excellent protective system when food is inadequate. And female Olympic runners who exercise to the point of having essentially no fat also shut off their reproductive cycle. And as thin women go through menopause and the ovaries stop producing most estrogen, the testosterone from their adrenal glands may be enough to begin growth of a mustache.

Boys with substantial fat will have higher estrogen levels that may in turn result in less vocal cord development and therefore a higher voice, as well as less body hair, etc. The size of a persons body as they grow up can dilute down or concentrate the level of these sex hormones. So there is a wide variation in hormone effects among the people we meet everyday, and which we largely ignore.

On rare occasions, a baby is born appearing to be a normal girl by external anatomy, and with all female structures developed inside as wellexcept there are testes rather than ovaries! And every cell in her body is XY! She had the testes-produced testosterone that should have produced a boy. But for hormones to have an effect, the cells in a babys body must also have the receptors on their surface to detect the hormone. Without those receptors, the testosterone just flows by in the bloodstream and is ignored. The cellsnot detecting the male hormonedeveloped into a female baby.

Testosterone and estrogens also affect brain development. A California researcher injected testosterone into a pregnant hamster and the resulting female baby hamsters all grew up to behave like males although they were female. He then located a region of the hypothalamus in their brains that was normally different between males and females, but had been changed by the prenatal injections so that the female hamsters acted male. Dr. Swaab in the Netherlands found the same sex differences in human brains (the INAH3 subnucleus) that had been donated after death. In the case of transsexuals, this brain area corresponded to how the child felt gender-wise at about age 6, regardless of opposing chromosomes and anatomy. But this brain region that determined whether the child felt masculine or feminine is not related to sexual attraction, making gender identity and sexual identity different.

Bottomline? What we used to simply call sex is determined by many factors: anatomy, chromosomes, hormones and hormone levels, and brain differentiation that determines both sexual attraction and gender identity. These should all align, with XY producing male anatomy and testosterone and a brain that feels masculine and is attracted to females, and XX producing female anatomy and estrogens and a brain that feels feminine and is attracted to males. Most students who understand this complexity sigh with relief that all of this biology aligned for them. But this complex sexual biology does not align for everyone. That requires our understanding, not simplemindedness.

John Richard Schrock has trained biology teachers for more than 30 years in Kansas. He also has lectured at 27 universities in 20 trips to China. He holds the distinction of Faculty Emeritus at Emporia State University.

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Oct 14th, 2019 | Filed under Testosterone

Sleep is a hot commodity for nearly everyone. Theres never enough time to get the proper amount of it, and Philadelphia 76ers forward Tobias Harris sees it as the looming problem in the NBA.Via ESPN:

"I think in a couple years," he says, "[sleep deprivation] will be an issue that's talked about, like the NFL with concussions."

Despite the leaguechanging around its scheduling procedures, players still arent getting the proper amount of sleep and it may be taking a toll on their performance, injury rate and long-term health. ESPNs Baxter Holmesdetailed the issue in a feature out Monday.

Dr. Charles Czeisler, the director of sleep medicine at Boston's Brigham and Women's Hospital and Harvard Medical School, said professional athletes are not immune from the public health problem of insufficient sleep.He told ESPN that players hes talked to sleep on average five hours a night, and some very famous ones have told him its more like three to four hours for them. With a pre-game nap, its approximately six hours of sleep per 24-hour cycle. But naps dont allow the brain to fully cycle through the stages of sleepand it is not as good as overnight sleep.

Young adults ages 18 to 25 and adults ages 26 to 64 are recommended to get seven to nine hours of sleep a night,per the National Sleep Foundation. The foundationrecommends having a strict sleep schedule(for example, always go to bed at 10:30 p.m. and wake at 6:30 a.m.), but its impossible for NBA players to do that.

Tobias Harris thinks sleep deprivation will become a huge issue in the NBA. (Photo by Michael Reaves/Getty Images)

Timothy Royer is a neurologist specializing in attention disorders, sleep management, stress and anxiety. He joined the Orlando Magic in 2012 as a consultant and began traveling with the team. Its when he noticed the inherent struggles in the schedule and travel responsibilities, per ESPN.

He views the NBA players schedules as a form of shift work,per ESPN,that goes beyond the struggle of working a graveyard/overnight shift a few nights a week. Unlike people who can stay on a daily schedule for the most part around their shifts, NBA players cant stick to a regimented daily schedule due to vastly different tip-off times. Going across time zones constantly makes it even worse.

"There's not a factory on the planet," Royer told ESPN, "that would move shift workers the way we move NBA players."

The time zone travel throws off circadian rhythms, the natural, internal 24-hour process that determines sleep and awake cycles. The World Health Organizations International Agency for Research on Cancer classified shift work with circadian disruptionas a probable human carcinogen. It impacts mainly emergency medical workers, military personnel, law enforcement and pilots. Studies found the casual link between shift work andcancer is biologically plausible,but more work is needed.

