The article that I cut and pasted discussed the use of deprenyl as a way to increase testosterone function. I am currently in PCT, (taking tamoxifen, DHEA, topical formestane, creatine (Swole V3) - all following a 30 day cycle of Halodrol) and although I am not feeling totally run down, I am feeling a little fatigued. I was wondering if anyone here has utilized deprenyl as part of their PCT, and if so, did the use of deprenyl lead to an improvement in mood, sex drive, and energy during the PCT period.

Restoring Hormonal Balance:
An Interview with
Dr. Rick Cohen

By David Jay Brown

Rick Cohen, M.D., is recognized as a leading authority in the treatment of male hormonal imbalance. He earned his degrees from Duke University and Hahenmann Medical University, and has a strong interest in optimum male health and performance. Dr. Cohen assisted the U.S. Senate on the safe promotion and progressive use of dietary supplements, natural hormones, and hormone precursors.

Dr. Cohen has focused his professional interests on how declining levels of testosterone effect men as they age, and he developed a series of effective treatments and products to help reverse this decline. His in-depth clinical experience and research prompted him to found MedLean in 1998. Dr. Cohen's primary goal in starting this company was to educate the male population on testosterone related issues, as well as to market natural testosterone enhancing products and self-testing materials.
Michael Fossel Photo
Dr. Rick Cohen
Testosterone is considered the quintessential male hormone, as it is quite literally what turns boys into men. Healthy testosterone levels are associated with sexuality and strength in men, and like most other hormones in the body, testosterone levels decline dramatically with age. (Insulin, cortisol and, in men, estradiol tend to go up.) Low levels of testosterone are associated with numerous health problems, including muscle weakness, insomnia, depression, an inability to concentrate, and a loss of interest in sex.

Testosterone is available by prescription in every pharmacy, but there are also numerous alternative—and often more effective—treatments available for naturally raising testosterone levels. These treatments range from using precursor prohormones like androstenediol, nutritional supplements and pharmaceuticals, to diet and lifestyle choices.

Unfortunately, the prohormone androstenediol—which is one of the safest and most effective prohormones that aging men can use to raise their testosterone levels—may soon be pulled from the market due to Congress passing the Anabolic Analogs Act. According to Dr. Cohen, the government's motivation for banning androstenediol has nothing to do with safety or health issues, but rather because the prohormone can significantly improve the performance of professional athletes.

Rick has a relaxed manner, and a lively interest in human longevity. We spoke about the relationship between hormonal decline and aging, how testosterone and estrogen levels shift in men as they age, and the best ways for aging men to restore hormonal balance.
Q: What sort of relationship do you see between hormonal decline and aging?

Dr. Cohen: There's a direct correlation between aging and hormonal decline, specifically with the bioavailable levels of testosterone. It pretty much declines one percent every two years after the age of thirty-five. So, on average, testosterone levels will continually decline. Some men will hold up and then will drop rapidly after some type of trauma or major stress in their life. Other men will do fine until they hit some type of threshold—sixty percent, fifty percent, or forty percent of what they were. They're still not "hypogonadal", but at some point they just don't feel well. Whether it's energy, drive, endurance, or interest in activities, they're just not the same person that they were.
Q: What are some of the other symptoms that men might experience from having their testosterone levels drop as they age?

Dr. Cohen: Some of the symptoms include a loss of muscle strength, fatigue, inability to concentrate, and difficulty sleeping. Obviously there may be a loss of sexual performance or sexual capabilities, and there can be mood disorders like depression and anxiety. Testosterone deficiencies are also related to cardiovascular difficulties, so it's just a whole slew of interactive or interrelated body functions. Testosterone enhances anything that is anabolic in the body—anything that works on improving function, strength, and activity. That's testosterone's job.
Q: What is the relationship between testosterone and estrogen in men as they age?

Dr. Cohen: Testosterone gets converted to estrogen. Normally estrogen is a byproduct of testosterone, converted in the liver and the fat cells. As the body ages, particularly in men, there's more fat than muscle. So that's one component to this, as fat is a major source of conversion of testosterone to estrogen. Also, as the body ages, the liver becomes a little less active in function, so that's another issue.

But I think the other bigger factor is alcohol, and drug use. Alcohol, antacids, antidepressants, and medications for cholesterol affect the liver. There are a number of different things that will affect the cytochrome and conjugation systems, such as environmental chemicals and environmental estrogens, which are obviously an issue that is not as much in the forefront as we would all like to see. But those also play a role, and certainly the longer we live the more of a burden we have on our body.

So that's also creating higher estrogen levels, and estrogen then serves as a feedback to suppress testosterone release. In the body that's pretty much the feedback mechanism. The hypothalamus reads how much estrogen is in the body, and when it sees too much estrogen it then begins to shut down testosterone production.
Q: How does testosterone affect men and women differently? Or does it?

