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The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression". [77] [78] Testosterone and other androgens have evolved to masculinize a brain in order to be competitive even to the point of risking harm to the person and others. By doing so, individuals with masculinized brains as a result of pre-natal and adult life testosterone and androgens enhance their resource acquiring abilities in order to survive, attract and copulate with mates as much as possible. [77] The masculinization of the brain is not just mediated by testosterone levels at the adult stage, but also testosterone exposure in the womb as a fetus. Higher pre-natal testosterone indicated by a low digit ratio as well as adult testosterone levels increased risk of fouls or aggression among male players in a soccer game. [79] Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males. [80] [81] [82] [83] [84]

Androgens are responsible for the growth spurt of adolescence and for the eventual termination of linear growth which is brought about by the fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates, but may cause a disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of growth process. Androgens have been reported to stimulate the production of red blood cells by enhancing the production of erythropoietic stimulating factor.

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    Reis and Abdo (2014) stated that with advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men.  The effectiveness of phosphodiesterase type 5 inhibitors (PDE5i), together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction.  For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder.  These investigators evaluated the use of androgens in the treatment of a lack of libido in women, comparing 2 periods, ., before and after the advent of the PDE5i.  These researchers also analyzed the risks and benefits of androgen administration.  They searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof.  They selected articles written in English, Portuguese, or Spanish.  The authors concluded that after the advent of PDE5i, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder.  However, they stated that the risks and benefits of testosterone administration have yet to be clarified.

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    Reis and Abdo (2014) stated that with advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men.  The effectiveness of phosphodiesterase type 5 inhibitors (PDE5i), together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction.  For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder.  These investigators evaluated the use of androgens in the treatment of a lack of libido in women, comparing 2 periods, ., before and after the advent of the PDE5i.  These researchers also analyzed the risks and benefits of androgen administration.  They searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof.  They selected articles written in English, Portuguese, or Spanish.  The authors concluded that after the advent of PDE5i, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder.  However, they stated that the risks and benefits of testosterone administration have yet to be clarified.

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