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By David Baron, MD, Past President of the Group for the Advancement of Psychiatry and member of the GAP Committee on Psychopharmacology

Doping, broadly defined as the use of a banned substance to gain an unfair competitive advantage in sports, has been a highly publicized and controversial topic for the past six decades. Yet, despite considerable effort by all stakeholders to level the playing field and create a fairor at least fairercompetitive environment, the issues only seem to have become more challenging and complicated.

The World Anti-Doping Agency (WADA), the worlds premiere doping control agency, and the International Olympic Committee (IOC) have proclaimed that efforts to control doping have three primary goals: the health and safety of the athlete; fair competition; and maintaining the integrity of sports.

However, the case of the South African three-time world champion runner, Caster Semenya, highlights one of the most difficult challenges for the world of sport in trying to achieve these goals. To be clear, however, hers is not a doping case; she did not use testosterone supplementation to gain an unfair advantage, and potentially put her health at risk. In fact, Semenya was assigned female at birth and raised as a girl. However, she was born with a 46, XY DSD, known as a Disorder or Difference of Sexual Development (DSD), and historically referred to as an intersex condition. This results in a higher level of testosterone than is typical for normal women.

To address the issue of what constitutes normal and what should be considered doping, WADA adopted a program several years ago called the Biologic Passport. This establishes the baseline for each athlete and compares the level over time. Each athlete is their own control, and so a positive test is determined by the change from their original baseline, not the baseline measure itself.

Unfortunately for Semenya, because she naturally has higher-than-normal levels of testosterone, she has still been banned from competition1 in certain track distances, although not all. And as far as I can tell, no one is accusing her of doping, or taking testosterone to improve performance. It is just that her baseline levels are above the arbitrary limit for a female to compete in certain distances. Some people think this is a fair decision. However, the key words here are arbitrary limit. I am not persuaded that athletes like Semenya should be singled out for a higher level of scrutiny of their natural abilities than others.

I am speaking from the perspective of a former athlete, a coach, a sports medicine physician, a sports psychiatrist, an Olympic Doping Control officer, a founder of the World Psychiatric Association Section on Exercise, Psychiatry and Sport, a board member of the International Society of Sports Psychiatrists, and an NIMH representative regarding federal Drug-free workplace legislation. I have witnessed firsthand many athletes who have won the genetic lottery and have a distinct competitive advantage as a result of fatethat is to say, because of their genes and not because of pharmacology. There are many examples of natural traits that are well beyond the normal range," yet athletes who benefit from them are not banned from competition or forced to have corrective measures to level the playing field.

For example, is it normal for a woman to be over 6 feet 4 inches tall with a wingspan approaching seven feet? Is it normal for a swimmer to be born with nearly webbed feet that act as mother natures fins?

Or if they did not win the genetic lottery, some athletes can benefit from factors that are not related to their commitment, dedication, and desire to win. Is it fair that athletes from some rich countries get access to the best training, coaches, and equipment from a very early age? Is it an unfair advantage to be born in a country where one can have access to all the best sports science has to offer to improve performance?

In any of the above cases, it is clearly not fair. However, it is by no means cheating.

What to do? There are no easy answers. Although fair competition is fundamental to sport, it is not as black-and-white an issue as one might hope for. The issue of achieving fairness for all concerned will continue to be the most significant challenge moving forward.

As sports fans, we marvel at the incredible accomplishments of elite athletes, often forgetting the blood, sweat, and tears that go into achieving what we observe. Like WADA, we expect fair competition, to maintain the integrity of sport and the ultimate determination of the champion. Cheating is not tolerated, but what is fair? Hopefully, the answer to this very complex and complicated question will be driven by science and thoughtful ethical considerations.

As highlighted in the award-winning Ted Lasso series, for some athletes, sport (soccer) is life. That level of dedication demands that those who determine fairness in sport deliver a gold-medal performance themselves.

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When Mother Nature Does the Doping - Psychology Today

A transgender woman has documented the physical changes they underwent while undergoing eight months of hormone replacement therapy (HRT) in a mesmerizing timelapse video.

Brendan McCann, from Fort Myers, Florida, took a selfie every day since starting treatment in August last year.

The 23-year-old, who uses non-binary they/them pronouns,decided to document their journey to give other trans people the 'confidence to start HRT.'

Brendan, a video journalist, said: 'The most rewarding part of my transition has been being able to share it with people and make a little piece of art out of it.'

