Testosterone Replacement in Athletes

The Evolution of Medical Care, or Bandwagon Treatment Lacking Evidence?

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Across the US, hormone replacement therapy is becoming more popular every year.  Recreational athletes are no exception to this trend, and this is perhaps most prevalent among the “weekend-warrior” masters crowd.  But just because it is a common theme in treatment, does that mean it’s good medicine?

I’m going to post a two-part series of articles examining hormone replacement therapy and its use in athletes.  Without a doubt, there are clinical conditions which require this treatment.  There are a growing number of patients, however, who are being treated without meeting accepted diagnostic criteria.  This could be the evolution of medical care, working to aggressively treat previously unrecognized conditions.  Or it could be a bandwagon on which patients and doctors are hitching their hopes, exchanging large amounts of money, yet missing the underlying problem.

Additionally, since this series is specifically aimed at an active patient population, I will discuss the implications of these treatment protocols when it comes to competition.  Athletes who register for an event sanctioned by a national federation often agree to abide by the code of the World Anti-Doping Agency (WADA).  If you are running your local 5K or marathon, you likely agreed to this code (and to be tested!).  If you sign up for the local sprint triathlon or cycling crit, the same thing applies.  Far too often, I see athletes in my office who have been placed on treatments which technically amount to doping!  I don’t believe they have any intent or awareness that they are breaking the rules, and many are stunned to find this out.  My goal in discussing this is not to point fingers!  Rather, it is to inform athletes of all levels that there are expectations and rules to which they have agreed and can be publicly punished for breaking.  And often times, there is a safer and healthier way to address their symptoms.

**Stay tuned for this two-part series.  The first article will be posted on Thursday afternoon, and the second on Tuesday of next week.**