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The quest for longevity is going mainstream. People are taking ice baths, fasting, and undergoing hormone therapy to stave off aging. kentoh/ Getty Images

Source: Insider

There is a growing body of scientific evidence that supports cold exposure as an anti-aging hack.

Whether you take a plunge into a pool of ice cold water, or try cryotherapy which involves spending a few minutes in a below freezing chamber cold exposure has benefits that may help slow down the clock.

Dr. Anant Vinjamoori, Chief Medical Officer of Modern Age,aNew York-based healthcare company focused on longevity,told Insider that cold exposure produces effective results in the short and long term.

A plunge into an ice cold bath results in "a surge in the production of neurotransmitters such as epinephrine and dopamine" which have immediate rejuvenating and energizing effects, he said.

"Over the medium to long term, there is some evidence that cold exposure may reduce systemic inflammation, which is known to be a driver of many chronic diseases," Vinjamoori added.

In 2019, Jack Dorsey said that he only eats one meal a day and fasts all weekend which might be bordering on an eating disorder, experts say.

However, research does suggests that time-restricted eating patterns can result in health benefits for those with diabetes and obesity or even enhance the body's defenses against oxidative stress.

"For me, the primary benefit of time-restricted eating is regulating circadian rhythms. Sleep quality almost always improves by limiting the consumption of calories in the evening hours," said Modern Age's Dr. Vinjamoori.

Red light therapy uses LED lights or lasers to expose the body to red light the longest wavelength of light on the visible spectrum. There is research to suggest that exposing oneself to red light for 5 to 20 minutes may increase production of adenosine triphosphate, which is a compound that provides and stores energy for the cells.

"While more research is needed to understand the full benefits and mechanisms of red light therapy, there is evidence to suggest it may be beneficial in improving certain skin conditions including acne, aging, hair loss, wound care, and sun damage," dermatologistLaura Bufordpreviously told Insider.

Nicotinamide Mononucleotide, or NMN, is a supplement that can help boost levels of a criticalcoenzyme in the body called NAD+.

NAD+ plays an important role in facilitating metabolic processes and maintaining healthy cellular function.

Harvard Medical School professor David Sinclair who has studied the relationship between NAD+ and aging saidin an interview with the YouTube channel Reverse Aging Revolution that the human body uses NAD+ as "a measure of adversity."As humans get older, NAD+ levels decrease, which mean the body's defense enzymes and repair enzymes take a hit and humans "succumb to aging" Sinclair said.

Since NAD+ is a large molecule, it's difficult to take it directly. Sinclair recommends taking its building blocks like B3, Nicotinamide riboside (NR) or NMN.

"What we've discovered in people, in clinical trials, is that the closer you get to the NAD itself, the better the boost in NAD that you get," Sinclair said, which is why he recommends NMN.

Ashwagandha is an herb that's long been used for anti-aging in Ayurveda, an ancient system of holistic medicine originating in India.

The herb, often classified as an adaptogen, has a host of health benefits that range from easing anxiety and stress to soothing arthritis to boosting cognitive function. Modern Age's Dr. Vinjamoori said that ashwagandha has been shown in research studies to reduce cortisol, a hormone associated with stress, and improve sleep in people without insomnia.

Recent research has also shown that ashwagandha could be a promising agent in anti-aging treatments. A study published in the Journal of Clinical Medicine in 2020 found that ashwagandha may help maintain the length of the key proteins at end of chromosomes known as telomeres. Telomeres are often shortened in the process of DNA replication which has been pointed to as the main factor that "speeds up cell ageing and promotes degeneration processes" the study noted.

Metformin, a pill prescribed for diabetes, is increasingly being used by biohackers as a way to improve how humans age, and slow the onset of diseases like cancer, cognitive decline, and vision loss, Insider reported.

The drug helps regulate blood sugar and decrease appetite, essentially giving the metabolism a boost and stimulating a cellular clean-up process known as autophagy, Insider reported.

In his book Lifespan, Harvard professor David Sinclair, said he takesa gram of metformin every morning along with his yogurt in the hope that it will regulate his metabolism and help his organs remain younger and healthier, Insider reported.

OpenAI CEO Sam Altman also said his personal anti-aging regimen includes metformin.

The body's balance of hormones can shift with age and spur a variety of age-related conditions like weight gain, mood swings, fatigue, and lower sex drive, two longevity focused doctors told Insider.As a result, they've seen an increasing patient interest in hormone therapy.

Modern Age's Dr. Vinjamoori told Insider that testosterone replacement has gained popularity among men and women as its become clear that optimal testosterone levels can impact mood, libido, and even metabolism.

"The importance of testosterone for women, in particular, is underappreciated testosterone is actually the most abundant hormone in a woman's body and is the first hormone to decline with age," Vinjamoori told Insider.

It's not just testosterone, but also sex hormone like estrogen and progesterone that are being sought out by patients. Vinjamoori said the options for hormone therapy range from pills to creams to patches to pellets. "The approach can be highly personalized to you and your needs."

Rapamycin is immunosuppressive drug used to help treat some cancers. It's also used in kidney transplants to help the an organ recipient's body accept new kidneys, Insider reported.

The pill can slow down cellular growth and reproduction which means it might be a way for "aging bodies turn down troublesome age-related inflammation" which can contribute to age-related diseases like cancer and Alzheimer's, Insider reported.

Insider reportedthat researchers have already seen rapamycin slow aging in flies, crustaceans, yeast, mice. In humans, studies have shown that it may help improve immune function, especially in older adults, Insider said.

Despite its potential to be a "fountain of youth" no one has really nailed down the right way to regulate the drug for aging, Insider said.

MattKaeberlein, a longevity researcher studying rapamycin's effects on humans, previously told Insider "the doses that people are taking off-label are all over the place," adding that, "it's the wild west."

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Anti-aging trends are sweeping the nation: Experts weigh in - Business Insider

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Mar 21st, 2023 | Filed under Testosterone

MONTPELLIER, France Penile rehabilitation is a measure for secondary prevention. The aim is to prevent erectile dysfunction (ED) from becoming chronic once it has occurred or been diagnosed after a critical episode. Is the concept of penile rehabilitation after radical prostatectomy, where it has been most studied, applicable to other populations? Stphane Droupy, MD, urologist and andrologist at Nimes University Hospital in France, addressed this question during the French-language conference on sexology and sexual health.

Prostate cancer is emblematic of diseases that cause sexual disorders, particularly ED. Could diseases that affect other organs that are less commonly associated with these conditions also benefit from rehabilitation of this type?

Penile rehabilitation involves early treatment of ED post-radical prostatectomy. Its aim is to improve the quality of erections during the recovery period (around 2-4 years), providing, of course, a nerve-sparing technique has been used, as well as to allow the patient to resume his sex life during the postoperative period and, perhaps, to avoid permanent aftereffects. The concept has been developed over the years, with intracavernous injections (ICI) only starting to be used regularly in the late 1990s, daily phosphodiesterase 5 inhibitors (PDE5Is) over the long term, and comprehensive integrated care (PDE5I, ICI, vacuum therapy, sex therapy, supplements to treat testosterone deficiency).