The timelapse clip features a total of 226 images that showcase how Brendan's physical appearance noticeably changed over a period of eight months.

Speaking of the project, theysaid: 'I've done video production and timelapse photography for a while, so I've had a lot of fun putting these time lapses together and seeing people enjoy them.

'The main reason trans people share timelines of their changes with HRT online is that people who are considering starting often go looking to see "what will it do to me? I want to find someone who looked like me when they started."

'Many timelines don't start with a person who looks fairly masculine and still has a beard, so I felt it was important to have it start from the beginning.

'I've gotten messages from people telling me that my video gave them the confidence to start HRT and that's very special.

'I wish I had had a video like this while I was figuring stuff out.'

Brendan, who is originally from the UK but moved to America when they were two, has not socially transitioned yet, which is one of the reasons they are using their birth name.

Due to medical costs related to physically transitioning, Brendan will not be undergoing any surgery in the foreseeable future but plans on getting laser hair removal.

Feminizing hormone therapy is typically used by transgender women and nonbinary people to produce physical changes in the body that are caused by female hormones during puberty.

This hormone therapy, also called gender-affirming hormone therapy, helps better align the body with a person's gender identity.

Feminizing hormone therapy involves taking medicine to block the action of the hormone testosterone.

It also includes taking estrogen which lowersthe amount of testosterone the body makes.

Feminizing hormone therapy can be done alone or along with feminizing surgery.

Not everybody chooses to have feminizing hormone therapy.

It can affect fertility and sexual function, and it might lead to health problems.

Source:Mayo Clinic

Brendan said: 'Physical changes take a few months to really show up and they're very minor at first.

'They are also contingent on having decent levels of estrogen and suppressed testosterone, among other things.'

The keen photographer said it took about four months before their bloodwork came back with good levels that mimic female puberty, adding: 'My medical transition is basically just HRT, which is more common than you would think for trans people.'

Brendan has said that their experience as a trans person has been mainly positive.

'The most surprising thing has been how supportive people have been, both online and in person.

'Most of my friends and immediate family know and no one has really taken it badly.

'Being in a somewhat conservative part of Florida I was expecting more negativity.

'Even online, the TikTok algorithm has been very good at not showing my videos to too many transphobes.

'My comments sections are overwhelmingly positive and that surprised me,' they explained.

However, Brendan does have concerns over the local government passing bills and legislation that could limit access to medicine and physical resources for trans people.

They said: 'Desantis, the governor of Florida, has been ramping up attacks on transgender people in the medical board of Florida and with bills that aim to limit access to gender-affirming care.

'Minors already have a lot of barriers in the way of getting gender-affirming care even in states where the legislation is kind to them. So here it is almost impossible.

'DeSantis already got all trans healthcare taken off of Medicaid in the state of Florida, essentially banning it for the poor.

'He is looking to get private insurance to stop covering it and to put restrictions on who can prescribe treatment.

'They're also about to pass a 'bathroom bill' which will ban trans people from using bathrooms in buildings that receive state funding.

'I didn't expect these changes to come so quickly and at some point in the near future it might make it necessary for me to leave the state.

'For me personally, as a transfeminine person, transitioning using estradiol and testosterone blockers my medications are not scheduled substances, so it would be fairly easy for me to order them from reputable pharmacies overseas and import them.

'If an all-out ban went into place, a lot of people would have to jump to that while they try to leave the state.'

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Transgender woman reveals how HRT transformed their face - msnNOW

While men put in a lot of effort to achieve ideal body/physique, they sometimes consume certain supplements or even steroids which helps induce muscle growth and strength but while maintaining physical strength and ensuring an increase in muscle mass, men do not realise that the testosterone they take to improve their appearance can adversely affect their fertility and overall health. According to health experts, when men use steroids to increase testosterone levels to build muscle strength, it can result in low sperm counts or even the absence of sperm.

Men often feel the pressure to maintain their physical appearance or achieve a certain level of fitness hence, they resort to the consumption of products like steroids which helps them attain the desired outcome of achieving muscle mass but in these situations, men fail to realize that the consumption of steroids harms a mans sperm health leading to fertility issues. Male infertility is an extremely sensitive issue for men to accept and for men, complications in fertility can be an unpleasant surprise which may result in increased stress levels and relationship strain due to the frustration of not being able to have a child.

