For those who want to avoid estrogens in any form, phytoestrogens from plants are a consideration. A soy extract that provides at least 50 mg of soy phytoestrogens are often a key ingredient for effective natural estrogen replacement therapy. Based upon records of dietary soy consumption inJapan, where breast cancer incidence is very low, daily soy isoflavone intake has been estimated at 50 mg per day. The typical Western diet, on the other hand, only provides 1 to 5 mg a day of the soy isoflavones that may protect against several forms of cancer.
When measuring testosterone levels, it is critical to determine the levels of both free and total testosterone to understand the cause of any observed symptoms of deficiency (Khosla et al 2008).
Because of difficulties with equipment standardization and inter-laboratory variability, it is recommended that physicians consistently use the same local laboratories and gain familiarity with the accuracy, precision and definition of normal values for the assays offered in their communities (Morales et al 2010).
Dihydrotestosterone (DHT) (referred to as androstanolone or stanolone when used medically) can also be used in place of testosterone as an androgen. The availability of DHT is limited; it is not available in the United States or Canada, for instance, but it is available in certain European countries, including the United Kingdom , France , Spain , Belgium , Italy , and Luxembourg .  DHT is available in formulations including topical gel, buccal or sublingual tablets, and as esters in oil for intramuscular injection.  Relative to testosterone, and similarly to many synthetic AAS, DHT has the potential advantages of not being locally potentiated in so-called androgenic tissues that express 5α-reductase (as DHT is already 5α-reduced) and of not being aromatized into an estrogen (it is not a substrate for aromatase).