Basketball is also unlike almost all other professional sports. Baseball players almost always play games at 7 p.m. local time, with a few afternoon games. When they travel time zones, they stay in one spot for two to three days. In the NFL, there is one game a week and the rest of the week is almost always spent at home where they can settle into a schedule.

New England Patriots quarterback Tom Bradycredited a good start to more sleep, thanksto Sunday afternoon games theyre not typically afforded.

Royer and his team tested testosterone levels and found vast reductions over the course of a season. In the study, which is not a double-blind, peer reviewed one per ESPN, testosterone levels dropped 64 percent in five months. They found similar results in employees who travel with the organization, leading them to believe it isnt about playing too much.

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He then had it analyzed against injury data and found there was a statistically significant increase in risk" when testosterone levels dipped far enough.

Phyllis Zee, chief of sleep medicine at Northwestern Universitys Feinberg School of Medicine, said sleep deprivation affects all of the bodys organs. Think about it as punching your other organs, Zee told ESPN.

For anyone, chronic sleep loss can have devastating consequences. It can lead topublic safety issues as well as obesity, diabetes, heart disease and a shorter life expectancy,per the Division of Sleep Medicine at Harvard Medical School.

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Oct 14th, 2019 | Filed under Testosterone

The globalmarket for testosterone replacement therapyis characterized by the presence of a large number of small and large scale manufacturers. All of the manufacturers have been steadfast in filling the meagre market gap in order to enhance their prospects of growth. Furthermore, research and development has been the central characteristic of al the market players operating in the global market.

In 2015, it was found that 80% of the total market share was held by the top five market vendors with AbbVie Inc. taking the lead. The large scale vendors are focusing on establishing an iconic brand for their product by resorting to rigorous marketing and advertising tactics. The smaller companies are expected to concentrate on capturing the local and regional markets to sustain themselves in the current scenario of stiff competition.

A negative implication for the leading market players in recent times has been the loss of patents for their products. This has not only plundered them of revenues but has also affected the workflow of these companies. The market players are expected to launch awareness campaigns about testosterone replacement therapies in order to educate and inform the consumers. Hence, the market for testosterone replacement therapies is expected to witness the emergence of several new trends and opportunities over the forthcoming years. Some of the key players in the global testosterone replacement therapy market include Bayer AG, Endo Pharmaceuticals, Inc., Novartis AG, and Allergen plc.

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The CAGR for theglobal testosterone replacement therapy marketis estimated to be -4.20% over the period between 2016 and 2024. The negative growth rate of the global market is expected to take the market value from US2.0 bn in 2015 to a decreased value of US$1.3 bn by 2024-end.

High Incidence of Hypogonadism to Drive Market Demand

Research studies suggest that around 30% of all men suffer from testosterone deficiency, which has driven demand within the global market for testosterone replacement therapy. Furthermore, the population demographic of men in the age range of 40-79 years is more likely to suffer from testosterone deficiency. The need for mutation or having an offspring amongst men in the aforementioned age range has driven demand within the global market. Moreover, the geriatric population has been on a rise, which underhandedly contributes to market growth. Several campaigns aimed at educating people about the benefits of testosterone replacement therapy have been an important propeller of demand within the global market. It is anticipated that more people suffering from testosterone deficiency would resort to these therapies over the coming years.

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Side Effects of Testosterone Replacement Therapy Could Obstruct Market Growth

Despite the rising awareness amongst the masses about the advantages of testosterone replacement therapies, the market growth is hindered by the apprehension of the people. The chances of developing metabolic disorders are higher in men who undergo testosterone replacement therapies. Furthermore, the risk of developing cardiovascular diseases also discourages people from resorting to testosterone replacement therapies. The FDA has also cautioned people about the use of such therapies by issuing strict warnings, which has further obstructed the growth of the global market.

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Oct 14th, 2019 | Filed under Testosterone

When the headline on the front page of the Financial Times declares capitalism needs a reset, there must be something wrong. But why has our economy become so rapacious and unsustainable?

Economist Gerald Epstein locates the blame in the way in which financialisation has transformed the global economy. Financialization and the World Economy, edited by Epstein, shows how financial motives, financial markets, financial actors and financial institutions have come to colonise every area of economic activity, resulting in the capture of our political and economic institutions by a tiny elite. Since the 1970s, economic growth in most advanced economies has benefitted the rentier class those who make their money from lending, investment and property (in other words, organised extraction) substantially more than working people.

The journalist Joris Luyendijk explores the psychology of the rentier in Swimming With Sharks, asking how bankers in the City of London could live with themselves after the crash of 2008. Most of the testosterone-fuelled traders he interviewed were not only free from guilt, they were actively seeking out new financial innovations that could help them evade the spirit of post-crisis regulation. The amoral culture of the City is not a natural outgrowth of human nature, Luyendijk concludes, it emerges from the structure of the loosely regulated, opaque and unaccountable banking industry itself.