In an interview with HT Lifestyle, Dr Anindita Singh, Fertility Consultant at Nova IVF Fertility in Kolkata, revealed, While analysing the primary reasons behind infertility, it is observed that certain supplements especially anabolic steroids can cause fertility issues. Steroids are synthetic supplements or versions of testosterone which help enhance strength and muscle growth among men. Steroids that are consumed to promote muscle growth can lower sperm count or even result in the overall absence of sperm which shrinks the male testicles.

She highlighted, However, the adverse impact on sperm health due to the consumption of steroids can be treated depending upon the time duration. When the person stops using steroids, it takes approximately three months for the sperm count to recover. In cases where men have used steroids for a long period, the recovery duration may take a longer time, approximately a year or more. Besides male infertility issues, steroids can pose several other health issues ranging from acne, breast development, liver problems, heart attack, or stroke which may be irreversible.

Dr Priyanka Reddy, Consultant - Infertility Specialist at Motherhood Hospitals in Bangalore's HRBR Layout, shared how steroids affect the male reproductive system:

She asserted that besides fertility, other major adverse effects of steroids can result in side effects in the bodys system which may cause permanent damage namely-

Insisting that use of testosterone should be administered by a physician, Dr Anindita Singh said, The use of testosterone is appropriate only when it is prescribed and administered under the supervision of a reliable physician. In cases where men have low testosterone levels, a physician prescribes hormone-regulating medications which help create adequate levels of testosterone without affecting the fertility level of a man. While taking steroids to improve strength and muscle mass, a man must exercise caution and be aware of the consequences of using steroids on their fertility health along with the risks that cause an impact on both the short- and long-term health of an individual.

Talking about how the production of sperm levels can be recovered, Dr Priyanka Reddy said, Recovery of sperm production depends on how long the man has been consuming steroids which increases testosterone levels. The amount of damage in sperm production depends on the amount of dose undertaken as well. If the dose is in fewer quantities for a while, the production of sperm resumes within three months however if the dose is in larger quantities for a longer period, then, the recovery rate takes longer. Before taking any supplement or drug which assures increased muscle mass, energy, or libido, it is important to consult a doctor to recognise the reproductive risks associated with the use of the supplements.

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Steroids, supplements impact male infertility. Here's how to recover sperm count - Hindustan Times

Tennis legend Martina Navratilova added her voice to the uproar over transgender cyclist Austin Killips winning the womens overall category at the Tour of the Gila event in New Mexico.

Killips became the first transgender woman to take home a victory in an official Union Cycliste Internationale (UCI) stage event. The UCI is the world governing body for sports cycling.

On Wednesday, Navratilova spoke out about Killips win.

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Austin Killips pictured on the podium after the women's elite race of the 'Kasteelcross' cyclocross in January 2023. (DAVID PINTENS/BELGA MAG/AFP via Getty Images)

"this will happen more and more- womens sports is NOT THE PLACE for trans identified male athletes," she wrote on Twitter as she tweeted a New York Post article about the win.

The UCI defended its rules governing transgender participation in its sport.

"The UCI acknowledges that transgender athletes may wish to compete in accordance with their gender identity," the organization said Tuesday.

"The UCI rules are based on the latest scientific knowledge and have been applied in a consistent manner. The UCI continues to follow the evolution of scientific findings and may change its rules in the future as scientific knowledge evolves."

CYCLING GOVERNING BODY DEFENDS TRANSGENDER PARTICIPATION RULES AFTER UPROAR

Jun 6, 2015; Paris, France; Serena Williams (USA) and Martina Navratilova pose with the trophy after her match against Lucie Safarova (CZE) on day 14 of the 2015 French Open at Roland Garros. (Susan Mullane-USA TODAY Sports)

The UCI tightened its rulesfor transgender femaleriders to compete against biological females in its events. According to Reuters, the organization halved the maximum permitted plasma testosterone level to 2.5 nanomoles per liter and doubled the transition period to 24 months.

The nine-time Wimbledon champion has been an activist for the gay community but has been against transgender women competing against biological women in sports.

In March, she applauded World Athletics for adopting a policy to exclude transgender female athletes from womens competitions. She called it a "step in the right direction."

"In the wake ofWorld Athletics announcement, I think the best idea would be to have biological female and biological girls categories and then an open category," she wrote in an op-ed in The Times of UK. "It would be a category for all-comers: men who identify as men; women who identify as women; women who identify as men; men who identify as women; non-binary it would be a catch-all. This is already being explored in athletics and swimming in Britain.

"Biological females are most likely to compete in the biological female category, as thats their best shot at winning and it maintains the principle of fairness. With an open category there are no question marks, no provisos, no asterisks, no doubts. Its a simple solution.