"Even now, 25 years after the first article was published on this topic, there is still no global consensus on the protocol for penile rehabilitation," Droupy acknowledged. What we do know is that, regardless of the technique, the outcome depends on the time and quality of the vascular-nerve sparing, with erection recovery between 30% and 85% in cases of bilateral preservation, and 15% to 55% for unilateral preservation.

To date, research into drug-based recovery post-prostatectomy in clinical practice has not yielded convincing results, probably in part because most studies do not last longer than 9 months. One study lasting 18 months suggests that a proactive attitude is beneficial, with quantitative and qualitative improvements seen in nonpharmacologically assisted erections (52% of patients in the rehabilitation group vs 19% of patients in the nonrehabilitation group).

The efficacy of PDE5Is (sildenafil/Viagra) was better in patients who had followed a rehabilitation program (64% vs 24%). How early this rehabilitation began is important. Immediate treatment with sildenafil 100 mg (prescribed for 3 months) gives better results than sildenafil 100 mg started 3 months post-operatively (for 3 months), in terms of erection quality at 12 months (41.1% vs 17.7%).

"A multitude of factors affect recovery," said Droupy. "The determining factor for the quality of erection postoperatively (rehabilitation with tadalafil [Cialis] 5 mg for 9 months) is patient satisfaction with his sexual relationships prior to surgery, the use of a robot-assisted device during the procedure, and nerve sparing."

Sexual function is significantly worse after brachytherapy, especially if it has been used in conjunction with chemical castration and radiotherapy.

All prostate cancer treatments impact a patient's sex life, especially the quality of his erection. In one publication, "radiotherapy teams tested rehabilitation, with the use of daily PDE5Is over 6 months (sildenafil 50 mg/day vs placebo, 2:1) in 279 patients," said Droupy. After 24 months, 81.6% of men on sildenafil and 56% of men taking a placebo reported functional erections with or without treatment (P = .045). "There was no difference between treatment with brachytherapy and with radiotherapy. In fact, during the recovery period, erections are better in subjects taking sildenafil, but once the medication is stopped, the quantity and quality of erections are similar for all men. So, this study doesn't prove the utility of penile rehabilitation, despite its positive conclusions."

Another study conducted with tadalafil was no more successful in preventing ED becoming a chronic condition.

Finally, in 2015 the UK's radiotherapy society came out in favor of early penile rehabilitation with PDE5Is, psychotherapy, use of vacuum therapy, et cetera.

"To sum up, although it's difficult to prove the concept of penile rehabilitation, we still think it's better to let patients benefit from it," said Droupy.

Regarding penile rehabilitation after cystectomy, a comparative study of 160 patients having undergone cystectomy, with or without nerve preservation, tested no treatment vs treatment with PDE5Is alone, intracavernous injections alone, and the combination of PDE5Is and ICIs. "Overall, the different solutions for rehabilitation do little more than nothing," said Droupy, "and the main condition for hoping to recover satisfactory erections is still nerve preservation."

Two relatively recent studies (with sildenafil and udenafil) seem to point toward a small benefit of penile rehabilitation after rectal cancer, a disease with a huge rate of sexual dysfunction, but this benefit remains to be proven. And with few studies, low sample numbers, and studies of only a few months' duration, demonstrating this benefit is not easy.

After a cerebrovascular accident (CVA), no study has focused on a pharmacologic-based intervention.

The usefulness of penile rehabilitation is slightly better documented following a pelvic fracture. The rate of ED is estimated at 35%, at 48% for patients with a bladder injury, and 58% for those with urethral rupture. A study published in 2022 somewhat supports the utility of such rehabilitation via the use of PDE5Is.

Finally, after myocardial infarction (MI), for which the rate of ED fluctuates between 50% and 79%, improvement of erectile function is evidenced by the resumption of physical activity (here, walking for 60 minutes, 4 times per week). The authors noted that PDE5Is were associated with reduced mortality in patients with a stable ischemic heart condition, as well as in those who had recently had an MI. Randomized studies are needed to better understand how PDE5Is function post-MI.

"Finally, there are very many indications for penile rehabilitation, since the critical episodes at the root of the ED or leading to its diagnosis are varied," said Droupy, "like the different types of cancer in a relatively comprehensive way (although there are no studies in lung cancer patients), including those treated with chemotherapy, radiotherapy, immunotherapy, hormone therapy, or surgery, but also CVAs, MI, various types of ischemic accident, neurological accidents, pelvic fractures, decompensation of chronic conditions (diabetes, kidney or respiratory failure), following admission to an intensive care unit (in the form of a drop in testosterone levels), and even COVID-19."

The specialist recommends recognizing the symptoms, assessing them, informing patients, and establishing a comprehensive rehabilitation plan. This plan includes the improvement of communication and the relationships between couples and within the workplace; reducing alcohol use; increasing physical activity; stopping smoking; reducing salt intake; reducing blood pressure; managing diabetes and reducing BMI levels; and evaluating cardiovascular risk and, therefore, reducing and treating risk factors without forgetting to investigate any possible iatrogenic drug-induced cause.

"Following a critical event, physicians should look for signs of ED," said Droupy, "and put in place a structured multidisciplinary treatment plan (therapy, an appointment with a sexual medicine/sexology specialist). If, according to the evidence-based medicine, drug-based rehabilitation over a period of 6-9 months with PDE5Is does not result in a significant improvement in maintaining erectile function at the end of treatment, early and extended treatment must be put forward and adapted at the request of the patient or couple. Finally, testing should be done to determine any testosterone deficiency, including in patients with prostate cancer."

This article was translated from the Medscape French Edition.

For more news, follow Medscape on Facebook, Twitter, Instagram, YouTube, andLinkedIn

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Mar 21st, 2023 | Filed under Testosterone

When it comes to herbs with applications in sports nutrition, the skys the limit. However, given the plethora of options, Im going to limit my discussion to three evidence-based herbs: ashwagandha, citrus bergamot, and shilajit.

Ashwagandha Extract

Ashwagandha (Withania somnifera) is an extremely popular adaptogenic herb in the dietary supplement industry and has been used in Ayurvedic medicine1 for over 3,000 years. Specific to sports applications, studies have shown that ashwagandha extract may be capable of increasing testosterone levels in men by about 15%-17%.2,3,4 This is significant given testosterones well-established role in building and maintaining muscle. Additional research has also shown that ashwagandha extract may increase muscle size and strength more than exercise alone, while helping to reduce body fat percentage by double compared to exercise alone.4 Likewise, ashwagandha extract has been successfully tested5 to enhance cardiorespiratory endurance (measured as maximal oxygen uptake, or VO2max) and improve self-assessed quality of life in healthy athletic adults. These cited benefits only scratch the surface of the expansive body of research on the health, wellness, and fitness value of ashwagandha extract.

Citrus Bergamot

Overwhelming scientific evidence indicates that bergamot polyphenolic fractions (BPF) from citrus bergamot fruit are responsible for the majority of the botanicals pharmacological effects.6 Among these effects is increasing nitric oxide (NO) levels which has value in the world of sports since NO can impact muscular pump, a term used in bodybuilding circles to describe the sensation of tight congestion, or swelling, of your muscles with blood coursing through them during weight-training sessions.7

A randomized, placebo-controlled study8 evaluated the effects of 4 weeks of BPF supplementation (650 mg twice a day for 4 weeks) on serum NO and other parameters. Results were that BPF significantly increased baseline NO levels and VO2max.


