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Androstenedione has been sold as a nutritional supplement for six years now. During that time much has been learned about it. Also during that time androstenedione, and other next generation andro products, have received considerable media attention. Unfortunately most of that media attention has been unjustifiably negative. It is the purpose of this package to reveal the facts about prohormones, and to counter some of the inaccurate criticisms that have been leveled towards them.


What are prohormones?

Prohormones are naturally occurring compounds, of little or no biological activity, that the human body can convert to active hormones. For instance androstenedione converts in the body to testosterone. The conversion occurs with the help of certain enzymes. However, since the levels of these enzymes in the body are finite, there are strict limitations to the amount of prohormone that can be activated (the importance of this fact cannot be overemphasized!!) These limitations prevent testosterone levels from being elevated much beyond the natural range seen in young men, despite the dosage taken.


What are the health benefits of prohormones?

A discussion of the health benefits of androstenedione and other testosterone prohormones is really the same thing as a discussion of the benefits of testosterone. More specifically, it is a discussion of the health benefits of moderate increases in testosterone levels, as prohormones (unlike active anabolic steroids) are unable to increase testosterone to ranges much beyond the natural physiological upper limit.

Prohormones were originally marketed to bodybuilders and athletes to provide a safe and legal alternative to anabolic steroids, which are controlled substances and have the potential for harmful effects if abused. These people take prohormones to aid in recuperation from training and to aid in the development of their musculature. Many have found prohormones to be quite effective in this regard, especially those who’s testosterone levels have been suppressed from intense training (endurance athletes, pre competition bodybuilders) or those whose testosterone levels are naturally low.

Although discussions in the media surrounding prohormones center around younger users, the real target market is aging males with declining testosterone levels.


Andropause

After the age of 30 men experience a continuous slow (average of 1-2% a year)1 decline of testosterone levels. The syndrome of low testosterone levels in aging males is known as Male Menopause, or Andropause. Symptoms of andropause are
Depression
Decreased ability to concentrate
Memory loss
Loss of libido, erectile dysfunction
Diminished muscle mass, strength, and stamina
Bone loss
Increased visceral fat
Increase in several cardiac disease risk factors
During the past 5 to 10 years, a tremendous amount of research has been performed on the effects of testosterone replacement therapy for the treatment of andropause. The evidence gathered from these studies has been overwhelmingly positive in regards to efficacy and safety of restoring testosterone levels to youthful levels. The following benefits have been reported:
Increased lean body mass and strength2,3
Increased libido and sexual function4,5
Improved blood lipid profiles6,7,8
Increased bone mass9,10
Cognitive improvements11,12
Increased coronary blood flow13,14
Improved mood, well being15,16,17
Improved memory18
Protection against Alzheimer’s disease19,20
As was mentioned before, prohormones can be effectively used to raise testosterone levels into the normal to high normal range, so all these benefits of testosterone replacement can be achieved with proper use of the appropriate testosterone prohormone.


What are the REAL risks of prohormones?

Some very serious dangers have been suggested to be associated with the use of prohormones, specifically androstenedione. What should first be stated concerning this is that androstenedione and other prohormones have been available for several years and there has yet to be a single valid report of any serious adverse effects that have come to our attention. Furthermore, while prohormone use is not completely without risk for certain adverse effects, these risks have to be taken into the correct context.

Lets examine some of the dangers that have been suggested for prohormones:

Heart Disease: This is based mostly on the traditional myth that testosterone is associated with a greater risk of heart disease, primarily because men have more heart attacks than women. Paradoxically however, studies strongly indicate that the risk for cardiovascular disease is INVERSELY related to testosterone levels in men21,22 . However, while there is no legitimate evidence that the increased testosterone from androstenedione usage can increase the risk of cardiovascular disease, there is conflicting evidence that increased levels of estrogens may or may not be a factor23,24

Liver dysfunction: The accusation that androstenedione usage, or the usage of any non-synthetic androgenic hormone, can lead to liver problems is misleading and completely false. Liver dysfunction is associated with the use of a certain class of synthetic oral anabolic steroids (testosterone derivatives) called 17alpha-alkylated steroids, but NOT with testosterone itself or any of its metabolites (prohromones).25

Prostate enlargment / cancer: Researchers have found no correlation between testosterone levels and BPH / prostate cancer26,27 . Estrogen however has been suggested to be a causative factors in BPH28

Masculinization of females: This is a possible effect of androstenedione or any other testosterone derivative (androgen) when women use it. It is dose dependent and also dependent upon the sensitivity of the woman to such compounds. Women can take androstenedione or other prohormones safely, however they must use small amounts and be aware of changes such as increased body hair growth or voice changes. Permanent virilization is easily avoidable if usage is stopped when these signs appear.

Stunting of growth of teenagers: Androstenedione and other prohormones have always been sold with the understanding that they are for adult use only. Teenagers using the compounds run a risk of premature epiphyseal closure, which means they may not grow to the height they normally would have. While really not a grave threat to health, this certainly can be a significant cosmetic concern.