"Once somebody has gone through male puberty, there is no way to erase that physical advantage. You cannot simply turn back the clock, for instance by trying to lower testosterone levels."

Split photo of Martina Navratilova and Austin Killips. (Getty Images)

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Navratilova said she hoped the decision would lead to other sports following its lead.

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Martina Navratilova on Austin Killips' cycling triumph: 'Womens sports is NOT THE PLACE' for trans athletes - Fox News

Sir Steve Redgrave has candidly opened up about his health after being diagnosed with a condition following months of being tired and depressed.

Redgrave, 61, was told his symptoms could be connected to testosterone deficiency just six months ago by a friend.

It comes after Redgrave was diagnosed with type 2 diabetes at the age of 35.

What Ive been noticing is more weight gain, especially around the stomach area, a little bit more tiredness, culminating in depression which I would class as the worst side of it," he told the Mirror as he outlined how his latest health condition had impacted him.

The five-time Olympic gold medalist (second from left) was diagnosed with a testosterone deficiency

PA

Type 2 diabetes, which impacts around 850,000 Britons, is closely linked with testosterone deficiency.

Men who have the deficiency are four times more likely to develop type 2 diabetes and around half of men with type two diabetes will have low testosterone levels.

The five-time Olympic gold medalist rower added: I had a grandfather who was diagnosed with type 2 diabetes in his sixties.

But I never dreamed that I would develop it. It was probably the furthest condition from my mind.

Normally a diabetic would be told to exercise more Im not sure I could have done that!

My first thoughts were that my career was over.

I didnt think you could be a top athlete with that condition.

But my consultant said Why not?

Sir Steve Redgrave confirmed he exercises three times a week on a static bike and also enjoys playing golf.

PA

Despite competing in five consecutive Olympic Games, Redgrave now admits he finds it hard to find motivation to exercise from home.

He confirmed he exercises three times a week on a static bike and also enjoys playing golf.

Redgrave, who won the Golden Sports Personality of the Year in 2003, intends to start testosterone replacement therapy and indicated he hopes to receive an injection rather than gel treatment.

He said: Im hoping for a bit more get up and go.

Redgrave concluded by urging men to consider whether they might be suffering from low testosterone

PA

My eldest daughter is expecting at the moment and Im looking forward to being a grandparent.

I want to be fit and healthy and there are a lot of projects I want to get done around the house.

Redgrave urged men to consider whether they might be suffering from low testosterone.

He suggested men take a simple blood test if they have weight control issues, tiredness, depression or a low libido.

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Sir Steve Redgrave opens up on debilitating private health battle that left him 'tired and depressed' - GB News

Sir Steve Redgrave has opened up on his health issues after his recent struggles.

The former rower, now 61, has been dealing with several symptoms related to testosterone deficiency in recent months, with knock on effects causing other damaging impacts.

He was diagnosed with type 2 diabetes when he was 35, just years before he retired from rowing.

He also found out he had ulcerative colitis in 1992, a condition which causes an inflammation of ulcers in the colon and rectum.

Speaking to The Mirror, Redgrave admitted his recent battles have resulted in symptoms of tiredness and depression, along with other noticeable feats.

'What Ive been noticing is more weight gain, especially around the stomach area,' he said. 'A little bit more tiredness, culminating in depression, which I would class as the worst side of it.

'At first, I thought it was just getting older,' he said. 'I just accepted it.It just wasnt something I had really considered.'

The five-time Olympic champion also discussed his battle with diabetes and the struggled he had to go through with the condition while still being an elite athlete.

He creditedhis medical team for their help, but it wasn't easy.

'When I was an athlete I was finger pricking my blood 10 times a day,' he revealed. 'Things have come a long way in treatment. The pump has made a big difference and my general health got a little bit better when I was being given a small amount of insulin all the time, 24 hours a day, compared to when you were injecting.

'I had an amazing medical team to help me find the way through.'

'My control is so much better than it was 20 years ago, though my wife Ann, who is a doctor, would say not as good as it should be.'

Redgrave's health appears to be on the decline, but he's determined to be as fit as he can be for the rest of his days.

He also urged more men to keep on top of their health, particularly when it comes to testosterone levels.

'I am starting to notice less feeling in my feet which is another one of the problems, especially being very tall,' he said. 'Youve got all these complications that dont hit you here and now, but will creep up on you sooner or later.

