By Jens Moeller
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Additional info for Cholesterol: Interactions with Testosterone and Cortisol in Cardiovascular Diseases
If exertion is excessive (dysstress), tissue hypoxia can arise from the extreme demand for oxygen. However, if physical activity is limited, so that hypoxia is avoided, both skeletal and cardiac muscles can be exercised in a beneficial way. Vagal tone is increased, stroke volume rises, oxygen is used efficiently, and testosterone production increased. As Ganong writes (1975, p 421): "One of the differences between untrained individuals and trained athletes is that the athletes have lower heart rates, greater end-systolic ventricular volumes, and greater stroke volumes at rest.
In older people, who are the biggest age group, the physiological factor is increasingly important and becomes more dominant than the pathological factor. As the physiological factor is refractory to treatment, the statistical results of such trials may give the completely wrong picture that testosterone treatment is not effective in a sufficient number of cases. An absolute condition for anyone participating in the discussion of CVD must be that he has at least some clinical knowledge. Everybody that I have met till now who proposes statistical evaluation has never dealt clinically with CVD patients, and they compare this ailment with other diseases where it is possible to conduct ordinary clinical trials.
Nevertheless, when I question male patients about their sexuality and hint at impotence and lack of erection some of them are very surprised that I raise this problem since they had themselves noticed that they began to feel less sexually active at the same time their circulatory disorder started. Endogenous testosterone only has an effect on the tissue of muscles and vessels if the individual is physically active. This is also true for administered testosterone. For this reason, patients are advised to move about to the limit of pain, but not any further.