Gynecomastia: Gynecomastia is the development of benign breast tissue in men. It most commonly takes the form of small (usually visually undetectable) lumps underneath the nipples. Due to the fact that androstenedione has an unfortunately high propensity to convert to estrogens, gynecomastia can occur in susceptible males.

References:

1. Morley JE, et.al, “Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men” Metabolism 46:410, 1997
2. Tenover JS, “Effects of testosterone supplementation in the aging male”, J Clin Endocrinol. Metab., 75:1092, 1992
3. Morley JE, et.al., “Effect of testosterone replacement therapy in old hypogonadal males” J. Am. Geriatr. Soc., 41:149, 1993
4. Davidson JM, Kwan M, Greenleaf WJ, “Hormonal replacement and sexuality in men.”,
Clin Endocrinol Metab, 11(3):599, 1982
5. O’Carrol R, Bancroft J, “Testosterone therapy for low sexual interest and erectile dysfunction in men”, Br J Psychiatry, 145:146, 1984
6. Tenover JS, “Effects of testosterone supplementation in the aging male”, J Clin Endocrinol. Metab., 75:1092, 1992
7. Swerdloff RS, Wang C, “Androgens and aging in men”, Exp. Gerontol., 28:435, 1993
8. Ellyin FM, “The long term beneficial effect of low dose testosterone in the aging male”, Endocrine Soc. 77th Annual Meeting. Program and Abstracts. 2-127:322, 1995
9. Finkelstein JS, et.al., “Increase in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism”, 69:776, 1989
10. Morley JE, et.al., “Effect of testosterone replacement therapy in old hypogonadal males” J. Am. Geriatr. Soc., 41:149, 1993
11. Kimura D, Hampson E, “Cognitive pattern in men and women is influenced by fluctuations in sex hormones”, Am. Psychol. Soc., 57-61, 1994
12. Janowsky JS, et.al., “Testosterone influences spatial cognition in older men”, Behav. Neurosci, 108:325, 1994
13. Webb CM, McNeill JG, “Effects of testosterone on coronary vasomotor regulation in men with coronary heart disease., Circulation, 100(16):1690, 1999
14. Rabijewski M, Adamkiewicz M, Zgliczynski S, “The influence of testosterone replacement therapy on well-being, bone mineral density and lipids in elderly men”, Pol Arch Med Wewn, 100(3):212, 1998
15. Rabijewski M, Adamkiewicz M, Zgliczynski S, “The influence of testosterone replacement therapy on well-being, bone mineral density and lipids in elderly men”, Pol Arch Med Wewn, 100(3):212, 1998
16. Tenover JL, “Testosterone and the aging male.” J. Androl, 18(2):103, 1997
17. Wang C, et.al., “Testosterone replacement therapy improves mood in hypogonadal men--a clinical research center study.”, J Clin Endocrinol Metab.,81(10):3578, 1996
18. Almeida OP, “Sex playing with the mind. Effects of oestrogen and testosterone on mood and cognition.”, Arq Neuropsiquiatr., 57(3A):701, 1999
19. Gouras GK, et.al., “Testosterone reduces neuronal secretion of Alzheimer's beta-amyloid peptides.”, Proc Natl Acad Sci U S A., 97(3):1202, 2000
20. McCarty MF, “Vascular nitric oxide, sex hormone replacement, and fish oil may help to prevent Alzheimer's disease by suppressing synthesis of acute-phase cytokines”, Med Hypotheses, 53(5):369, 1999
21. Simon D, Charles MA, “Association between plasma total testosterone and cardiovascular risk factors in healthy adult men: The Telecom Study.”, J Clin Endocrinol Metab, 82(2):682, 1997
22. Barrett-Connor EL, “Testosterone and risk factors for cardiovascular disease in men.”, Diabetes Metab, 21(3):156, 1995
23. Barrett-Connor E, Khaw KT,” Endogenous sex hormones and cardiovascular disease in men. A prospective population-based study”, Circulation, 78(3):539, 1988
24. Yarnell JW, et.al., “Endogenous sex hormones and ischemic heart disease in men. The Caerphilly prospective study. Arterioscler Thromb. 13(4):517, 1993
25. Kopera H, “Side effects of anabolic steroids and contraindications”, Wien Med Wochenschr, 143(14-15):399, 1993
26. Nomura A, et.al., “Prediagnostic serum hormones and the risk of prostate cancer”, Cancer Res, 48(12):3515, 1988
27. Carter HB, et.al., “Longitudinal evaluation of serum androgen levels in men with and without prostate cancer”, The Prostate, 27:25, 1995
28. Krieg M, et.al., “Effect of aging on endogenous level of 5 alpha-dihydrotestosterone, testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic human prostate”, J Clin Endocrinol Metab, 77(2):375, 1993