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TestosteroneThe 1985 edition of Goodman and Gilman’s The Pharmacological Basis of Therapeutics states that “the use of these agents (i.e., androgens) does not cause an increase in muscle bulk, strength, or athletic performance ­even when phenomenally large doses are used.

The commonly observed increase in body weight (seen secondary to steroid use) is due to the retention of salt and water.” This conclusion is based on a review of 25 published papers.

What was so interesting about the aforementioned views on androgen use by athletes was the prevailing notion (among physicians and scientists) that androgens had no ergogenic effect.

That notion changed drastically in light of the landmark study by Shalender Bhasin. 2 In this study, 43 normal men were randomly assigned to one of four groups:

  1. Placebo-no exercise
  2. Placebo-exercise
  3. Testosterone-no exercise
  4. Testosterone-exercise

Testosterone enanthate (TE) or placebo was given intramuscularly once weekly (600 mg) for 10 weeks. Exercise consisted of traditional weightlifting exercises 3 times per week. Among those in the nonexercise group, TE treatment increased triceps brachii and quadriceps femoris muscle area more than the placebo; furthermore, bench press and squatting exercise strength improved significantly more in the testosterone-treated group. Those assigned TE plus exercise had the greatest improvements in fat-free mass and strength. No change in mood or behavior was seen in any of the men given TE. And perhaps more importantly, there were no significant changes in plasma triglycerides, HDL- or LDL­cholesterol.

Although this study was considered landmark in the field of androgen physiology, for the vast majority of athletes, it was nothing less than a confirmation of what they had already known for the past 40-50 years. An intriguing aspect of Bhasin’s study was the fact that skeletal muscle hypertrophy can be induced without an exercise stimulus. This went against the prevailing notion that androgen administration was useful for building muscle mass only when you also engaged in heavy resistance training. Furthermore, the lack of behavioral or mood changes flies in the face of the commonly held idea that androgen use could lead to aggressive behavior, often termed raid rage by the uninformed.

Though a relationship between testosterone levels and aggressive behavior can often be found in various animal species, it is unclear that such a phenomenon occurs consistently in humans. Perhaps those individuals who are already predisposed to aggressive behavior might become more aggressive under the influence of androgens. Alternatively, we would posit the notion that because androgens contribute to gains in skeletal muscle mass, these individuals (who are now larger) are more apt to act aggressively towards other men (or women) knowing full well they will not be challenged simply due to their greater body size.

A distinct dichotomy exists in how the media, scientists, and physicians view androgen use. Clearly, this study showed a beneficial effect on body composition and muscular strength. However, it is unclear why the media in particular have chosen to ignore the fact that 10 weeks of high-dose TE administration had no harmful side effects. No changes in behavior or plasma lipids were seen. Aren’t the two most commonly stated. claims of risk associated with androgen use raid rage and increased risk of heart disease?

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Furthermore, the hypocrisy of the medical establishment in prescribing estrogen replacement therapy for women while ignoring the potential health benefits of androgen administration in older men is absurd. Only when this topic is devoid of the usual political correctness will health and medical professionals realize that androgen administration might offer enormous benefits.

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