Also part of the Ayurvedic tradition, shilajit is an exudate secreted from sedimentary rocks (largely in the Himalayas) composed of rock humus and organic substances that have been compressed by layers of rock mixed with marine organisms and microbial metabolites.9 Shilajit has been shown in research10 to increase testosterone levels by 20.45% and free testosterone by 19.4%, increase exercise time by 9%-13%,11 and increase levels of adenosine triphosphate (ATP; the bodys energy currency) by 14%12 in healthy active volunteers.


While there are many excellent herbs which can be used in sports nutrition, ashwagandha extract, citrus bergamot, and shilajit are three of the very best, with solid scientific evidence to support their benefits for promoting fitness applications.

About the author

Gene Bruno, MS, MHS, RH (AHG), is a certified nutritionist and registered herbalist with more than 40 years of dietary supplement industry experience. With a masters degree in nutrition and a second masters degree in herbal medicine, he has a proven track record of formulating innovative, evidence-based dietary supplements. Bruno currently serves as both the vice president of scientific and regulatory affairs at NutraScience Labs (Farmingdale, NY) and professor of nutraceutical science at Huntington University of Health Sciences.


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Top herbs in sports nutrition - Nutritional Outlook

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Mar 21st, 2023 | Filed under Testosterone

What You Need to Know About the Relationship Between Sleep and Sex

Both sleep and sex are important for your health and well-being. But most people dont realize that one affects the other the quality of your sleep can determine the quality of your sex life, and vice-versa. For example, research shows that sleep disorders increase the risk of erectile dysfunction. And you know how having an orgasm can make you drowsy? Its due to the release of certain hormones.

Sleep and sex go hand in hand. Both are important for physical, mental, and emotional health and well-being, and problems in one often contribute to problems in the other, says Sarah Melancon, PhD, sociologist and clinical sexologist at Sex Toy Collective. Melancon previously worked in a sexual health clinic that included both sexual dysfunction and sleep programs. Frequently, sexual dysfunction patients also had sleep disturbances this is no coincidence.

RELATED:The Best Sleep Aids for aDeeper, Most Restful Sleep

Understanding the relationship between sleep and sex can help you improve your habits to optimize these two key areas of your lifestyle. Heres what you need to know.

Sleep is a restorative time that regulates the endocrine system, which produces our sex hormones, according to Melancon. For example, testosterone is an important sex hormone for men, fueling sex drive. Sleep affects the natural rhythm of your testosterone levels and can thus affect your sexual health and libido. Research has shown that sleep loss reduces testosterone levels in males. Testosterone works partly in alignment with our circadian rhythm, peaking in the morning and falling throughout the day. In particular, REM sleep is important for testosterone synthesis and appears associated with nocturnal erections, adds Melancon.

So, if you suffer from insomnia or dont get enough quality sleep, it can have an impact on your ability to crave sex and perform in the bedroom partly because of the link between sleep and testosterone, but also because of other factors. For instance, one study found a significant connection between insomnia and sexual dysfunction. According to the researchers behind the study, stress may be to blame, as being stressed may not only cause sleep disturbances, but can also negatively affect sexual function.

Sleep apnea is a potential disruptor as well: several studies have found a link between sleep apnea and erectile dysfunction. The takeaway? Sleep hygiene matters more than you think when it comes to your sex life.

Now that you understand how sleep can affect sex, lets consider how sex can affect sleep. The most important thing that you need to know is that an active sex life can improve the quality of your sleep.

If you have found yourself drowsy and uncontrollably sleepy after sex, it is normal. When a man reaches ejaculation, various chemicals are released from the brain, including prolactin, vasopressin and oxytocin. Prolactin is a hormone present in sleep and is also linked to sexual satisfaction in men. When you have sex, the orgasms from intercourse releases prolactin four times more than prolactin released during masturbation, according to Nicole Eichelberger, a BSM-certified sleep experts specializing in insomnia, apnea, and circadian rhythm disorders and a consultant at Mattressive. According to her, during sex, your levels of cortisol the stress hormone also drop. As she puts it, sex can positively affect a man's life, as a man with an active sex life sleeps better.

Theres an interesting other side of the coin sexual frustration, which can increase stress and interfere with a good night of sleep. Sexual frustration may be conceptualized as sexual tension plus a lack of satisfying release, accompanied by feelings of stress, anxiety, or even anger all of which interfere with sleep, says Melancon.

To recap the information above, sleep disturbances can cause problems in the bedroom, yet having sex can improve your sleep. Its a bit of a vicious cycle, but you can take steps to turn it into a virtuous one and improve both your sleep and sex life.

The first order of business is aiming to get a full nights sleep every night longer sleep is associated with healthy testosterone levels, according to Melancon, who recommends living in accordance with your natural circadian rhythm to help you get there. How? Go to bed early and awake around sunrise. Get early-morning and midday sunlight on your skin and in your eyes (without glasses). Use blue light-blocking glasses in the evening and red glasses an hour before bed to stimulate the release of melatonin, which helps you feel sleepy. TrueDark is a good brand, says Melancon.

Exercise is also crucial, as it improves both sleep and sexual function. Youll also want to take care of your mental wellbeing. Use mindfulness, yoga, tai chi, qigong, or related practices to relax and de-stress. Mindfulness has been found to improve erectile dysfunction, adds Melancon. Finally, as Philip Lindeman, MD, PhD, a physician and sleep specialist at GhostBed suggests, avoid excessive alcohol: It's not going to help sex or sleep.

If you adopt all the lifestyle changes above and still struggle with sleep and sex, talk to your doctor there may be underlying medical issues to address, such as getting treatment for sleep apnea. Great sex and sleep await.

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Understanding the Hidden Connection Between Sleep and Sex - AskMen

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Mar 21st, 2023 | Filed under Testosterone

Republican lawmakers in Georgia are trying to change the law to stop transgender minors like Michael from receiving hormone replacement therapy or having surgery to help them physically align with their gender identity.

From birth, Michael was raised as a girl. But Michael said he knew for years that he was a boy. The pain of living his life in a body that didnt match his gender identity led him to self-harm and suicidal thoughts. He credits hormone treatment, in his case testosterone, with giving him a path to bringing his body and his identity into alignment.

Now, cases like Michaels have exploded into the political consciousness as some conservatives voice concern that such treatments are hasty. Legislatures in red states across the nation are proposing bills to intervene. In Georgia, versions of the bill have passed both chambers. It would apply to anyone under 18 years of age.



The House on Thursday passed Senate Bill 140 largely on a party-line vote, with Republicans supporting the measure. Such party-line votes on the issue are the norm in the Republican-majority General Assembly. Since the bill was amended in the House, it will now go back to the Senate for its consideration.

Its not the first time transgender children felt like they were political targets in Georgia.

Last year, lawmakers passed a bill that allows any athletic association to ban transgender girls from competing on girls teams. A month later, the Georgia High School Association voted to require athletes to compete based on their biological sex.

