On the one hand, testosterone is misused to enhance performance in sports. On the other hand, it is used as an important pharmaceutical for certain diseases. Following you will find important information that athletes should consider before starting a medical treatment with testosterone.
Testosterone is the most important sex hormone in men and is largely responsible for building muscle mass and the production of sperm cells. It also promotes growth of body hair, increases libido, and generally boosts drive and endurance.
Because of these effects, testosterone and other substances derived from it are called anabolic androgenic steroids and rate among the most commonly misused doping substances in sports.
More information on the consequences of doping with anabolic androgenic steroids can also be found on GEMEINSAM GEGEN DOPING
At a glance:
The use of testosterone is prohibited in sport at all times. The rules do allow athletes to apply for a Therapeutic Use Exemption (TUE) for testosterone; however, as testosterone is such a powerful performance-enhancing substance, the requirements for approval are very strict. It must be proven that there is a documented testosterone deficiency, originating from an organic cause. Athletes who cannot demonstrate an organic etiology risk an anti-doping rule violation and receiving a long-term ban.
The use of testosterone is prohibited at all times in sports. Therefore, if athletes have to use testosterone for medical reasons, they require a Therapeutic Use Exemption (TUE). Athletes, who are member of a NADA Germany testing pool or certain professional German sports leagues , must apply for a TUE before using testosterone. All other athletes who are not a member of a NADA testing pool must apply for a retroactive TUE for testosterone after an in-competition doping control and upon request by NADA.
TUEs for the use of testosterone can only be approved in special exceptional cases. In particular, an organic etiology of hypogonadism has to be demonstrated. These may be for example genetic abnormalities, bilateral testicular trauma or torsion or bilateral orchiectomy, radiation treatment, chemotherapy and genetic abnormalities and pituitary or hypothalamic tumors. TUEs cannot be approved for low circulating testosterone due to functional states (i.e. due to stress, obesity, malnutrition, overtraining or aging). This rule applies to all athletes, regardless of their testing pool status.
For this reason, NADA strongly advises all athletes to begin testosterone therapy only if there is a clearly diagnosed organic etiology. The mere detection of low testosterone levels is not sufficient for granting a TUE! If you have any questions or uncertainties, please contact NADA's Department Medicine.
WADA's guideline on hypogonadism and how to apply for TUEs can be found at https://www.wada-ama.org/en/resources/therapeutic-use-exemption-tue/medical-information-to-support-the-decisions-of-tuecs-male).
If you have any further questions, please contact NADA’s Department Medicine by phone at 0228 812 92 - 132 or by mail at medizin(at)nada.de.
Another area of application of testosterone is hormone replacement therapy for trans men. these athletes must also apply for a TUE. Depending on the testing pool status they have to apply for a TUE before the application or after a doping control. For this purpose, the completed TUE application form and a current specialist report with history, findings, current medication, possible duration of treatment, and reason why no other substance can be used must be submitted.
NADA is solely responsible for approving the use of prohibited substances or methods in relation to transgender athletes. Decisions on the eligibility of athletes to compete fall into the competence of the national or international sports federations.
Important medical information and WADA guidelines on gender reassignment TUE applications can be found here.
