Testosterone Replacement Therapy Might Be Legal, but It’s Still Cheating in Professional Sports

Posted by Dr. Michael White, Updated on September 17th, 2023
Reading Time: 9 minutes

To "T" or Not to "T" that is the Question for Professional Athletes

Doctor-prescribed Testosterone injections, gels, and creams are in the limelight these days, as everyone is talking about HRT (hormone replacement therapy) the hot topic today, and how it helps adult men overcome naturally induced, age-related hormone deficiency.

Testosterone replacement therapy (TRT) has taken on a life of its own in the heated dialogue regarding its legality for medical treatment.

But there is also concern about the legality of performance-enhancing drugs (PEDs) being used as an advantage by mixed martial artists who step in the arena to fight it out for victory.

Mixed Martial Arts Took Professional Sports Like A Storm

MMA was hardly known one to two generations ago, and then it came out of the horizon like a wild sand storm or snowy blizzard out of nowhere and it is one of the most popular sports in the world.

I remember when I was traveling the world a decade ago, and would see MMA on high mounted TV sets at bars in countries where they didn't even speak a word of English.

I giggled at how obsessed people were at watching American WWE professional wrestling, no matter what country I went to where English was not commonly spoken.

Should Testosterone Injections be Allowed in Sports?

There are proponents of TRT and HGH injections in the milieu of MMA, bare-knuckle pugilism, and old-fashioned 12-round boxing, advocating for its use, but it's still cheating if some are using it without legitimate medical purposes, and others are not using it at all, but they happen to step into the same ring.

It's cheating because the fighters using Testosterone have a distinct advantage over those not using it. If you put two equal fighters in the ring, and one is using Testosterone and the other is not, my betting money is on the one with the Testosterone.

If you have any doubts that exogenous (external) Testosterone does not give an advantage, just look at the difference between bodybuilders using steroids and those who take the non-steroidal natural approach to build their bodies. The difference is night and day.

Athletes Rarely Disclose TRT Usage

Even if a person is using TRT for legitimate purposes, and in a safe manner, if they go against someone who isn't using it, they hands down have a better chance of winning. Most MMA athletes using Testosterone or HGH are not disclosing it for obvious reasons. Thus, we now have a complex situation which is going to require more dialogue to untangle the controversy. And this is going to have to be systematic.

Crossroads of Amazing Hormone Production and Products

We are at a kind of crossroads these last numbers of generations, because medical science has reached a pivotal time in human history where they can biologically synthesize many of the hormones that are naturally produced by our glands and organs with astonishing ease.

Since the 1980s, HGH has been manufactured by genetically engineering E-Coli bacteria to mass-produce the complex pituitary molecule that is both a protein and a hormone. Testosterone has been around for a long time, and currently, it is extraordinarily affordable to produce the bio-molecule.

And the cost of manufacturing, purely at the pharmaceutical level, is getting cheaper every decade.

The First HGH Shot was in 1959

Before the 1980s they had to extract HGH from the pituitary glands of cadavers, which is why one-shot cost $10,000. The very first HGH shot was thought to be in 1959, for a child who was short in stature.

It worked wonders as therapy continued and excited the medical community at the time beyond words.  Today, for roughly $500 to $1,000 per month, people can go on doctor-monitored HGH treatment programs.

Testosterone is far cheaper than HGH: a 10-week Testosterone program under doctor supervision can cost around $500 to $600, depending on what other medications are added in the protocol.

One does not typically just use Testosterone by itself -- there are other medications that go along with it to prevent side effects.

And these general prices for HRT are constantly falling over time, as you can see, from their initial cost of $10K per injection regarding HGH. I can foresee in the far future, when a month of well-rounded hormone therapy will cost no more than a single dinner for two at a restaurant and a night out at the movies.

Intellect and Skill Through Training Decide Champions

We implicitly, often without ever articulating it verbally, expect athletes to be credible and have good reputations, who reflect the spirit that intellect and skill should be the deciding factor between who wins in any competition.

We expect those with the best combination of body and mind, and training, of course, to be the deciding factor in determining who is superior on the playing field. And by our very natures, we love a good fight, we love to see two equally matched people in the arena fight it out in a long battle of attrition.

We delight in seeing the combination of chance and choices, and mental focus winning the day. We love seeing our favorite team win the championship after a long season of hard training.

Tooth and Nail

We don't want to see a boxing match end in the first round and we don't want to see a football team win 47 to 0. Watching Mike Tyson knock someone out in the first round is anticlimactic and not as enjoyable as watching someone get knocked out in the twelfth round or winning for superior performance.

We want the "nail biter" that keeps us at the edge of our seats.  If two roughly equal fighters in height, weight, training, and skill enter the arena, the guy who is using injectable Testosterone is going to likely be the winner -- its almost a safe bet in the aggregate.

Testosterone replacement therapy gives athletes a significant advantage because it directly relates to muscle development, fat burning, bone mineral density, and mental focus.

We know this because men who suffer from testosterone decline often report symptoms of muscle loss, fat gain, loss of libido, mental fog and weak brittle bones.

So we come back full circle, hanging in the balance is whether we allow all athletes to use performance-enhancing drugs, primarily, Testosterone (and HGH) or not. Right now the answer is "no", but there is too much wink-wink when it comes to that "no".

Coaches can feign they are against Testosterone utilization, but they know in the back of their mind it provides the winning advantage and hence their career reputation. Many coaches are motivated by ego, not effort.

Testosterone is a Game Changer and Undeniably Advantageous

Testosterone treatment absolutely improves the natural bone and muscle makeup of MMA fighters and boxers -- there can be no doubt about it from a scientific perspective -- or any athlete for that matter (not just fighters).