This years bill would ban health care professionals from giving hormones such as estrogen or testosterone to transgender minors. Doctors also would not be allowed to perform surgeries on children seeking to align with their gender identity.

Treatment for transgender adolescents is a two-step process, first pausing hormones and puberty, and then giving new hormones to advance puberty in the target sex. If the bill becomes law, the second step would be banned for those under 18.

Medical professionals would still be allowed to prescribe a hormone treatment that aims to delay puberty or stop it from progressing under the proposal. Children who dont identify with their biological sex at a young age are often prescribed the puberty blockers.

Scientists who deal with such patients say a new, yearslong delay between pausing puberty and beginning hormone replacement therapy could lead to both physical and psychological issues.

The bill would also allow for minors to continue to receive hormone treatments if they began before July 1, when the bill, if signed into law, would take effect, so minors in Michaels situation wouldnt be affected.



SB 140s sponsor, state Sen. Carden Summers, a Cordele Republican, says the legislation aims to stop parents from allowing their children to make permanent decisions about their gender identity before they are legal adults.

Its also been proven that children who have gender dysphoria issues sort of outgrow them as they mature. ... They should get a little bit more mature before they make a decision that is 100% irreversible, he told the House Public Health Committee on Tuesday. After (transgender children turn) 18 years old, whatever they decide to do is their business. This bill is simply to pause.

An AJC reporter contacted organizations more than a week ago that support the legislation in an attempt to speak with Georgians who received transgender treatment and regretted transitioning. The person whose information was provided did not respond to a request for comment.

Opponents of the legislation say bills such as SB 140, which are advancing across the country in Republican-controlled legislatures, are targeting a small, already vulnerable population. According to a 2022 study by the law school at the University of California, Los Angeles, about 1.2% of Georgians between the ages of 13 and 17 identify as transgender, or about 8,500 minors.

Studies have found that transgender youth, and adults, consider suicide at a rate exponentially higher than those who are not transgender.

Michael first told his mother that he was transgender when he was about 11 years old, but the family didnt immediately address it. Thats when Michael said he fell into a depression and began cutting his arms as a way to deal with what he was feeling. Cutting, or self-injury, is a nonsuicidal, yet harmful way to cope with emotional pain, sadness, anger and stress. Michael said he eventually considered suicide.

I didnt understand at the time, but seeing Michael in so much pain made it impossible not to address, his mother said. I needed Michael to be happy, and I was going to do whatever that took.

A study published in 2020 in the Journal of Interpersonal Violence, a peer-reviewed publication that studies victims and perpetrators, found that 56% of transgender youth between ages 14 and 18 who were surveyed said they had tried to take their lives within the previous six months.

According to a 2019 U.S. Centers for Disease Control and Prevention study, 9% of high school students reported attempting suicide in the previous 12 months.



The British journal The Lancet reported a risk of suicide in one U.S. study in 36% of patients of all ages with gender dysphoria the distress that comes from feeling youre one gender when you physically look like another. In contrast, risk of suicide was found in only 5% of the group without gender dysphoria.

Major scientific organizations such as the American Medical Association, the American Academy of Pediatrics and the World Health Organization say that medical and surgical care to transition genders is appropriate when properly administered.

Some dissenters have formed alternate groups, disagreeing with the organizations and calling for a halt to such treatments.

Erica Anderson, a California-based clinical psychologist and former board member of the World Professional Association for Transgender Health, told a reporter for the website the BMJ that she believes some kids are allowed to transition too fast.

We dont have lab tests that reveal if someone is trans nor not, Anderson told the BMJ. We have growing numbers of self-reported transitions that were very rapid in my opinion, too rapid getting on hormones right away, getting gender affirming surgery, and then shortly thereafter regretting it all.

Health care leaders in Finland and Sweden have slowed the administration of gender-affirming care in adolescents, recommending it only on a case-by-case basis.

In issuing the new Swedish guidelines, that countrys National Board of Health and Welfare cited the lack of new research and what it called the new knowledge that some young transition patients have regretted their transition and reversed their transition.

It also said that the number of young patients seeking to transition had significantly increased in recent years, especially among those seeking to transition from female to male, and that it wanted to better understand why.

Credit: Natrice Miller/AJC

Credit: Natrice Miller/AJC

To minimize the risk that a young person with gender incongruence later will regret a gender-affirming treatment, the Swedish guidelines were changed, it said. It added, Questions on how to ensure that all young people suffering from gender dysphoria be taken seriously and confirmed in their gender identity, well received and offered adequate care are becoming increasingly relevant, and will need to be answered.

Scientists say that some patients who transition end up stopping, and some end up reversing their transition. But they say the numbers are tiny compared with the numbers who transition.

However, many of those who specialize in transgender care say that careful psychological assessment is important.

Dr. Dane Whicker of Duke Universitys School of Medicine, a clinical psychologist who works with transgender patients, said hes had two or three kids in his decade-plus experience who didnt go through transitioning.

A key point is the concept of regret.

Stopping or reversing a transition doesnt mean the patient regretted the transition, said Dr. Angela Kade Goepferd, a pediatrician and medical director of gender health at the Childrens Minnesota hospital system. Instead, she said, almost all of those who stop often adults do so because theyre getting backlash from their communities and families.

Theyre experiencing too much stigma, too much discrimination, and they just cant do it, Goepferd said. Its not that they want to stop, but they feel like thats the choice they have to make.

Dr. Izzy Lowell, who runs the Decatur-based gender transition practice Queer Med, said her clinic has about 4,000 active clients from across the South, and about 20% of them are under 18.

She has a handful of patients who are as young as 6 or 7 who only come in to her practice once a year and receive no medical treatment. The bulk of her patients that are under 18 are in their teens and usually have to have already started puberty before being treated with puberty blockers or other hormones. She does not do surgical treatment on minors, nor does she know anyone who does in Georgia.

Lowell said people who seek out her practice want medical treatment, though she partners with mental health providers for patients who want to undergo therapy.

In the best cases, the family has known theyre trans their whole life, they come in and, as soon as we can, we get them on treatments, everything goes smoothly and they never have to experience the wrong puberty and go through that terrible dysphoria, Lowell said. The worst cases, patients come to me after a suicide attempt and the family decides that theyll try anything not to have their child kill themselves. And thats far more common than it should be.



Families with transgender children who spoke with the AJC say that while it may have taken children a while before putting the feeling that they were transgender or nonbinary into words, it was always evident. Someone who is nonbinary doesnt identify as strictly male or female. Dare, a 16-year-old from Dacula who uses they as their pronoun, said they were about 10 when they started to think they may be nonbinary.

Ive always been gender neutral my whole life, Dare said. My mom talks about how, when I was really little, I would pick toys from the boys aisle and the girls aisle.

Dare and their sibling, a 13-year-old transgender boy named Jay, told their parents about their gender identities about the same time in 2020. Neither has been able to secure an appointment to get a diagnosis of gender dysphoria and begin medical treatment, so their transition has been social meaning changing their names and dressing in a way that more aligns with their gender identity.

Being nongender conforming isnt a decision thats made on a whim, Jay said. Theyve most likely known for a long time before they decided to tell anyone.



