Testosterone Replacement Therapy in MMA: Controversy and the Arguments For and Against
The use of testosterone replacement therapy (TRT) has been one of the key issues in the world of Mixed Martial Arts in the past few years, especially after Chael Sonnen was suspended for using the treatment and failing to disclose it to the California State Athletic Commission prior to his fight with Anderson Silva.
With the treatment seemingly becoming more and more common, or at least more open, opinion has been divided on whether or not it should have a place in MMA. Several major fighters have admitted to using the treatment and additionally, UFC President Dana White has publicly defended the practice. Despite this very public backing of the use of the procedure from within the sport, it remains highly controversial.
Dana White has, on several occasions, proclaimed the UFC to be the most regulated sporting league in the world when it comes to testing for performance enhancing drugs and that may well be the case. However, critics of TRT would argue that it is, in itself, a performance enhancing drug and yet it is often approved for use by athletic commissions and by the UFC itself.
What is Testosterone Replacement Therapy?
Put simply, testosterone replacement therapy is a procedure which raises the testosterone levels present within a person’s body. It can take the form of intramuscular injections, or testosterone gels and patches.
As a man ages, his levels of testosterone decline naturally. Usually, after the age of 30, this decline occurs at a rate of around 1% per year. Low testosterone has a number of unsavory symptoms, including lower self-esteem, depression, concentration problems, erectile dysfunction and a lower sex drive. Perhaps more specifically related to Mixed Martial Arts, problems with low testosterone levels can also include fragile bones, increased body fat and decreased muscle mass.
Typically, testosterone replacement therapy is prescribed as a treatment for people whose testosterone levels have declined abnormally, rather than naturally with age.
Why TRT Should be Allowed in MMA
Several high-profile fighters, including Chael Sonnen, Frank Mir, Dan Henderson and Quinton ‘Rampage’ Jackson have admitted to using testosterone replacement therapy in the past. In the UFC, fighters can apply for a therapeutic use exemption, which allows them to utilise the treatment for legitimate medical reasons.
To be clear, there are a number of legitimate medical reasons for why testosterone replacement therapy may be required. For example, if someone has a previous history of steroid use, it can drastically affect the body. Common side effects of steroid abuse include heart problems, testosterone hair loss and a decreased libido, but in addition, it can cause problems with testosterone in the body, even years after steroid use has ceased. This low testosterone level is referred to as anabolic steroid induced hypogonadism. It could therefore be the case that a fighter has previously used steroids, been clean for a number of years and yet their testosterone levels have not recovered.
A number of other medical conditions, such as pituitary gland dysfunction can lead to hypogonadism, or low testosterone levels. Dana White has previously argued that, in his opinion, the cause of the hypogonadism is irrelevant to him, as long as TRT is only used to elevate testosterone to the levels associated with a normal male of the same age. Some argue that testosterone replacement therapy has a place in MMA and merely allows fighters with legitimate medical problems to compete on an even playing field with other fighters.
The Argument Against TRT Use in MMA
However, others take a contrasting viewpoint. For one, many people would argue that if a fighter has abused anabolic steroids earlier in their career, a substance which is illegal in MMA, it is their own fault and they should have been aware of the consequences of their actions. If those actions render them unable to compete at the highest level of MMA in the future, perhaps it will discourage others from using anabolic steroids in the first place.
Other people feel that TRT is little more than a performance enhancing drug, which allows increased muscle mass and stronger bone structure through unnatural means. It has been argued that if someone has testosterone levels that are too low to remain competitive in the world of Mixed Martial Arts, they should simply look for another career, in much the same way that an athlete would have to quit athletics if their muscles became too weak to cope with the strain. Questions have also been asked about the safety of TRT and whether it could have detrimental long-term effects.
A final argument against the use of testosterone replacement therapy in MMA is the potential for abuse. The State Athletic Commission’s rules open up the potential for fighters to exploit loopholes. Essentially, it is possible for a fighter to falsely claim the need for TRT and gain a prescription from a doctor in order to do so. Abuse of testosterone therapy has been seen in the world of professional wrestling in the past and with TRT offering the potential for physical benefits such as enhanced muscle and bone development, it is easy to see why this could appeal to a competitive MMA fighter.
In truth, the arguments for and against the use of TRT in Mixed Martial Arts are both compelling. It is perfectly possible that TRT could be a legitimate medical requirement of a MMA fighter and offer them the chance to maintain a career which could otherwise be lost, through no fault of their own.
On the other hand, it is equally possible that TRT could be exploited, or used to mask problems associated with previous performance enhancing drug use. Understandably, this raises concerns over whether TRT is, in itself, little more than a performance enhancing drug or whether people should have any sympathy for those experiencing side effects from previous abuse of PEDs.
However, for now, it is important to underline the fact that TRT, carried out after a prescription from a doctor, is perfectly legal and therapeutic use is permitted within the UFC and most other major MMA promotions.
Lily Harrow is a freelance writer and mixed martial arts enthusiast, who was recently involved with writing a report into the intelligence of fighters.