'My eldest daughter is expecting at the moment and Im looking forward to being a grandparent. I want to be fit and healthy, and there are a lot of projects I want to get done around the house.

'Us blokes dont help ourselves. We think, "Ill ignore that" and we dont tell our mates because theyll take the mickey out of us. I mean, it took me nine years to get help.

'But if you have weight control issues, tiredness, depression or low libido, you can rule things out with a simple blood test. Its about finding things earlier.

'Theres a lot of evidence that testosterone therapy can even help reverse type 2 diabetes.

'Its known that diabetics will probably die earlier than they would have done. If there is a way to improve your health and mortality, why not take it?'

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Sir Steve Redgrave admits he has struggled with depression since discovering low testosterone levels - Daily Mail

By Edmund Willison For The Mail On Sunday 22:30 29 Apr 2023, updated 22:30 29 Apr 2023

Premier League footballers are almost never tested for the banned performance-enhancing drug testosterone, a Mail on Sunday investigation has found. And top-flight stars can expect to be subject to even the most basic drug test as infrequently as once per season.

An FA spokesman told this newspaper that doping in English football is very rare while also refusing to provide any detailed data about how many tests for specific substances are actually undertaken each season.

Instead, the FA told the MoS to ask Britains drug-busters, the UK Anti-Doping Agency, for figures on testing.

And UKAD declined to provide us with any detailed doping test statistics and in the process breached the Freedom of Information Act.

UKAD say they are concerned the data could be misinterpreted and undermine their testing programme.

In reality, UKAD have never sanctioned a Premier League footballer for blood doping or taking testosterone.

We can reveal however that 13 professional footballers in the UK were formally investigated for elevated testosterone levels between 2006 and 2009 but UK Sport, UKADs predecessor, closed every case involving those players without taking any disciplinary action.

A current director of a leading anti-doping agency has told The Mail on Sunday that the Premier Leagues anti-doping programme, run by UKAD, is inadequate, and that synthetic versions of testosterone and blood doping substances would provide great benefit to professional footballers.

The Mail on Sunday can reveal that UKAD, on behalf of the FA, collected an average of 2.5 doping samples from each Premier League footballer during the four seasons between 2017-18 and 2020-21.

But multiple samples (for urine, blood and Athlete Biological Passport sample collections) can be collected during one doping test, therefore it means that some players could have had perhaps a single appointment with testers each season, if any.

In comparison, in 2019, World Athletics collected six times as many samples from track and field athletes as UKAD did from Premier League footballers, despite having 45 fewer athletes in their testing pool.

The extent of doping in athletics, cycling and skiing has been well exposed in recent decades but there has been a dearth of scandals involving footballers despite widespread belief that the problem extends to the beautiful game.

This lack of doping cases in English football is partly explained by the FA and UKADs lax testing programme. Statistics, obtained via a Freedom of Information request, show that doping testing across the game has decreased since 2017.

In the 2017-18 season, UKAD collected 1,923 samples from about 500 first-team players in the Premier League.During 2018-19, 2019-2020 and 2020-21 seasons, the numbers decreased to 1,766, 1,458 and 729 samples respectively.

Testing was impacted by the Covid-19 pandemic but the decrease in testing started before 2020.

UKAD have refused to reveal how often English professional players are tested for blood doping substances.

UKAD claim that to do so would undermine their testing programme despite the fact that UEFA release publicly how many of these tests they perform annually. As of 2004, the FA were not performing EPO testing.

EPO is prohibited for use by the World Anti-Doping Agency and was widely taken by cyclists, such as Lance Armstrong. EPO has a drastic effect on endurance and recovery which would provide substantial benefits to footballers.

When an anti-doping agency collects a doping sample from an athlete, they must choose how rigorously to analyse the sample.

Testing for blood doping substances and banned testosterone, while more expensive, are much more effective than the basic analysis.

This newspaper has now been able to establish that UKAD and the FA are providing footballers with an opportunity to take prohibited testosterone and then go undetected.

UKAD screens footballers for elevated testosterone ratios but a further confirmatory test, called IRMS, is required to confirm the presence of synthetic testosterone.

If the test returns a positive result then the player can be charged with an anti-doping rule violation.

The United States Anti-Doping Agency used this method to catch Justin Gatlin, the former 100m Olympic and world champion, in 2006.

UKAD refused to provide these exact figures but in 2021, the last full year for which figures are available, UKAD performed only 68 of these tests on the 6,943 samples they collected across all sports. The number of those undertaken in the Premier League is therefore minimal.

Now, The Mail on Sunday have found 13 footballers in Britain showed elevated testosterone levels between 2006 and 2009.

However, UK Sport, who ran the FAs anti-doping programme at the time, did not perform tests to confirm the presence of synthetic testosterone in the majority of these cases.

UK Sport, by monitoring the players future drug tests, attributed the irregular testosterone values to natural variation and ruled that the footballers had no case to answer. This was consistent with anti-doping rules at the time.

The head of operations at UK Sport during this period was Nicole Sapstead, who became UKAD boss in 2015. Sapstead now runs the International Tennis Federations anti-doping programme.

Since UKAD assumed all anti-doping responsibilities from UK Sport in 2009, any doping cases involving footballers who were cleared of suspected testosterone use is no longer made public. Previously, all doping cases, including those that ended in no sanction, were uploaded to a publicly available database by UK Sport.

Margaret Goodman, the director of the Voluntary Anti-Doping Agency, the body that polices doping in professional boxing, told The Mail on Sunday that the Football Association and UKAD should perform more rigorous drug testing.

From the provided statistics, footballers are unfortunately inadequately tested, she said. What would be more beneficial to a footballer than anabolic steroids and EPO? I strongly believe that if you are going to create a deterrent, the only rationale is to perform the most advanced testing every time.

In contrast to the FA, UKAD and almost all other national anti-doping agencies, Goodmans agency test every sample they collect for both synthetic testosterone and EPO. The agency have a catch rate of four per cent, compared with UKADs 0.2 per cent. This arguably shows how efficient VADAs testing programme has been.

UKAD and other national anti-doping agencies still have not adopted this, albeit more expensive, more effective testing strategy. Goodman says that she was criticised for performing such effective testing.

I believe that national anti-doping agencies and any WADA signatory should include IRMS on every collection, said Goodman. Several years ago, our agency was criticised and almost threatened that we were going to be ostracised for including IRMS on every collection. Bottom line: it was cost-prohibitive.

When the British boxer Ryan Martin was caught doping by VADA in 2018, UKAD had to retest his sample using IRMS testing because he had passed their more basic testing.

Last year, Conor Benn failed two VADA drug tests despite passing all of his UKAD tests. A UKAD spokesperson said that it was not feasible to test all samples for synthetic testosterone, although the agency still only tests one per cent of all samples for the drug.

It is not feasible to analyse all samples using this technique, which is why we strategically use the steroidal module of the Athlete Biological Passport to inform our selection of samples, a UKAD spokesperson told The Mail on Sunday.

It is important to note that IRMS is not a technique used in isolation and is in fact part of a suite of analytical tools available to us to detect prohibited substances.

In response to this story, UKAD told this newspaper: Our football testing programme uses an intelligence-led and risk-based approach to targeting areas of the sport and the individuals who we believe have the potential to dope.

'While it is individual players who are picked out from a team for testing, testers are regularly present at football clubs across the UK, which serves as a deterrent for the whole team.

Testing is conducted with no advance notice and no player is aware if they are to be chosen for testing; this is determined by UKAD alone. The FAs investment into the football testing programme over a number of years is commended by UKAD.

The FA said: We take anti-doping extremely seriously, and we are fully compliant with the Department for Digital, Culture, Media and Sports latest National Anti-Doping Policy.

We fund one of the worlds most comprehensive national anti-doping testing programmes, which is directed by UK Anti-Doping, and is constantly reviewed in order to make improvements wherever possible.

Over the past year, The Mail on Sunday has made numerous attempts, via the Freedom of Information Act, to gain access to these statistics on drug testing in British football but our requests have been refused, on almost every occasion, including on appeal, by UK Anti-Doping. UKAD also refuse to reveal how many British athletes, including footballers, have been investigated for blood doping.

UKAD also breached sections 1, 10 and 17 the Freedom of Information Act by failing to respond to this newspapers requests within the legally mandated time frame.

In 2022, The Mail on Sunday revealed that 15 Premier League footballers failed drugs tests between 2015 and 2020 but none of them were banned by UKAD.