Jen Slipakoff, a Kennesaw resident, said her daughter first started talking about being transgender when she was 5. Up until then she had been raised as a boy. Shes 15 now.

We already knew exactly what was happening before she ever said anything, Slipakoff said. She has an older brother, so our house was full of traditional boys toys. And our daughter would play with those toys in a very different way than our son was. She would take her little soldiers shopping instead of putting them on the battlefield. She was always drawn to what we would consider traditional girls toys and traditional female clothing.

When she turned 5, she asked her mother to change her name.

She became more and more insistent, Slipakoff said. Thats when we realized like OK, this is something that we need to address.

During a Senate hearing last month, Slipakoff told lawmakers she was concerned that her teenage transgender daughter would be bullied by her classmates when she came out as trans.

Im happy to report, she has never been bullied by her classmates, Slipakoff said. Thats not to say she doesnt have bullies. Here in this room right now, they sponsored this bill and theyre the ones that are going to vote for it. ... She doesnt want and she doesnt need your protection. She wants you to leave her alone.

Democratic lawmakers and other opponents of SB 140 have also questioned how the same group of lawmakers could push legislation last year that allowed parents to opt their children out of school policies for things such as vaccines, masks and lessons and now say that parents shouldnt be able to make health decisions for their children.

During a House panel debating the legislation on Tuesday, state Rep. Shelly Hutchinson, a Snellville Democrat, read a series of arguments Republican lawmakers made in the media during those debates. Among them were comments such as parents have the right to make decisions about their childrens health care without interference from government.

At what point did Georgia shift from giving parents rights to taking away their rights for whatever medical treatment they deem appropriate with their doctors? she asked Summers.

Im just doing the bill to protect children, Summers said. Thats it, pure and simple.

Opponents of the bill say it would harm more children than it would help.

Michael, the 17-year-old Duluth resident, said if SB 140 was the law at the beginning of his transgender journey and banned him from receiving testosterone, he doesnt think he would still be living.

I most likely, honestly, would not be alive, he said. Thats what Im saying. Thats how much it affects me. Thats how much its changed my life. And I just couldnt imagine it because I know where I was, and I know I wouldnt be here without it.

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Trans kids say they have target on their back with GOP initiative - The Atlanta Journal Constitution

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Mar 21st, 2023 | Filed under Testosterone

Shortly after South Dakota passed its gender-affirming care ban for trans minors last month, Elizabeth Broekemeier rushed to see whether her insurance network would cover treatment in neighboring Minnesota for her 13-year-old son. Hes been using the puberty blocker Lupron for about a year, and the recently passed legislation will make it impossible for him to access it in South Dakota by the end of this yeareffectively forcing him to detransition.

It really was just a gut punch, especially since legislators were presented with the facts and opponents of the bill were medical professionals, medical organizations. And for them to still really blindly follow extremist ways, its actually quite frightening, Broekemeier told VICE News days after Republican Gov. Kristi Noem signed the bill into law.

Broekemeier found two in-network doctors who provide gender-affirming care in Minneapolis, meaning her insurance would cover their services. But she hasnt heard back from them yet, and is unsure whether theyll accept new patients. If and when she does get in, Minneapolis is about a four hour drive from her home in Sioux Falls, South Dakota.

Its a matter of my son having to miss school or either myself or my ex-husband having to take time from work to travel, Broekemeier told VICE News. But honestly, if Minnesota doesnt pan out its scary to think about because I dont know what we would do other than my child being forcibly detransitioned.

Now, families like Broekemeiers are left facing a difficult decision: find a way to get gender-affirming care out-of-state, or stop care altogether. And for some, theres no meaningful choice to be made, because travelling out of state is not an option.

People are scared. Parents are considering leaving because theyre like, this is not going to get better. These are options that people are considering. Its fear and its sadness and its grief, April Carrillo, chair of LGBTQ advocacy organization Equality South Dakota told, VICE News. We know how expensive moving is. Like, what the fuck are these families going to do?

People are scared. Parents are considering leaving because theyre like, this is not going to get better.

South Dakotas gender-affirming care ban is one of at least five anti-trans bills introduced in the state this year alone. The move is in lockstep with several other Republican-led states that have introduced bill after bill legislating away trans rights, banning drag shows and books about LGBTQ issues, and barring trans girls from playing on girls sports teams. But its also an example of how the rhetoric written into anti-trans bills is becoming bolder and more aggressive: South Dakota is the first state in the U.S. to explicitly force trans youth who are already using puberty blockers or hormone replacement therapy to wean off the treatmentsin other words, to detransition.

We have seen a continuous escalation of laws targeting the trans community, and trans youth in particular, transgender researcher and activist Erin Reed told VICE News. Early on, the billslike in Arkansaswere bad enough in and of themselves. But the language within the bills has escalated and [legislators] continue to refine these bills so they are harder to challenge in court and more cruel towards trans people.

Before the ban passed, Broekemeier testified against it, alongside medical professionals. But even after experts, families, and trans people themselves spoke out, the South Dakota senate passed House Bill 1080 in a sweeping 30-4 vote.

Republican legislators continue to pursue anti-trans legislation even though science isnt on their side: Numerous medical governing bodies, including the American Medical Association, American Psychological Association, the American Psychiatric Association, and the American Academy of Pediatrics, have endorsed gender-affirming care for minors as medically necessary. Far-right pundits and some Republican politicians falsely equate gender-affirming care to sterilization and castration, and tout its supposed dangers. But extensive medical evidence shows that gender-affirming care isnt harmful; its life-saving.

Studies show that trans people are more likely to experience mental health struggles, including anxiety, depression, PTSD, and thoughts of suicide, than cisgender people. Nearly half of all LGBTQ youth have seriously considered suicide. But, experts say, some of these issues can be mitigated with gender-affirming care, which includes puberty blockers and other therapies. These interventions are safe and effective, and are correlated with better mental health outcomes for trans people. Teens who are able to access gender-affirming therapy typically also have better mental health outcomes than trans people who have to wait until adulthood to transition.

And yet, after South Dakota Gov. Kristi Noem signed the gender-affirming care ban into law, GOP State Rep. Fred Deutsch tweeted a picture of himself toasting beers with fellow Republican policymakers. Signed HB1080 into law to protect gender-confused children, Deutsch wrote. His Twitter account has since disappeared. (In leaked emails obtained by VICE News that reveal interactions between anti-trans lobbyists and lawmakers, Deutsch, known for his push to restrict abortion rights, is repeatedly CCd and exposed as a key player in anti-trans legislative pushes in South Dakota and other states, including Florida.)

As Republican lawmakers celebrated, trans people and their families felt anger and fear. Today it is much more a feeling of desperation, Broekemeier said two weeks after Noem signed the bill. Obviously Im still really angry about what's going on, but now it has turned more to the panic of oh my god, what are we doing to do?

JC, whose identity is being withheld for privacy reasons, grew up in South Dakota and came out as trans at 13. Gender-affirming care in the form of hormone replacement therapy helped JC transition before he turned 18something that trans youth, including JCs friends, wont be able to access starting July 1, when the bill goes into effect. Healthcare providers who violate the law will risk losing their professional licenses and could face civil lawsuits.

