Exogenous testosterone steroids

“There’s this drumbeat that muscularity equals masculinity, and so we’re seeing more and more young men with muscle dysmorphia,” says Pope. The consequences of this kind of thinking can be dangerous. As more and more men hit the gym in the hopes of transforming themselves into the Rock, many are also turning to anabolic steroids to achieve the muscle mass they associate with masculinity. Up to 4 million Americans—nearly all of them male—have tried steroids at some point, according to Pope’s recent research .

A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH U/L, FSH U/L, T nmol/L). Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months.
MAIN OUTCOME MEASURE(S):Baseline and stimulated T levels and LH pulsatility; effect on sexual function.
RESULT(S):Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S):Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.

All bets are off the table when high-dose testosterone and its many metabolites are used illegally, such as with anabolic steroid abuse. Strokes, embolisms, and cardiovascular disease are all more likely, as is sudden death, and liver and kidney disease. 44 In women, acne, irreversible deepening of the voice, baldness, increased facial hair, enlarged sex organs, breast reduction, depression, and infertility have all been reported. In adult men that abuse anabolic steroids, acne, baldness, permanent infertility, gynecomastia, loss of libido, erectile dysfunction, testicle shrinkage, and profuse sweating are all reported side effects. Increased testicular cancer hasn't been reported, though. 45,46

A recent case of a 51 year old male with an interest in testosterone replacement illustrates the benefits of the multi-parametric prostate MRI scan. Noting a PSA value of only ng/ml; the digital rectal exam (DRE) identified an area of interest on the left side, albeit, it was not definitive for prostate cancer. Neither the gray scale ultrasound nor Color Flow Doppler ultrasound evaluation suggested any specific abnormality consistent with the area of interest previously identified on DRE. An MRI scan was suggested as the next best step in the evaluation. The scan isolated a region of interest on the left side at the Apex to Middle portion of the prostate gland concordant with the findings on the DRE.  Based upon the findings of the MRI scan, a targeted biopsy with 6 needle cores was recommended and implemented. An Antiandrogen was initiated pre-biopsy to mitigate against “needle tracking”. Specifically, an Antiandrogen selectively blocks the receptor on the prostate cell from attracting testosterone as it exits the capsule, thereby, disabling the cells in preparation for cell death or apoptosis. The Pathology evaluation revealed a grade of cancer that was amenable to being treated conservatively or focally. In this case, the failure to use a MRI scan would have exposed this patient to the possibility of missing the cancer altogether; associated with sampling bias, a very real possibility for needle tracking (assuming cancer was found), or worse yet, the go ahead to supplement with testosterone, when in fact, the cancer was missed. Using  testosterone in this scenario would have stimulated cancer cells to grow wildly, while causing the PSA to spike abnormally, thereby, making the diagnosis of prostate cancer – a potentially uncontrollable clinical event, albeit, avoidable. Given the expertise of a Urolologic consultation, this case turned out well. The patient is now contemplating a focal treatment with high intensity focused ultrasound with a plan to supplement with testosterone once his cancer has been cured. An inability to document the resolution of prostate cancer by a repeat MRI scan and/or a stable PSA post-operatively will preclude this patient from using testosterone replacement therapy.

For the off-season athlete there is no anabolic steroid more important or beneficial than testosterone. High levels of testosterone will promote significant increases in lean muscle mass and strength. This is assuming that the individual is consuming adequate calories. Compounds like Testosterone Propionate are not magical, you will still need to feed your body enough calories. During an off-season period of growth, this means total caloric intake will need to be slightly above maintenance. This will, unfortunately, promote body fat gain. However, the key to a successful off-season is gaining lean tissue while minimizing body fat gain to the fullest extent possible. By supplementing with Testosterone Propionate you will be able to achieve this more efficiently. High testosterone levels will promote a stronger metabolic rate. This is not a license to eat like there’s no end in sight, but you should be able to make better use of your calories.

Exogenous testosterone steroids

exogenous testosterone steroids

A recent case of a 51 year old male with an interest in testosterone replacement illustrates the benefits of the multi-parametric prostate MRI scan. Noting a PSA value of only ng/ml; the digital rectal exam (DRE) identified an area of interest on the left side, albeit, it was not definitive for prostate cancer. Neither the gray scale ultrasound nor Color Flow Doppler ultrasound evaluation suggested any specific abnormality consistent with the area of interest previously identified on DRE. An MRI scan was suggested as the next best step in the evaluation. The scan isolated a region of interest on the left side at the Apex to Middle portion of the prostate gland concordant with the findings on the DRE.  Based upon the findings of the MRI scan, a targeted biopsy with 6 needle cores was recommended and implemented. An Antiandrogen was initiated pre-biopsy to mitigate against “needle tracking”. Specifically, an Antiandrogen selectively blocks the receptor on the prostate cell from attracting testosterone as it exits the capsule, thereby, disabling the cells in preparation for cell death or apoptosis. The Pathology evaluation revealed a grade of cancer that was amenable to being treated conservatively or focally. In this case, the failure to use a MRI scan would have exposed this patient to the possibility of missing the cancer altogether; associated with sampling bias, a very real possibility for needle tracking (assuming cancer was found), or worse yet, the go ahead to supplement with testosterone, when in fact, the cancer was missed. Using  testosterone in this scenario would have stimulated cancer cells to grow wildly, while causing the PSA to spike abnormally, thereby, making the diagnosis of prostate cancer – a potentially uncontrollable clinical event, albeit, avoidable. Given the expertise of a Urolologic consultation, this case turned out well. The patient is now contemplating a focal treatment with high intensity focused ultrasound with a plan to supplement with testosterone once his cancer has been cured. An inability to document the resolution of prostate cancer by a repeat MRI scan and/or a stable PSA post-operatively will preclude this patient from using testosterone replacement therapy.

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