Policy on Prescribed Testosterone
OCB handles theraputic use exemptions for prescribed testosterone due to androgen deficiency in the manner that the World Anti-Doping Agency (WADA) does.
Exemptions are possible in cases where there's a pathological physical change in the
structure of an organ or within the
hypothalamic-pituitary-testicular axis, such as:
- Genetic abnormalities – Isolated hypogonadotropic
hypogonadism (IHH) and variants, Klinefelter’s Syndrome
and variants (i.e. 47,XYY/46XY, 46,XX testicular DSD,
45,X/46,XY), dysgenetic testes, myotonic dystrophy.
- Developmental abnormalities – cryptorchidism, congenital
- Metabolic abnormalities – hemochromatosis.
- Direct testicular
trauma, surgical bilateral orchidectomy, testicular torsion.
- Orchitis – severe bilateral with subsequent testicular atrophy
due to mumps or other infections.
- Radiation treatment or
disorders – hypopituitarism, tumor, infection, hemochromatosis,
hyperprolactinemia due to prolactin-secreting pituitary tumor.
- Structural and infiltrative effects of systemic diseases – CNS
developmental abnormalities, infection,
β-thalassemia/hemoglobinopathies, granulomatous diseases,
lymphocytic hypophysitis hemochromatosis, sickle cell disease.
- Anatomical problems - pituitary stalk section, hypophysectomy,
pituitary-hypothalamic disease, traumatic brain injury.
Exemptions are not made in cases where there is no pathological physical change in the structure of an organ or within the hypothalamic-pituitary-testicular axis, such as:
- Overtraining, malnutrition/nutritional deficiency.
- Chronic systemic illness (chronic organ failure, diabetes mellitus, malignancy, rheumatic disease, HIV infection, Crohn’s disease, inherited metabolic storage diseases).
- Aging/Late onset hypogonadism.