While the authors are justified in arguing that they found five significant results, some of their other claims are harder to defend. Smith points out that there’s a difference between a statistically significant result and a practically significant result. Two runners can have different times without one having a significant competitive advantage over the other. And while most in the track and field community would consider the two-second difference found between low-T 800 meter runners and high-T 800 meter runners to be significant, that’s only the authors’ best guess for the time difference—it could be a difference as small as a fraction of a second, or as large as four or five seconds. As Smith says, “the broader implications are unclear.”
Dihydrotestosterone (DHT) (referred to as androstanolone or stanolone when used medically) can also be used in place of testosterone as an androgen. The availability of DHT is limited; it is not available in the United States or Canada, for instance, but it is available in certain European countries, including the United Kingdom , France , Spain , Belgium , Italy , and Luxembourg .  DHT is available in formulations including topical gel, buccal or sublingual tablets, and as esters in oil for intramuscular injection.  Relative to testosterone, and similarly to many synthetic AAS, DHT has the potential advantages of not being locally potentiated in so-called androgenic tissues that express 5α-reductase (as DHT is already 5α-reduced) and of not being aromatized into an estrogen (it is not a substrate for aromatase).
Abnormally high testosterone levels in women can lead to a variety of symptoms. Most often, women with high testosterone levels develop male pattern hair growth (hirsutism), especially on their faces and chests. More rarely and over time, some women may experience virilization, which is increased muscle mass, redistribution of body fat, enlargement of the clitoris, deepening of the voice, male pattern baldness , acne , and/or increased perspiration. It is important to note that some women develop hirsutism without having a high testosterone level.