MYTH

"Testosterone Roid-Rage Mythology - Testosterone induces aggressive undesireable behavior" . Testosterone is an anabolic steroid hormone, which turns ordinary men into wild "Roid-filled" angry males or some into highly "hypersexual" men.

REALITY

It is surprising to me in my medical practice that on the contrary men with the "low T syndrome" or "T deficiency syndrome" (TDS) are often angry, irritable, edgy and depressed. When their T levels are restored to normal levels they become happy, pleasant men. There is no rage or hypersexuality or other such behaviors seen when T is at normal levels in well adjusted men.

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MYTHS

1. The higher the T level the higher the sex drive.

2. The higher the T level the higher the risk for prostate cancer.

3. Men with well treated-cured prostate cancer should never be treated with T.

4. A woman with a history of breast cancer should never receive T therapy.

REALITIES

1. SEX DRIVE.
Good sex drive and sex function does not require one to have super high T levels. You only need a "quarter tank full of T" for good sexual function. Whereas for muscle gain and other T effects the higher the T the more greater the capacity to build muscle, bone or other tissues.

2. PROSTATE CANCER.
Prostate is like a "sponge" once it is filled with T or its by metabolites such as estradiol and dihydrotestosterone having higher circulating T blood levels does not matter from a "prostate prospective". It does not change the saturated prostate cells to become cancer cells.

3. Men with treated prostate cancer and non-detectable PSA's can be treated with T, but need to be watched closely.

4. BREAST CANCER.

If a woman has had "estrogen receptor sensitive breast cancer" then she should not be treated with T. However, if there are very strong indications and need for T or T like androgens. Then methyl testosterone may be given to some women. Methyl T does not convert the estrogen. Methyl T could decrease some of problems associated with breast cancer (weakness, muscle loss, osteoporosis), which are associated with chemo therapy, irradiation, surgery etc. Often anti-estrogen drug therapy is used with anti-aromatase drugs like Anastrazole (Arimidex) to stop any androgen production that may occur. Androgens (T) in the body could potentially convert to estrogen. It has been widely discussed by the International Women Sexual Health and Wellness Group (www.isswsh.net). The consensus by leading endocrinologists and others is that methyl T or other non estrogen converting angrogens may be used in these women especially if they are already on anti-aromatase meds (anti-T converting meds).

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MYTH

Testosterone is only for men and not for women

REALITY

In my medical practice I prescribe T for both sexes. Testosterone has a profound effect on females and may induce such changes as:
a) more assertive,
b) sometimes aggressive,
c) may feel a different persona-personality - feel a "new self" - more confident,
d) increased sex drive,
e) occasionally anxious or edgy if too high T levels or increased sensitivity to T.
Women may need only as little as 1 to 5 mg of T per day to gain benefits. Men need from 25 to 100 mg of topical T to have therapeutic effects.

It is interesting that when you treat men who are low in T and then go up to normal levels you often hear them report:a) feel happier,
b) more confidence,
c) less anxious, less edgy and depressed,
d) libido may increase dramatically in men who have been very low in T for a long time.
e) libido often levels off after the brain gets used to normal T levels.

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MYTH

All men and women need to be in "normal" T lab ranges.

REALITY

The female T laboratory range is about 20-70 ng/dL for total T and about 0.1-6 pg/mL for free T (cell-available T). The male T laboratory range is about 350-1100 ng/dL for total T and about 50-150 pg/mL for free T (cell- available T). The ranges of normal T levels vary from lab to lab.

There is no one single T value within the normal T range, which is optimum for optimal T health for anyone. One must look at the clinical results of therapy first. If there are positive effects and no adverse reactions then this is the right dose for the person. If there aren't positive clinical effects or adverse reactions then T levels and T metabolites, estradiol (E2) and dihydrotestosterone (DHT), should be measured. The only way to find out is to treat and test in complex cases.

Some men or even women need above normal values to feel normal clinically (supraphysiological laboratory value levels). These people may have some degree of "androgen (T) receptor resistance" that needs to be overcome.

In the main females are much more sensitive to T therapy. Most likely that is because females throughout their lifetimes experience so little T exposure compared to men. A little T (androgen) goes a long way in a female in terms of behavioral and physical effects.

This is especially evident in female athletes. From my 25 some years of experience in sports medicine I have seen dramatic sports performance changes in women who appear to have altered their androgen levels only slightly but illegally without getting caught.

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MYTH

Testosterone turns women into men

REALITY

Small doses of 1 to 5 mg of T do not turn a woman "into a man". Women do not grow beards and do not display male features. Some women may complain of hair changes, oily skin or acne as early signs of T excess or high T sensitivity. At extremely high T levels such as seen in female body builders may develop hoarse voices, decreased breast tissue and take on masculine features.