I was 16 when I started hormones. They were absolutely life saving for me, JC told VICE News. I would not have made it through high school if I wasn't able to go on testosterone. My dysphoria was absolutely crippling. In school it was very difficult because people just saw me as a tomboy until I started taking hormones. I was constantly misgendered.

I would not have made it through high school if I wasn't able to go on testosterone. My dysphoria was absolutely crippling.

Today, JC, 19, is a college freshman, so the ban wont take his healthcare access away. But his friends who are still in high school will be affected.

A lot of them are still under 18 and some of them are getting gender-affirming care and its going to just devastate them, JC said. I have one who is on testosterone. Hes been on testosterone for about a year now and he will be forced to stop.

At the end of the day, [the gender-affirming care ban] is not going to make my son not trans anymore, Brockmeier said. Its just going to make his life much more difficult, his mental health will be affected. All of these kids, their mental health and quality of life will be affected.

In the meantime, South Dakotans are protesting the baneven though they know that it wont necessarily change the minds of the GOP politicians who voted for it. Us being at a rally is not going to change like what happened. But we can show each other that there are people that care and community, Carrillo said.

Many people in South Dakota, a state of only about 900,000 people, are also already seeking work-arounds to the ban by connecting families with each other and useful resources. Aviana Knochel, 29, is an activist who is helping facilitate conversations on Discord and Reddittwo platforms youth are using to seek out support and resources at a time when Twitter is inundated with more hate than ever, they said. For example, some people in the state are considering setting up shuttles for trans youth who may need to access out-of-state care, or fundraising for families who may need financial support to get their kids to other states for care, Knochel said.

I dont know how to fully articulate how fucking awful and devastating this is, Carillo said. There are trans children, I work with folks who do have trans kids, I see trans youth, and to know that the state they live in basically goes, Hey, you dont exist.

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TIMESOFINDIA.COM | Last updated on - Mar 11, 2023, 00:00 IST

Among every 5 men 1 faces the problem of low libido due to various reasons like stress or hormonal imbalances that make them want to avoid any kind of sexual activity. Yet, sometimes a loss of sex desire is a symptom of a deeper issue. Men's decrease of sex desire can frequently be attributed to depression, stress, drunkenness, illicit drug usage, and weariness.

Here are several reasons why men may experience low sex drive:

High levels of stress can affect testosterone levels and reduce sex drive. If a person is distracted by a certain situation or goes through severe mental pressure, then his sexual drive decreases.


Dr. Caranj S.V., M.B.B.S., M.S. (General Surgery), M.Ch. (Urology), Medical expert with Kindly Health says, Issues such as low testosterone levels, can lead to decreased sex drive. Men who have hypogonadism are determined to struggle with the problem of low testosterone levels estimated below 300 ng/dl. Such men face a lack of urge for any sexual activity.

Some medications can have side effects that reduce sex drive, such as antidepressants and blood pressure medications. Men taking radiation treatments or chemotherapy for cancer suffer from decreased sex drive along with those who take anabolic steroids like sportsmen.

Poor diet, lack of exercise, smoking, consumption of excessive alcohol, and drug use can all contribute to low sex drive. Also, if proper sleep and rest are not taken then that also creates problems and causes low sex drive.

Problems with a partner, such as communication issues or unresolved conflicts, can reduce sexual desire.


Addressing stress: Finding ways to manage stress, such as through exercise, meditation, or therapy, can help improve sex drive.

Adopting a healthier lifestyle: Cessation of smoking, eating a balanced diet, exercising regularly, and reducing alcohol and drug use can all help improve sex drive.

Treating hormonal imbalances: According to Dr. Caranj, If low testosterone levels are the cause, hormone replacement therapy may be necessary.

Addressing relationship issues: Working with a partner to address communication issues and resolve conflicts can help improve sexual desire.

Switching medications: If medication side effects are the cause, switching to a different medication may be necessary.


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Mar 13th, 2023 | Filed under Testosterone

You may have heard of Testo Max from Crazy Bulk and wanted to know more before buying. This real Testo-Max review has been updated for 2023 - will cover all you need to know. We will tell you how this legal sustanon alternative works for muscle mass gains, strength and stamina, fast recovery and bulking and cutting cycles.

We will also compare it with sus 250 and tell you why Testo Max is a better supplement for bodybuilders. There are also some real Testo Max reviews from customers and show before and after results with photos.

CLICK to view TESTO-MAX price and special offers for 2023

The best place to order Testo Max in 2023 is through the CrazyBulk website. There are no additional fees for shipping and they also offer a wide range of payment options including local currencies like USD$ or CAD$.


Here is a selection of Testo Max before and after pictures showing the results of real users.

Testo Max can be stacked with other legal steroids to create bulking or cutting stacks.


Testo Max is a legal steroid from Crazy Bulk, and is probably the supplement that is central to the bodybuilding stacks they manufacture, much like Sustanon 250 or any of the other Testosterone esters are in a synthetic anabolic steroid cycle.

Testosterone is the bedrock of all steroid cycles because it is our natural anabolic steroid hormone.

Present in both men and women, albeit at different levels, testosterone was the first natural hormone to be synthesized in a laboratory, and its chemical structure is at the heart of all anabolic steroids today.

It is, therefore, kind of important.

However, the reasons for its importance and the way in which it is used and manipulated makes the difference between a legal steroid and an illegal steroid.

Well explain all of this, of course, but the key lies in the fact that Crazy Bulk legal steroids like Testo Max increase your endogenous (natural) production of testosterone, rather than being injected directly into the muscle.

Direct intramuscular injection of synthetic steroids comes with much more responsibility and risk, and requires both on-cycle and post-cycle therapy to recover from.

There is no easy road with synthetic steroids, whereas the Legal, Natural, and Safe type are much simpler to use and manage.

Testo Max from Crazy Bulk is formulated to increase your endogenous free testosterone levels by stimulating the pituitary gland and testicles to produce the prohormones that in-turn trigger the manufacture of testosterone itself.

Free Testosterone is the type we are most interested in because it is that which is unbound, circulating the body, available for use in muscle and bone tissue for the growth of muscle and strength.

The benefits of boosting testosterone like this are as follows:

Faster muscle growth from resistance training

Denser Stronger Bone Growth

Increased Testosterone Production

Increased Fat Burning

Safer Alternative to Sustanon

Improved Energy Levels

Sharper Cognitive Function

Testo Max Gives A Higher Sex Drive

No Injections Necessary

No Negative Side Effects

Legal to buy

Available in Australia, Canada, UK, Ireland, USA, Europe etc.

Testo-Max contains a massive 2352mg of D-Aspartic acid in every serving (thats more than any other brand on the market)

Crazy Bulk Testo Max is marketed as an alternative to sustanon - a natural testosterone booster supplement that can be used for bodybuilding or by anyone that has low testosterone levels.

Testo-max is formulated extremely well and is one of best testosterone supplements available to buy over the counter or online.

Providing your body with the right nutrients is essential for promoting muscle mass growth. However, as you age, your natural testosterone levels begin to decline, making it harder to build new muscle.

