The HRT conundrum
As science progress along we are finally getting to a position within the medical community where the implementation of hormone replacement therapy for males, has become much more accepted and understood. At one time the mere mention of testosterone replacement regardless of dysfunction would bring about the same reaction that an athlete would receive when talking about using drugs in a sport-doping scenario. As if taking testosterone at the age of 43 would somehow give you the neighborhood advantage at mowing grass on Sunday mornings.
There have been significant mislabeling of the drug testosterone due to the fact that it does have anabolic properties in relationship to the masculinization and growth of muscle tissue, and for those that don’t have an understanding or perhaps an intrinsic desire to live within the world a physical culture. Everything about testosterone use marks an increase in biological traits widening the masculine divide between physical external and the intellectual internal. Let face it, if testosterone had zero side effects; and contrary to popular opinion increases in anabolic growth is indeed a side effect. There would be little conversation about the drug, but there is still a sliver of animal self in all humans. The last time I studied the mating habits of social gatherings, the really smart guy with man boobs doing trigonometry at the bar wasn’t pulling “Bilzerian” quantities of ass. Testosterone is in the end the thing that makes us male, and currently a lot of figure and fitness girls a little more male too.
However, with the increase and scientific progression of a technology that is actually quite old we are seeing a transition and acceptance towards the application of the hormone. An acceptance that comes in my opinion with the exponential advancements of technology and social stress. There is a strong correlation between the chronic elevations of cortisol and the decreases in testosterone and free testosterone. Where we once had a natural balance in our daily lives that has been replaced by chronic commitment and expectation. So those who may have never picked up a sporting implement in their youthful years are now running headlong into chronic fatigue adrenal depletion and a failing libido.
The implementation of hormone replacement therapy is not a topic that I typically discuss openly, due to the fact that there has been so much miss placed opinion. Yet as I get closer to the age of 40 and look back on how extremely demanding I was on my body both athletically and socially. I feel that I can no longer sit idly by and watch what I consider to be one of the biggest hazards currently in the personal training industry.
The hazard that I’m speaking about is in relationship to turning back the hands of time through the use of testosterone and testosterone related compounds. Without taking into consideration that although we may feel the renewed vigor and youth we are still operating with in the confinements of a physical system that no longer has the youthful renewability that it once did. This is an area of strength and conditioning programming in particular that I put a lot of focus on for private clients, due to the fact that we start to see a number of correlated issues.
When we are dealing with a client that introduces hormone replacement therapy to their life with a goal of reestablish what I would referred to as neutral or positive testosterone ratio, we begin to see an increase in not only vigor and energy but also an increase in response of muscle tone and strength. This increase in response of muscle tone via hypertrophic muscle mass and increased rates of restoration drives the hormone replacement client to push at levels more indicative to someone 10 to 20 years there Junior. When personal trainers and coaches start working with clients that are actively using hormone replacement they have a tendency not to take into consideration that outside of peptides like IGF-I or growth hormone which are not typically included in an HRT protocol there is little that testosterone replacement can do to help regulate the regeneration and elasticity of connective tissue.
A secondary factor that is often not taken into consideration is the fact that although the hormone replacement therapy is working to counter act the persons chronic long-term stress reaction, and potentially negatives from detrimental lifestyle. Without a conclusive and complete reevaluation of daily and weekly habit you’re simply putting a brand-new engine into a really old car.
Hormone replacement therapy clients that are 35 years or older you have to always be cognizant of the fact that they may be bringing with them 20 years of acute and chronic orthopedic issues from a very active past. Or on the inverse, the 50-year-old executive male who makes the decision to pursue longevity and health simultaneously, and may have zero background in physical activity. Yet now with the introduction an anabolic compounds to which benefits can come fast and progressive regardless of age of administration the potentiation of muscle tears ruptures and/or chronic inflammation are abundant. When dealing with a history it is incredibly important to take into consideration the age of the body not the emotional aptitude and wellbeing of the client.
Remember to always focus on the fact that hormone replacement therapy does not lower the cortisol or decrease the stress it’s simply allows their body to tolerate that the causes more efficiently. In fact one area of contention that we often run into is related to the realization that HRT allows clients to push harder at an increasing age. Perhaps even potentiating the stress related health issues that can occur like high blood pressure, heart disease and adrenal fatigue. Making a person that is a type ‘A’ more so.
So it’s extremely important that when your program for the plus 40 HRT category of clients that you balance progressive slow overload with ample restoration. Even though they may feel as if they are recovering quicker then the rest that you were allowing them in their training program. The sensation is almost best described as superficial and you have to explain to them in detail that restoration happens in two phases. The external perceived which are muscle soreness fatigue and energy, and the internal, which is hormonal and orthopedic. I would argue that when working with HRT clients over the age of 50 for example it would be very similar at times to training a very young or new athlete / client. Now I understand there’s always going to be exceptions to the rule, and someone with 35 years of quality training and expertise in the field will probably fall outside of these recommendations. But then again they’re probably not hiring a trainer at golds gym three times a week
The reason why someone is put on HRT in the first place is due to the fact that either through lifestyle or external circumstance they have not been able to keep up with their lifestyle demand in relationship to the hormonal profile.
Simply put, the cortisol has been elevated for so long that their testosterone and adrenal function is kaput, or it is a client who intermittently used hormones in the past and has done a natural disservice to the process of testosterone production. Regardless of how the client got to the point they’re at currently the one thing that you can conclude is that they are of a personality type and lifestyle design that currently doesn’t support a healthy hormonal profile.
So you have to take into consideration a program or design that allows them to continually improve their health and wellness hypertrophy and strength but it is imperative that you take into consideration that although they may feel 28 in the pants they are still a decade or two older in the joints.
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