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Does the Premier League have a drugs problem? - Daily Mail

A few days ago, producer Chittibabu had criticised Samantha Ruth Prabhu by saying that her career as a star heroine has ended after her recently released film Shaakuntalam underperformed at the box office. Following his remark, Samantha had seemingly taken a dig at Chittibabu in her Instagram stories. Now, the producer has once again targeted Samantha over her cryptic post. In his earlier interview, Chittibabu had said that Samantha was using cheap tactics to promote her movies. He had also mentioned that he was surprised to see her playing the lead role in Shaakuntalam. After his statement, Samantha had taken to her Instagram stories and stated that she was searching How do people have hair growing from ears" on Google and the internet revealed that it happens because of increased testosterone. Many people speculated that it was a jibe at Chittibabu's statement.Responding to Samantha's jibe, Chittibabu said in a new interview, "She has noticed my ear hair and hair grows in many other parts of my body and I have no objection to study and report on it."He also clarified his earlier statement about Samantha and said that all he meant was the actress was not suitable to play young characters anymore. She said that Samantha is not 18-20 years old, which doesn't make her a suitable choice for the role of Shakuntala. He further added that her glamorous days are over and its time to move on to supporting roles. He also mentioned that the actress is not ready to accept the truth. On the work front, Samantha will be next seen in an upcoming romantic film Kushi opposite Vijay Deverakonda and in the action thriller web series Citadel alongside Varun Dhawan. Speaking about the series, Samantha had told IANS, "The Citadel universe, the interconnected storylines between the productions across the globe, and most importantly, the script of the Indian installment really excited me. I am thrilled to be a part of this brilliant universe conceptualised by the Russo Brothers' AGBO." Samantha has already begun shooting for Citadel with Varun Dhawan.Also See: Best Hindi Movies of 2023 | Top 20 Hindi Movies of 2023 | Latest Hindi Movies

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Chittibabu responds to Samantha Ruth Prabhu's 'increased testosterone' jibe: Hair grows in many other par - Times of India

Getting older is an obvious one, but lifestyle choices and chronic conditions are culprits, too.

Discussions around low testosterone often focus on the symptoms of low-T.

Conversely, you sometimes hear exclusively about what you're missing out on due to suboptimal testosterone levels. The conversation immediately shifts toward what testosterone replacement therapy (TRT) may be able to do for you: better energy, improved mood, improved sex drive, better lean muscle-to-fat ratio and better erectile function.

Unfortunately, the modern tendency to look for quick-fix pharmacological solutions leads people to overlook the underlying causes of a medical issue. They get into a big rush to alleviate the symptoms in the quickest, easiest way possible.

That's especially true for the delicate natural hormonal balance in the body. It requires careful calibration to function correctly. It's not like taking an antibiotic for a bacterial infection.

Coming at testosterone with a sledgehammer of clumsy, inexpert or poorly thought-out "treatment" can be disastrous, especially if you don't try anything else first.

For that reason, most reputable men's health specialists don't go directly to TRT. They begin any conversation about potential low-T symptoms with a thorough assessment of the patient's history and lifestyle. They want men to understand they have a great deal of control over their own testosterone levels.

As with any condition, it's important to know the causes of low testosterone and how aging may or may not affect testosterone production. Let's dive into that information and look at a set of possible testosterone-related behaviors that's been dubbed "irritable male syndrome."

On an abstract level, many people realize that modern Western life is unhealthy. The types of food we eat, the level of exercise many of us choose, the type and amount of substances we takehell, the very air we breatheall of these things conspire to compromise our health across a variety of bodily systems.

Look at a typical American man's lifestyle through the lens of testosterone production and it really snaps into focus.

Let's start with one of the biggest impediments to testosterone production and general health in modern life: obesity. As of 2018, more than 42 percent of American adults were obese, and 30.7 percent were overweight. About 1 in 11 adults were severely obese, meaning they had a body mass index (BMI) of 40 or higher, according to the National Institutes of Health (NIH).

Obesity leads to more adipose tissue, or body fat. That excess fat is thought to convert testosterone to estrogen, thereby decreasing testosterone levels. The process itself is more complicated than that, but at its base, excess fat hinders testosterone production.

Multiple studies show a strong link between obesity and low-T. The connection is clear.

One 2017 study featured a man who was morbidly obese and hypogonadal (low-T). He underwent a gastric bypass procedure and his testosterone returned to normal levels so completely that he was taken off exogenous testosterone, according to the researchers.

This study, albeit with a sample size of just one, dovetails with a 2019 review of obesity and low-T. That research suggested that obesity leads to low-T, but the opposite is also true: Low testosterone can cause increased fat accumulation.

Diabetes is closely linked to obesity, and the two of them together are a warning sign of low-T. A certain portion of men with erectile dysfunction (ED) can be expected to have hypogonadism, according to the NIH, but that number increases if those men are obese or have diabetes.