Testo Max from Crazy Bulk is designed to help reverse this process by boosting your testosterone levels naturally.

The active ingredients in Testo Max (amino acids, vitamin B6, d aspartic acid) have been used for centuries to treat erectile dysfunction, lack of sexual desire and promote muscular strength.

"D-aspartic acid is an amino acid regulator which manufactures luteinizing hormone the very hormone that powers your testosterone production"

Research has shown that the natural ingredients can increase testosterone levels (testosterone hormone production) by stimulating the release of luteinizing hormone from the pituitary gland.

This, in turn, leads to an increase in testicular production of testosterone. In addition to its effects on testosterone, the ingredients have also been shown to improve blood circulation and reduce inflammation.

As a result, it can not only help you to build new muscle, but also to recover from workouts more quickly.

To get the most out of Testo Max, Crazy Bulk recommends that you take three capsules per day with meals. For best results, they recommend using the product for at least two months.

Here are the ingredients contained in the Testo Max testosterone booster dietary supplements.

A Testo Max capsule contains: Magnesium (from Magnesium Oxide and Magnesium Citrate 200mg) 53.33% of RDD(Recommended Daily Dosage)

Vitamin d (vitamin d3 52 mcg)

Vitamin B6 (from Pyridoxal-5-Phosphate)

Amino acid

D-Aspartic Acid 2352 mg.

Nettle Leaf Extract 4: 1 40 mg.

Red Ginseng Extract 4: 1 40 mg.

Fenugreek Extract 4: 1 40 mg.

Boron (from Boron Citrate) 8 mg.

Bioperine 95% Piperine 5 mg.

D-Aspartic Acid is a naturally occurring amino acid that is involved in the synthesis of testosterone.

While testosterone levels vary from person to person, research has shown that D-Aspartic Acid can help to increase testosterone levels in both animals and humans. In one study, rats that were given Aspartic Acid showed a significant increase in testosterone levels after just 12 days.

In another study, healthy men who were supplemented with the amino acid for 12 days also experienced an increase in their testosterone levels. While the exact mechanism by which it boosts testosterone levels is not fully understood, it is thought to work by stimulating the release of luteinizing hormone, which in turn stimulates the production of testosterone by the testes.

In addition to its ability to boost testosterone levels, this powerful amino acid has also been shown to improve sperm quality. In one study, men who were supplemented with D-Aspartic Acid for 90 days had a significant increase in their sperm count and motility.

Given its effects on both testosterone and sperm quality, it's not surprising that aspartic acid has been included in several popular testosterone boosters, including Testo Max.

The Testo Max testosterone supplement contains three key vitamins that work together to support muscle development and health.

Vitamin B is essential for energy production, and helps the body to convert food into fuel. Vitamin D is needed for calcium absorption, and helps to keep bones strong.

Vitamin K is important for blood clotting, and helps to prevent bleeding. These vitamins work together to help gain muscle and burn fat, and help the body to recover from exercise.

Research has shown that Testo Max can increase testosterone levels by up to 30%, making it an effective supplement for those looking to build muscle mass and increase healthy testosterone levels.

Sustanon is actually a mixture of testosterone esters rather than being one single testosterone ester compound.

It was originally developed by Organon, one of the powerhouse steroid manufacturers since their beginnings.

While effective for Testosterone Replacement Therapy, other people discovered its potential for bodybuilding and athletic performance enhancement.

Sustanon has since become a very popular product on the black market.

The idea behind multiple sized esters was to provide a treatment for testosterone replacement that would start taking effect quickly but then cycle through the esters, thereby sustaining the effect. Hence, Sustanon.

Patients would only require one single injection of Sustanon 250 every few weeks.

For people using it for its original purpose, the injections are infrequent at 2 to 3 weeks.

Bodybuilders and athletes who are using it for building muscle mass and physical enhancement dont just want to replace normal levels of testosterone; they want to multiply them. Therefore they take the drug more often.

Bodybuilders might even inject it every other day!

Even natural testosterone aromatized to estrogen as part of a normal and necessary cycle. The average male with above average endogenous levels of testosterone will not experience many estrogenic effects, because their system can regulate it.

With steroids, however, much more of the testosterone or similar hormone is entering the body exogenously.

This means there is more to convert to estrogen which in turn can lead to estrogenic side effects becoming apparent.

Estrogen is the dominant female sex hormone and so the side effects reflect that: Gynecomastia (man-boobs) and excess water retention (leading to high blood pressure) are the main ones.

Someone taking Sustanon or another single ester testosterone will not need to worry about this; they are after all simply making up for what they are lacking.

People who use it for enhancement will most likely need a few other drugs to counteract the side effects.

Aromatase Inhibitors (AIs) like Anastrozole (brand name Arimidex) and Letrozole (brand name Femara) lower the estrogen level by preventing the conversion of testosterone to estrogen.

AIs themselves can have a negative effect on cholesterol (lowers HDL and raises LDL) so people with high cholesterol (specifically LDL) should never use Sustanon or any synthetic testosterone.

Laws covering steroids are hazy in some countries and black and white in others. The US is quite clear that the possession and use is against federal law.

Europe, the UK and Canada currently have a controlled status on them but possession for personal use is usually not punished.

It is always best to take the cautious route and double check the specific law concerning the actual steroid you are interested in.

In our opinion, the risks are too great; for your health, finances and security. Choose an alternative product which can lead to similar gains but without all the mess associated with steroids.

Its not far off a century since testosterone was first isolated from a bulls testes.

That was 1935, and it began a sequence of experiments and discoveries that would lead us down the road to androgenic anabolic steroids and testosterone booster supplements.

Steroids made outside the body are known as exogenous steroids. Those we make naturally from our own glands are called endogenous steroids.

Exogenous steroids have several additional effects on the body than the obvious intended effects of increasing anabolic muscle growth and so on.

One of those effects is to suppress our endogenous testosterone production. The body senses the influx of exogenous steroids which triggers a negative feedback loop that minimizes or shuts down its own production.

Thats testosterone suppression, and it can lead to all kinds of side effects.

Synthetic anabolic steroid users treat this problem in the short-term by injecting more testosterone. The body needs it one way or another, so it does stabilize them.

However, their testicles will shrink because the testosterone isnt being manufactured there. Small balls, no big deal right?

Once the steroid cycle is over, the body will not simply revert to making its own testosterone again, there is a delay on that. Most guys take reducing amounts of synthetic testosterone - meaning more injections - to ease the body back into it. But heres the rub

The longer the steroid cycle, and the more testosterone you inject, the more the body gets used to not having to manufacture its own. And ultimately, low testosterone syndrome can become a permanent problem.

And all of that aboveis only one of the side effects of injecting synthetic steroids.

Crazy Bulk Testo Max, on the other hand, triggers an increase in endogenous production of testosterone, thereby avoiding the testosterone suppression problem altogether.

The other potential side effects, such as acne, water retention, premature balding, man-boobs (gynecomastia) are all more manageable as well when the body is in control of its own testosterone production.

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Mar 13th, 2023 | Filed under Testosterone

Scientists are currently experimenting with contraceptives, that would allow men to share responsibility for birth control with women.