This acquisitive culture extends far beyond the Square Mile. John Lanchesters novel Capital follows inhabitants of Pepys Road a fictional residential street in London in the run up to the financial crisis. Many of the characters become caught up in the delusion of thrift, believing that they have amassed unimaginable wealth through their own hard work and smart investments, when in fact they are simply living through the tail end of a financial boom. Like so many others, residents of Pepys Road released the equity from their houses for home improvements without anticipating what would come next.

In the spirit of JM Keynes who famously called for the euthanasia of the rentier many would have us believe that the rentiers rise represents a perversion of an otherwise well-functioning capitalism. The reality is far more complex. Tony Norfields The City draws on the work of the Marxist economist Rudolf Hilferding to assert that the growing dominance of finance in the global economy is not an aberration of an otherwise sound model, but a result of the development of capitalism. If you do not like finance but have no problem with the capitalist system, you ought to think a little more, since the two are inseparable, Norfield argues.

Nowhere is this clearer than in politics. Capitalism is, after all, not simply an economic system, but a social and political one, too. As Astra Taylor observes in Democracy May Not Exist But Well Miss It When Its Gone, the principles of democracy solidarity, interdependence and community have been corrupted by the logic of financial capitalism: greed, exploitation and ruthless competition. As the elite uses its power to tilt the rules of the game to its advantage, Taylor calls for a radical rethink not just of capitalism, but of democracy. The only way to solve the crisis in capitalism is for the interests of those who live from work to trump those of people who live off wealth.

Grace Blakeley is the author of Stolen: How to Save the World from Financialisation (Repeater).

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Oct 14th, 2019 | Filed under Testosterone

For the first time, a global consensus positionstatementon use of testosterone therapy for women with low sexual desire has been published in various medical journals. The statementwhich is completed and should be read in its entiretywas prompted because of the uncertain benefits and risks of treating women with testosterone. In many countries, the therapy is prescribed off-label, using either testosterone formulations approved for men with dose modification, or as compounded therapies.

There is a need to delineate, based on available evidence, when a trial of testosterone therapy is appropriate, to enable women who might benefit to be treated, and equally when it is inappropriate to protect women against inappropriate treatment, said lead author Susan Davis MBBS, FRACP, PhD, FAHMS, president of the International Menopause Society and chair of Women's Health at Monash University in Melbourne, Australia.

Dr. Davis toldContemporary OB/GYNthat testosterone therapy is effective in women with low sexual desire that causes them distress, as long as their blood levels are within the normal premenopausal range.

There is currently no other clinical indication for testosterone therapy for women, according to Dr. Davis.

In such women, there is no evidence of serious adverse events, she said. Few women will experience an increase in hair growth or acne, and when either occurs the effects are mild.

Therapy does not cause alopecia, clitoromegaly or voice change. However, the safety of long-term testosterone therapy has not been determined.

The recommendations are based on findings from blinded placebo/comparator randomized clinical trials (RCTs) of at least 12 weeks duration of reported outcomes. The authors noted that the diagnosis of hypoactive sexual desire disorder/dysfunction (HSDD) should include a full clinical assessment. Other factors contributing to female sexual dysfunction (FSD) must also be identified and addressed before beginning testosterone therapy. But a blood total testosterone level should not be used to diagnose HSDD.

Treatment of HSDD should be limited to testosterone formulations that achieve blood concentrations of testosterone that approximate premenopausal physiological concentrations. Given the absence of any approved female product by a national regulatory body, male formulations can be judiciously used in female doses, but blood testosterone concentrations must be routinely monitored.

The statement recommends against using compounded testosterone. Inaddition, data are insufficient on which to base a recommendation for use of testosterone in premenopausal women to treat sexual function or any other outcome.

Conversely, testosterone therapy does not increase mammographic breast density nor does short-term transdermal testosterone therapy impact breast cancer risk. However, data from the RCTs are insufficient to gauge long-term breast cancer risk.

But there is strong evidence in the literature that appropriate testosterone treatment benefits sexual function, with an average of one satisfying sexual event per month and increases in the subdomains of sexual desire, arousal, orgasmic function, pleasure and sexual responsiveness, along with a reduction in sexual distress.

It is our hope that our global consensus statement will encourage regulators to approve a testosterone formulation for women, Dr. Davis said.

The statement also advocates more research on testosterone therapy for women, plus developing and licensing testosterone products indicated specifically for women.The position statement has been endorsed by more than a dozen leading societies, including the International Menopause Society, The Endocrine Society, The European Menopause and Andropause Society, and The International Society for Sexual Medicine.


Susan Davis receives honoraria from Besins Healthcare and Pfizer Australia. She is also a consultant to Que Oncology.

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Global consensus statement on using testosterone therapy for women - Contemporary Obgyn

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Oct 7th, 2019 | Filed under Testosterone