The assumption is that the athletes are really pushing themselves in the gym and training ring, because taking Testosterone by itself is not enough. Athletes who use Testosterone as a crutch to make up for laziness, will never beat their equal opponents who do not use Testosterone but train hard.

Testosterone makes great fighters become amazing fighters, good fighters become great fighters, at the level of performance expected in professional sports.

Testosterone can easily be a deciding factor in the ring ,and sometimes is, and we can see the difference with our eyes. Which is why Testosterone is an unfair advantage if one of the fighters is depending on training and studying alone without TRT.

Any fighter at the top of their game will go to the next level with testosterone replacement therapy. This is why there have to be ethical boundaries in MMA and other sports, which are sorely lacking.

The administration of sports leagues are finally starting to test players on a regular basis.

Testosterone Usage Should Be Required to Be Disclosed

It is something which should be disclosed, if one of the fighters is getting TRT treatment for legitimate therapy or not. There are ethics in business, in universities, in government jobs, in political offices, so why not sports?

Why should TRT use be a secret? Some would argue TRT should be allowed in the sport as it takes the athletes performance to the next level, some consider it cheating, in the end.

If it were required to be disclosed, and there was expulsion for not disclosing it, then perhaps sports could be more out in the open about it. But now things just got more complicated.

Because now its usage would become a mandate. As it stands, users have no choice but to be completely silent about their use of testosterone.

Right Now Users Seem to Have No Choice but to be Mum (Silent) About it.

American Testosterone replacement therapy and treatment protocols are very legal for a wide variety of valid reasons, even today.  The problem with TRT is, while it is legal in the United States, it is cheating if not disclosed by the user and this is the point that must be hit home.

The problem is, if someone admits to using TRT, they would be thrown out of sports.

Administrative leadership has banned its use in the sport because athletes typically do not disclose it and not everyone uses it, and if it were allowed in sports, many would use it but there would be some who did not want to use it for health concerns.

Optimal Versus Abuse

The health concerns are simple. There are those using optimal testosterone replacement and those who are abusing it. Remember all those professional wrestlers from the 1980s and 1990s, who are no longer with us? Who died young? They were using insane amounts of steroids, far above optimal amounts. They paid the price when they hit their midlife. Another sour note -- remember the bodybuilder Rich Piana? He died in his mid-40s after admitting he abused steroids at astronomically high doses for 25 years and was willing to take the risk.

You can't force people to use injectable hormone therapy to be equal and this is what is starting to happen: It's getting to the point where if you do not use performance-enhancing drugs, you won't be equal to your peers, and this is exactly why many sports are mandating blood testing to see if their athletes have exorbitant levels of growth hormone or testosterone in their body.

Testosterone in Sports: Allowed or Not Allowed. The Debate Continues.

Should we deny people injectable testosterone who genuinely need the therapy? No, of course not. But these types of therapies should not be used for an unfair advantage and they are currently being used as such.

Some athletes are claiming they had a deficiency in testosterone, but in reality did not, based on their blood work, and thus are using Testosterone therapy as a ruse to outperform their counterparts.

If we are going to allow people to have this unfair advantage, then we should divide up sports by leagues that use hormone replacement therapy and those that don't.

The ones that don't should have their blood tested regularly to see if abnormal use is going on. For leagues which allow testosterone therapy, those players are taking a risk to their long-term health if they decide to abuse these legitimate therapies at higher than prescribed doses.

Now you can see why this is a problem. Optimal usage has been argued by doctors as being safe and effective, but no doctor would ever argue that high doses of these hormones are good for long-term health. How would we control athletes from not abusing these safe drugs?

You would have to institute strict policies to eject athletes with dangerous levels of these very important hormones.  As it has been said in the past, there are athletes who genuinely might have hypogonadism or hypopituitarism (low-T or low HGH).

What Makes Greatness in Sports: Focus Not Needles

We should measure greatness in sports like the long, grueling process of long, hard work in the weight room, cardiovascular training, diet, study and ever-rising mental will power.

It is all aspects of training, dedication, perseverance, obsession with overcoming the obstacles in the mind -- such as when the body says no, the mind must say yes -- which defines greatness.

It is sacrifice and spirit that wins the day, or at least that is how it was for generations before the advent of TRT -- testosterone replacement therapy.

All things being equal, hormone replacement therapy under safe, specialist doctor supervision, or worse, dangerous back-alley steroids, gives an unequal and unfair advantage in sports because of how it alters the body composition.

And there are athletes who will do anything to win, even unfairly, cutting corners, injecting formerly frozen red blood cells. There really should be no cutting corners, but unfortunately HRT is so rife in professional sports, to not use them almost puts many at a disadvantage.

This is regrettable and sends a wrong message to kids, teenagers and adults, that they too can unfairly cut corners in life, instead of working smart and working hard.

Hard-Work, Not Back Alley Steroids

Many of the superstar professional wrestlers from the 80s and 90s died far too young, literally in their 50s and 60s, some even earlier.

For the image and reputation of any professional sport, mixed martial arts included,  it should be one where the natural approach of hard work is ultimately what separates the individual champions when gladiators who step into the arena duke it out.

Conclusion: PEDs give an Unfair Advantage Against Those Who do not use PEDs

Do we allow testosterone, EPO and HGH injections as just another variable in the players game performance?

The leadership in almost every sport bureaucracy have made it clear: they think it's cheating, yet coaches still seem to look the other way, but act or speak as if they are against performance-enhancing drugs.

PEDs are a complicated subject, but the fact of the matter is, the men who abused the illegal stuff without a doctor's supervision are likely to pass away, on average, earlier than their counterparts who used these substances under doctor supervision for genuine medical therapy.

Our clinic does not provide TRT for patients who want to use it for performance enhancement in professional sports or bodybuilding.

TRT Might Be Legal, but It Is Still Cheating

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