In the 1960s, hormonal contraceptive pills were introduced and gave women the ability to control their own bodies by choosing when to start a family. However, unintended pregnancies are still common, with almost half of all pregnancies being unintended both in the United States and around the world. According to National Geographics, scientists are currently experimenting with contraceptives for men: pills, gels, and implants.

These new methods may be more convenient and reliable than condoms or vasectomies, and some are being developed without the hormones that often cause side effects for women. This development is seen as a shift towards greater equity between the sexes, according to Heather Vadhat, executive director of the Male Contraceptive Initiative, which funds contraceptive research.

To understand how these new birth control methods work, it is important to have a basic understanding of the male reproductive system. Successful reproduction in men requires the right balance of hormones, especially testosterone, which triggers the production of sperm in a process called spermatogenesis. It takes about 74 days for sperm to develop and mature, and mature sperm are stored in the testes.

During ejaculation, more than 250 million sperm are released from the testicles and seek to fertilize an egg. While female birth control disrupts the production of one to two fertile eggs a month, male birth control needs to stop millions of sperm in their tracks to prevent conception.

Male hormonal birth control

A new type of birth control is being developed for men that use hormones to stop the production of sperm. This method specifically targets spermatogenesis and slowly shuts down the sperm production process.

The most studied version of this method is a topical gel that is applied to a man's shoulders and arms every day. The gel contains a synthetic female hormone called progesterone that lowers the levels of testosterone in the body, which is a male reproductive hormone. By lowering testosterone levels, the man can no longer produce sperm.

As the gel is absorbed into the skin, small amounts remain just underneath, slowly releasing contraceptive hormones that make the man infertile for as long as he continues to use the gel. The gel has few side effects, and the results of clinical trials have been promising, according to Christina Wang, an expert on male contraception at the University of California, Los Angeles.

To prevent side effects like low libido, the gel also contains a small amount of testosterone that's added back into the body, meanwhile still ensuring that testosterone levels are too low to produce sperm.

In a 2012 clinical trial, 99 men used the gel, and almost 90 percent of them experienced temporary infertility. Participants reported side effects similar to those of female hormonal birth control, such as weight gain, acne, low libido, and mood swings.

Hormonal gels are already used to treat hormone deficiencies, which is one reason why this method is appealing to researchers. Wang has recruited 400 couples to test a male birth control gel, and she estimates that it could be widely available by about 2030.

Vasectomies have been available for men as a birth control method since the late 19th century.

The procedure involves blocking tubes in the scrotum that carry sperm from the testes to the semen. Doctors typically insert a clip or cut and tie the tubes directly. While vasectomies are not easily reversible and painful during the recovery, new options are on the horizon, such as a gel developed by Contraline that is currently in early clinical trials in Australia.

Contraline's gel is currently in early clinical trials in Australia, and participating men will be evaluated over the next three years. This new method of vasectomy could become a less invasive and more easily reversible option for men seeking birth control.

A recent study published in Nature Communications has shown promise for a contraceptive pill that could be taken before intercourse and wear off after about a day. The pill works by targeting an enzyme called Soluble adenylyl cyclase (sAC), which is responsible for telling sperm to start swimming. Suppressing this enzyme prevents sperm from getting past the vagina. The pill has been tested on mice and was effective in making them infertile after 15 minutes, with fertility returning to normal after two hours. The researchers hope to test the enzyme blockers on humans within the next two to three years, with the possibility of the pill being on the market within the next decade.

The big question is:

Will men be interested in using male birth control?

According to a survey of 5,000 men from around the globe, many are interested in trying out a contraceptive.

There was a belief that men wouldn't use it and women wouldn't trust them to use it. But a global survey of 5,000 heterosexual men suggests that this stereotype may not be completely true. The survey found that many men were interested in trying a contraceptive, with the most enthusiastic men in Nigeria and the least enthusiastic in the US, where only about 40% of men would be willing to try birth control.

According to Steve Kretschmer, who conducted the survey, men's interest in birth control increased over time in all the countries surveyed. Also, most women in each country said they would believe their male partner if he said he was taking birth control.

Vahdat is excited about the potential of male birth control, which has been long awaited. She believes that when it becomes widely available, it will change how we think about reproduction and who is responsible for it. Currently, female autonomy is often associated with contraceptive use, but with male birth control, this stereotype could shift.

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Mar 13th, 2023 | Filed under Testosterone

Dr. Keith Roach| To Your Health

Dear Dr. Roach: I had been on hormone replacement therapy for 20 years or so and was diagnosed with breast cancer last year. I had a lumpectomy (stage 1) and radiation (external, five days a week for 21 treatments). Now, the oncologist is saying I need to start taking tamoxifen indefinitely. I have read online that it can cause memory loss, liver injury, stroke, blood clots and/or endometrial cancer. What are the chances of any of these happening? These possibilities seem potentially worse than the original cancer spreading.


Dear E.H.: Tamoxifen for breast cancer is indeed associated with a risk of serious medical issues, but you need to consider the benefits as well.

Memory loss was seen in some studies of tamoxifen. Verbal memory was decreased in one study (by about 0.2 points on a 45-point scale), and executive function speed was reduced by about 0.2 seconds. These results were statistically significant but small.

Women with breast cancer may develop fatty liver disease on tamoxifen treatment. This rarely causes symptoms and does not seem to increase the risk of severe liver damage. The risk can be reduced by about 50% through exercise.

Because tamoxifen acts like an estrogen in some ways, the risk of blood clots and stroke is increased. It is estimated that about three women per 1000 will have a stroke due to tamoxifen. However, tamoxifen protects against heart disease. So, about three women per 1,000 will not get a heart attack who otherwise would have, making the net effect of combined stroke and heart disease almost none. However, women at high risk for blood clots should probably not take tamoxifen.

The risk of endometrial cancer in post-menopausal women after five years of tamoxifen is approximately three women per 1,000, whereas it is less than 1 woman per 1,000 for premenopausal women treated with tamoxifen.

The risks of tamoxifen are real but small, and so you must weigh them against the benefits. I dont have enough information to estimate your risk of a recurrence of breast cancer, but your oncologist does. As an example, a low-risk woman with small stage 1 cancer might have a risk of recurrence of 10%. Tamoxifen would be expected to reduce that by 30% to 40%, meaning an absolute risk reduction of 3% to 4%. For most women, the benefit in breast cancer recurrence is greater than the combined risk of stroke, blood clot, endometrial cancer and serious liver disease. Most women are on tamoxifen for five years, though some high-risk women will benefit from 10 years but not indefinitely.

Your oncologist should give you more-personalized risk and benefit estimates than I can give, in order to give you the best information to make your choice.

Dear Dr. Roach: Can I take testosterone replacement if I have benign prostatic hypertrophy?


Dear P.T.: Because prostate tissue can grow with testosterone treatment, its a reasonable question. But, in a large study comparing men who were on testosterone treatment versus an inactive placebo, there wasnt any difference in the symptoms of an enlarged prostate (among the most common symptoms are a slow urinary stream and increased urinary frequency). Thats probably because the testosterone replacement just gets men back to normal levels of testosterone, not to excessively high levels.

Readers may email questions to

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Mar 13th, 2023 | Filed under Testosterone
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