Sleep apnea becomes more common in men as they reach middle age, and this condition may exacerbate the natural drop in testosterone production that occurs with age. Simultaneously treating obstructive sleep apnea and low-T can help, according to the NIH.

Excessive alcohol consumption and chronic use of drugs, particularly opioids, can impact testosterone production in a significant way.

"The big one for medication is going to be opioids," said Amy Pearlman, M.D., a men's health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida. "Opioids that people use for pain can drastically reduce testosterone levels. I don't know if taking them just for a couple of days can impact testosterone, but I do know that patients who are on them chronically have very low levels, and that's supported by the research."

Men's testosterone production begins to decline by about 1 percent per year after age 30 or so. This sounds like a damning figure, but there's more to unpack here before you rush off to the clinic the day after you turn 30.

"Yeah, testosterone goes down as people get older, but that doesn't mean it's going to be lowif they keep themselves healthy," Pearlman said. "Some of my healthiest patients that come in are in their 80s and 90s and are hoping they have low-T because they have some fatigue or they're not as sharp as they were before. They're hoping their testosterone level is low so I can put them on testosterone and they can go live their best lives.

"I find that the people who are moving and grooving and staying active and treating their bodies well, just because they're 80 or 90 years old doesn't mean they're going to have low testosterone," Pearlman added.

Another important point: That 1 percent drop in testosterone per year may sound like a slow death sentence to your libido, but in the grand scheme of things, it's not a lot.

"One percent is not that much," Pearlman said. "So if someone has total testosterone of 600 nanograms per deciliter, then 1 percent is going to be 6 nanograms per deciliter per year."

Researchers are connecting the dots between the proven scientific phenomenon of lower testosterone production in older men and the anecdotal evidence that some older men become more irritable and depressed and have lower self-confidence and less energy. They're calling it "irritable male syndrome," but it is strongly linked to what's clinically called "andropause" or sometimes "male menopause."

Now, it's safe to say we should take that clickbait-heavy term with a grain of salt.

What is indisputable is that the normal age-related reduction in androgen productionandrogens are "male" hormones, such as testosteroneis linked to moodiness and the other symptoms mentioned above.

One study on irritable male syndrome looked at the end of mating season for a species of ram called the Soay ram. Researchers found the drop in testosterone production at the end of the mating season resulted in the animals appearing to be more fearful and agitated.

What was also striking was that they fought more, resulting in more frequent physical wounding.

Ultimately, testosterone production is something you can control to some degree.

You can't stop aging, but you can get more active, eat healthier, cut drug and alcohol use, and lose excess weight. Doing these simple things can help you stay "moving and grooving" well into old age like one of Pearlman's 80- or 90-year-old, active, healthy patients with great testosterone levels.

Eating better and exercising more may not be a quick fix, but it's a sustainable, healthy way to start your journey to optimal testosterone levels and feeling better in general.

Originally posted here:
What Are the Many Potential Causes of Low Testosterone? - Giddy

Singer-songwriter Robbie Williams has opened up about his sex life, revealing how his libido dropped after he stopped taking testosterone.

The 53-year-old said in an interview with The Sun that since coming off hormone replacement therapy, which he was using to treat depression, his incredible sex life with his wife of almost 13 years, Adya Field, had slowed down considerably.

The sex we had when I was on testosterone was incredible, he told the newspaper. It was all the time. We were insatiable. It goes to show how into each other we really are, though, because when I was on it, we couldnt take our hands off each other.

I miss that. That was a fun period. Sometimes now, though, Ayda will turn to me on the sofa and say, We should do sex, and Im sitting there eating a tangerine and just sort of shrug. So, ya know, sometimes we try.

Thankfully, the couple's lack of intimacy in the bedroom hasn't affected their relationship outside of it, Williams said.

Field added they are still always cuddling and kissing.

Everyone knows there is no sex after marriage, Williams continued. Thats just the way it is. I was on testosterone for a while but, because Im an addict, that had to stop. I got these massive square shoulders and started to look like a doorman. It wasnt a good look.

No sex in a marriage is only a problem if youre on different pages, he added. If one person wants it, and the other doesnt, [or] if you have different expectations or requirements.

Field agreed: Intimacy is the important, meaningful side of love. I have friends who feel obliged to have sex with their husbands and that must be awful. Me and Rob are on the same page. We are happy.

Read the original:
Robbie Williams Opens Up About Sex Life and Low Libido after ... - Men's Health UK

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