Testosterone replacement therapy (TRT) is a much criticized treatment when it comes to combat sports, and MMA in particular. Over the last few years we have seen a steady rise in the use of TRT and the accepting nature of the athletic commissions when it comes to granting a therapeutic use exemption (TUE) in relation to TRT.

What seems to be forgotten somewhere along the way is that TRT was not meant to be used as a means of prolonging an aging athlete’s career, nor was it a means of counteracting the consequences of past drug use, though that seems to be the case in the present day.

TRT was introduced solely for the purpose of producing a level playing field for competitors who, through no fault of their own, naturally do not produce testosterone to the same extent as the rest of the population at large. Note that this is the general population as a whole and does not allow fighters any higher levels than any other male regardless of profession.

Therefore, it would stand to reason that the target market of such a treatment would be the fighters who would ordinarily be in their prime years, but, due to an underlying condition such as hypogonadism, cannot train and perform at a high level even though their skill set and efforts may warrant the same.

Instead of this scenario, what we are seeing is a trend of fighters in their mid to late 30s begin the treatment seemingly out of nowhere in an attempt to rejuvenate themselves and their careers. What’s more is that the treatment is now being taken up by fighters at an alarming rate, to the point that it is getting to be somewhat of an epidemic within the mixed martial arts world.

Fighters are now buying into the perception that TRT is some form of miracle anti-aging treatment which can roll back the clock and see them perform as if they were much younger yet still benefit from the advantage of their true age, making it the best of both worlds. This perception can be likened to the way in which the cosmetic industry manages to make women believe the latest high-end cream will make them look and feel 10 years younger.

Of all of the fighters who have taken up the treatment, the most high-profile name to utilize this loophole in the regulations is Vitor Belfort. This is due to the fact that since it first became apparent that the Brazilian was using TRT, he has been finishing fights in devastating fashion in a way that is not expected of a fighter faced with advancing years. The reason for Belfort’s label as “Public Enemy No. 1” when it comes to TRT is not just his advancing years, but his past drug use, which may well be the very reason he is now testosterone deficient.

Belfort’s nutrition and fitness coach, Mike Dolce, has attempted to answer back to the critics by likening the Brazilian’s need for TRT to that of a diabetic requiring insulin, a statement which would no doubt infuriate diabetics the world over. To liken a shortage of testosterone to diabetes seems a somewhat ignorant comment to make, especially from someone who is no doubt a world-class nutrition advisor and professes to be a “longevity advocate.”

The importance of testosterone cannot be understated, nor can the impacts of proven drug use upon the body’s ability to produce testosterone, a fact that Dolce seems to ignore entirely when discussing the subject.

Furthermore, there have been definitive links between a male with insufficient testosterone and diabetes itself. And as such, if we are to liken the two, then it would stand to reason that if we are to believe that these fighters that are in such dire need of TRT may require treatment to counteract the onset of type 2 diabetes that is known to go hand in hand with a lack of testosterone.

It now seems that it is acceptable to right past wrongs using TRT, and we are expected to feel sorry for the recipient, irrespective of how the need for the treatment originated. The very nature of combat sports is that each fighter has a relatively short shelf life and there is a constant refreshing of the talent pool due to the aging process. The open acceptance of TRT now sets a dangerous precedent, so that when an elite fighter begins to notice his body slowing down, he can simply go and see his local doctor to get on a TRT program instead of letting nature take its course and accepting the consequences.

However, in a sport that has been continually tarnished with a reputation of being barbaric and illegitimate, allowing fighters to utilize TRT for competitive gain is irresponsible, to say the least. If this trend continues, one possible outcome is that the legitimacy of the sport could come into question and produce a sense of unease, similar to that which the cycling world currently faces post-Lance Armstrong.

When looking at some of the benefits of TRT, it is easy to see why fighters looking to gain a competitive advantage may consider the treatment. It is said to increase bone density, increase muscle mass and strength, decrease body fat and improve energy levels and allow for better sleep to name just a few.

Whilst the benefits listed above may seem like an attractive proposition for some fighters, the negatives associated with the treatment should discourage all but those only in real need from pursuing TRT as a course of action. These negatives include liver problems, increased red blood cells leading to increased chances of blood clots, and also increased risks of prostate cancer.

As we approach the beginning of a flurry of big MMA events, we will no doubt begin to hear rumors of the latest recipient of a TUE, and it will inevitably lead to increased scrutiny of that particular fighter, as we have seen with Belfort. However, in a combat sport that is based on the primary rule of “protect yourself at all times,” it seems contradictory to allow fighters to disregard their own well-being. as well as that of the fighter across the cage, by utilizing these kinds of treatments to gain a competitive advantage.