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A fraction of the androstenedione is converted to testosterone, which in turn undergoes conversion to estradiol by an enzyme called aromatase. This process, however, is a reversible one, and women who have lost their ovaries don't have this conversion to estrogen on hand, causing increased androgens and estrogen levels in their bodies. In order for estrogen to return to normal, estrogen must be converted back to androstenedione. Androgen replacement therapy is available to relieve androgen-induced side effects as well as to improve the appearance and function of breasts. Asterisks, symbols, and other characters are used to indicate that a study is published in a medical journal. The following guidelines describe studies showing the benefits of testosterone with respect to various parameters of health and behavior: Studies that have found no difference: There are no data to suggest that testosterone is harmful to men. Takes place only in men over age 40: The study is limited to men who have not yet had their testicles removed, or who could not be studied directly with the exception of those who are in a vegetative state. Some studies have found a positive association in men: An increasing number of studies have found associations between testosterone levels and various health markers, including cancer. Treatment of men with low testosterone levels: Testosterone replacement therapy may lead to significant changes in the physiology, including improved muscle strength, improved sexual function, greater bone density, reduced depression and anxiety, increased testosterone and energy, increased sexual interest, improved quality of life, and improved mood. Treatment of men with hypogonadism: Testosterone supplementation can be useful in improving mood, energy, sexual functioning, and fertility. The only data to suggest these benefits are from studies of men who need to be on this therapy for a long time. The clinical trial for treating hypogonadism in women is still in progress. Treatment of men with low levels of testosterone: Treatment of low testosterone is also being explored for men who are over age 40 and have not yet had their testicles removed. Treatment of men with low levels of both testosterone and androstenedione: Because high testosterone levels are also associated with depression, men with low testosterone levels should be offered treatment for depression. Treatment for a depressed patient should address the factors that contribute to depression, including poor living environment, insufficient sleep, and social isolation. Treating men with low levels of both androstenedione: If low testosterone levels are also associated with depression, low testosterone levels need to be treated for depression and other problems. Asterisks, symbols Related Article: