Charles J. Ryan

My first read was a library book. I bought a kindle edition and got a lot more of the nuances on the second read. The second time I include more quotes from the book because reading it on Kindle makes it easy to highlight.

Here are a few interesting points:
- Both low and high levels of testosterone has undesirable effects.
- Low Testosterone has been used for treating cancer. There is investigation of using high levels for the same purpose.
- Women have about 10X less testosterone than men.
- Men have about 10X less estrogen than women
- Testosterone and oxytocin are antagonistic
- Testosterone declines when parenting
- 'Testosterone is the chemical of aggression, dominance, and reduced empathy.'


This book raises a lot of concerns that are not easily addressed. It addresses them from the perspective of an oncologist who has seen the effects of high and low testosterone.

"Consider this scene from Plato's Republic, written more than two thousand years ago:
"I [Cephalus] was once with Sophocles the poet when someon asked him, "How do you feel about sex, Sophocles? Are you still capable of having sex with a woman?""
"He replied, "Be quiet, man! To my great delight, I have broken free of that, like a slave who has got away from a rabid and savage master.""
"I thought at the time that this was a good response, and I haven't changed my mind. I mean, there's no doubt that in old age you get a great deal of peace and freedom from things like sex. When the desires lose their intensity and ease up, then what happens is absolutely as Sophocles described - freedom from a great many demented masters. (43)" (Page 74)

"For now, exercise, nutrition, and keeping the brain active are the best we can offer as a recommendation to prevent Alzheimer's and mild cognitive impairment." (Page 94)

"I can imagine a future in which I have this potential conversation with patients: "If you undergo hormonal therapy, [to reduce testosterone levels] you might get Alzheimer's disease; if you don't you might die of prostate cancer." (Page 94)

Chapter 9: Poetry and Placebos
"The placebo effect may actually be one of three phenomena:
1. The Hawthorne effect, ... because they are being observed by a researcher;
2. The ‘ritual effect’ in which the subject' experience of the therapeutic ritual (for example, of taking pills) results in reports of improved symptoms; or
3. The "attention effect,". In which having the attention of doctors and the medical community ... result in self-reports of improvement.” (107) (Page 146-147)

"About 80 percent of beef cattle in the United States get dosed with [Trenbolone] or someting similar before slaughter." (Page 178) (Trenbolone is a synthetic testosterone)

The end of the last paragraph in the book is: "At the heart of our knowledge is the fact that while virility gives life amazing color and dynamism, it can also extract a cost. That's a paradox we'll just have to live with." (Page 203)

Part 1: The chemicals that bind us (chapters 1-4)
Part 2: The many faces of virility (chapters 5-8)
Part 3: Evolution, manipulation, and adaptation (chapters 9-12)

Chapters:
1. ... From competition to compassion
2. ... How fetal testosterone shapes our thinking
3. Women and testosterone: Inner virility and outer identity
4. Bell curves and binaries: Womanhood and testosterone among the outliers
5. ... The chemistry of coupling
6. ... Testosterone and Alzheimer's
7. ... Of hair and hormones
8. ... The biological underpinnings of sexual aggression
9. Poetry and placebos: The ongoing quest to rekindle virility
10. ... Supplementation and its discontents
11. Beauty versus the beast: Bodybulding, steroids, and the aesthetics of manhood
12. ... Hormones and the nurturing environment that shapes families
Notes and an Index… (plus d'informations)

This book raises a lot of concerns that are not easily addressed. It addresses them from the perspective of an oncologist who has seen the effects of high and low testosterone.

'Testosterone is the chemical of aggression, dominance, and reduced empathy.'

"Consider this scene from Plato's Republic, written more than two thousand years ago:
"I [Cephalus] was once with Sophocles the poet when someon asked him, "How do you feel about sex, Sophocles? Are you still capable of having sex with a woman?""
"He replied, "Be quite, man! To my great delight, I have broken free of that, like a slave who has got away from a rabid and savage master.""
"I thought at the time that this was a good response, and I haven't changed my mind. I mean, there's no doubt that in old age you get a great deal of peace and freedom from things like sex. When the desires lose their intensity and ease up, then what happens is absolutely as Sophocles described - freedom from a great many demented master. (43)" (Page 74)

"For now, exercise, nutrition, and keeping the brain active are the best we can offer as a recommendation to prevent Alzheimer's and mild cognitive impairment." (Page 94)

"I can imagine a future in which I have this potential conversation with patients: "If you undergo hormonal therapy, [to reduce testosterone levels] you might get Alzheimer's disease; if you don't you might die of prostate cancer." (Page 94)

Chapter 9: Poetry and Placebos
"The placebo effect may actually be one of three phenomena:
1. The Hawthorne effect, ... because they are being observed by a researcher
2. The "ritual effect" in which the subject' experience of the therapeutic ritual (for example, of taking pills) results in reports of improved symptoms; or
3. The "attention effect,". In which having the attention of doctors and the medical community ... result in self-reports of improvement.(107) (Page 146-147)

"About 80 percent of beef cattle in the United States get dosed with [Trenbolone] or someting similar before slaughter." (Page 178)

The end of the last paragraph in the book is: "At the heart of our knowledge is the fact that while virility gives life amazing color and dynamism, it can also extract a cost. That's a paradox we'll just have to live with." (Page 203)

There are 142 notes and an index.

Part 1: The chemicals that bind us (chapters 1-4)
Part 2: The many faces of virility (chapters 5-8)
Part 3: Evolution, manipulation, and adaptation (chapters 9-12)

Chapters:
1. ... From competition to compassion
2. ... How fetal testosterone shapes our thinking
3. Women and testosterone: Inner virility and outer identity
4. Bell curves and binaries: Womanhood and testosterone among the outliers
5. ... The chemistry of coupling
6. ... Testosterone and Alzheimer's
7. ... Of hair and hormones
8. ... The biological underpinnings of sexual aggression
9. Poetry and placebos: The ongoing quest to rekindle virility
10. ... Supplementation and its discontents
11. Beauty versus the beast: Bodybulding, steroids, and the aesthetics of manhood
12. ... Hormones and the nurturing environment that shapes families… (plus d'informations)