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For both men and women, an alternative to testosterone replacement is low-dose clomifene treatment, which can stimulate the body to naturally increase hormone levels while avoiding infertility and other side effects that can result from direct hormone replacement therapy. [17] This therapy has only been shown helpful for men with secondary hypogonadism. Recent studies have shown it can be safe and effective monotherapy for up to 2 years in patients with intact testicular function and impaired function of the HPTA( http:///ijir/journal/v15/n3/full/ ). Clomifene blocks estrogen from binding to some estrogen receptors in the hypothalamus, thereby causing an increased release gNRH and subsequently LH from the pituitary. Clomifene is a Selective Estrogen Reuptake Modulator (SERM). Generally clomifene does not have adverse effects at the doses used for this purpose. Clomifene at much higher doses is used to induce ovulation and has significant adverse effects in such a setting.

In men, low testosterone levels in the body can be supplemented by hormone replacement with testosterone. Testosterone replacement therapy can be prescribed as an intramuscular injection usually given on a biweekly basis; as a patch or gel placed on the skin, or as putty that is applied to the gums of the mouth. Each of the treatments has its risks and benefits. The decision as to which form of testosterone to use depends upon the clinical situation. Discussions between the patient and health care professional often helps decide which medication to use.

In the United States there are currently no preparations that are FDA approved for testosterone replacement for women.

But I'm not more aggressive—a behavior change often tied to testosterone. That's not surprising to Robert Sapolsky, ., a neuroendocrinologist at Stanford University and a leading researcher on stress and behavior. "It's really not the case that testosterone 'causes' aggressive behavior," he says. "Instead, it makes the brain more sensitive to social cues that trigger aggression. And in support of that, a guy's testosterone level isn't a very good predictor of how likely he is to be aggressive."

Dr. Cabrera received his medical degree, with Honors, from Cetec University in the Dominican Republic. In 1992 he completed his residency in Internal Medicine at the . Hospital in San Juan, Puerto Rico. Dr. Cabrera is part of a select group of physicians that has completed a fellowship in Functional and Anti-Aging Medicine. Dr. Cabrera is an active member of the American Academy of Anti-Aging Medicine and the Institute of Functional Medicine. Dr. Cabrera is faculty of Fellowship of Metabolic and Nutritional Medicine and currently holds a certification in both exercise and physical fitness.

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Dr. Cabrera received his medical degree, with Honors, from Cetec University in the Dominican Republic. In 1992 he completed his residency in Internal Medicine at the . Hospital in San Juan, Puerto Rico. Dr. Cabrera is part of a select group of physicians that has completed a fellowship in Functional and Anti-Aging Medicine. Dr. Cabrera is an active member of the American Academy of Anti-Aging Medicine and the Institute of Functional Medicine. Dr. Cabrera is faculty of Fellowship of Metabolic and Nutritional Medicine and currently holds a certification in both exercise and physical fitness.

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