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Testosterone is more than a “male sex hormone”. It is an important contributor to the robust metabolic functioning of multiple bodily systems. The abuse of anabolic steroids by athletes over the years has been one of the major detractors from the investigation and treatment of clinical states that could be caused by or related to male hypogonadism. The unwarranted fear that testosterone therapy would induce prostate cancer has also deterred physicians form pursuing more aggressively the possibility of hypogonadism in symptomatic male patients. In addition to these two mythologies, many physicians believe that testosterone is bad for the male heart. The classical anabolic agents, 17-alkylated steroids, are, indeed, potentially harmful to the liver, to insulin action to lipid metabolism. These substances, however, are not testosterone, which has none of these adverse effects. The current evidence, in fact, strongly suggests that testosterone may be cardioprotective. There is virtually no evidence to implicate testosterone as a cause of prostate cancer. It may exacerbate an existing prostate cancer, although the evidence is flimsy, but it does not likely cause the cancer in the first place. Testosterone has stimulatory effects on bones, muscles, erythropoietin, libido, mood and cognition centres in the brain, penile erection. It is reduced in metabolic syndrome and diabetes and therapy with testosterone in these conditions may provide amelioration by lowering LDL cholesterol, blood sugar, glycated hemoglobin and insulin resistance. The best measure is bio-available testosterone which is the fraction of testosterone not bound to sex hormone binding globulin. Several forms of testosterone administration are available making compliance much less of an issue with testosterone replacement therapy.

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Heterosexual, homosexual, and bisexual pedophiles were compared to nonviolent nonsex offenders using the Reitan Neuropsychological test battery, the Luria-Nebraska Neuropsychological test battery, Wechsler Adult Intelligence scale, and CT scans. The men were classified into their groups based on criminal history, a standard Sex History assessment, and a phallometric test of erotic preference. Pedophiles tended to have lower IQ's than controls and showed significantly more impairment on all measures. Left temporo-parietal pathology was noted more often for pedophiles. Results were not changed appreciably when history of alcohol and drug abuse or age variation were taken into account. The findings suggest that neuropsychological examination can provide useful and potentially discriminating information in pedophilia and should be considered an important supplement in clinical assessments of the disorder.

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