Dr. Cohen: Not necessarily. It's just the preponderance in men as for women. Men generally have about eight times more testosterone than women, so women are actually much more sensitive to the effects of testosterone than men. But obviously the ratio of estrogen to testosterone creates different functions and activities in men and women. In women, testosterone certainly has a role with muscle strength. They're not going to get the same amount of muscle strength as men because they never have the same amount of testosterone, but if it's very low they can sometimes have some difficulty with muscle tone. Testosterone probably has its greatest effects with sexual desire in women as they age. The greatest decline in testosterone is after menopause, and like all these hormones, they need to be at optimal levels for someone to function at their best, and generally testosterone is not replaced in women, other than with functionally-oriented doctors. But the mass physician bias is obviously prescribing synthetic hormones, and testosterone is rarely a part of that.
Q: How are testosterone levels affected by other hormones like DHEA and pregnenolone?

Dr. Cohen: In what way? DHEA and pregnenolone are precursors to testosterone.
Q: Then why would someone need to take testosterone supplements if they were taking DHEA or pregnenolone?

Dr. Cohen: Taking DHEA and pregnenolone does not necessarily go to testosterone because there are other pathways. DHEA and pregnenolone are too far up the metabolic chain. Going down the metabolic chain is like going down a stream of tributaries, and there are too many tributaries in men before it gets to the area where it can be converted into testosterone. In women, you can see some testosterone increases with DHEA, but rarely can you take enough DHEA to get a good reliable bump in testosterone. I'm not saying that this is true for everyone, but for the preponderance of people it's not going to happen. You might feel better if you take DHEA or pregnenolone, but it's not going to reliably raise testosterone.
Q: So what do you think are the best ways for aging men to restore declining hormonal levels and regain proper hormonal balance?

Dr. Cohen: I guess it all depends on what age range you're talking about. If you see guys in their twenties and thirties with low testosterone, it's either a true hypogonadal situation due to some pathological issue, or there's some major stress or nutrient imbalance that's playing a role. So in those people, you can work on the brain and lifestyle more reliably because their genetics are still able to pump out testosterone as long as there's not a disease. As you get into the forties you have to be more careful, and a lot of times this means adding nutrients and essential fatty acids to their diet, losing weight, and getting them active again. In those men we'd also sometimes use something called HCG [human chorionic gonadotropin] to actually stimulate the testes, or deprenyl to stimulate the brain. We would try and work on the other pathways that might enhance testosterone indirectly.
Q: Deprenyl enhances testosterone?

Dr. Cohen: Yeah, we've seen that with bromocriptine and deprenyl.
Q: Really?

Dr. Cohen: Yeah, there's a relationship between the neurotransmitter dopamine and testosterone.
Q: What's the relationship?

Dr. Cohen: Dopamine provides feedback to the endocrine system, and enhanced dopamine and testosterone are directly related. I've actually seen phentermine increase testosterone as well. When you think about it you can see how they're directly related. The actions of dopamine—of focus, intensity, vigor, preparing to fight, preparing to hunt, preparing for sex—are all what you see with testosterone.

Studies show that athletes and fans have higher testosterone levels after a victory. They're rowdy. They're riled up. They're excited. Dopamine is one of the neurotransmitters that is going to play a role in that, and testosterone levels are up. If you're feeling tired, fatigued, or depressed, your serotonin levels are either high or your dopamine and testosterone levels are low. Both dopamine and testosterone levels are also high in the morning. But are they exactly related? No, although they pretty much follow a similar activity pattern.

So we've seen that by working to increase dopamingeric activities, in whatever way that might be, this can also play a role in testosterone production. We would do this when men are in the forties and fifties, depending on how healthy the person is. First we would try and work indirectly, and let the body restore itself, because that's always the nicest way to do it. As you start getting older then you'll go to straight [hormone] replacement, always making sure to cover for increased levels of estrogen, and trying to look at thyroid because thyroid and testosterone work together. I've seen replacing thyroid levels enhance testosterone as well.

So it's really looking at all these different factors, and how they're interrelated. You can't always get them to coordinate, but maybe you could if you kept on plugging away. There's the science of medicine, and then, I guess there's the art of treating people. Sometimes people don't care, and they just want to feel good. Then I say, okay, we can do this, this, and this, and it might take us six months to really figure out exactly what's going on. Then you might have to take four vitamins, a nutrient, and do this to feel good. Or we could give you some testosterone directly, and you do one thing a day, maybe watch for estrogen, and you'll feel good.

Now, it's not exactly natural, but you won't have any problems if we do it this way. They're both safe, so you can do it either way. Some guys say that they want to do what's going to completely work with their body, and other people say, just help me get better tomorrow. So it's really up to what the person wants. But at least there are options, and, when you need to work with someone in a specific way, you have alternatives to work with.