All individuals, whether male or female, possess both female hormones (estrogens) and male hormones (androgens). During puberty, levels of these hormones may fluctuate and rise at different levels, resulting in a temporary state in which estrogen concentration is relatively high. Studies regarding the prevalence of gynecomastia in normal adolescents have yielded widely varying results, with prevalence estimates as low as 4% and as high as 69% of adolescent boys. These differences probably result from variations in what is perceived to be normal and the different ages of boys examined in the studies.
The potential for testosterone transfer from healthy males dosed with FORTESTA to healthy females was evaluated in a placebo-controlled, three-way crossover study . The washout period was approximately 29 days. Six males were treated with either FORTESTA (30 mg testosterone) or placebo to one thigh only. At 2 hours after the application of FORTESTA to males, the females rubbed their forearms for 15 minutes on the thigh of the males. Serum concentrations of testosterone were monitored in females for 24 hours after the transfer procedure. When direct skin-to-skin transfer occurred with FORTESTA mean Cavg increased by 134% and mean Cmax increased by 191%, compared to direct skinto- skin transfer with placebo. When transfer occurred with FORTESTA while covering a thigh with boxer shorts, mean Cavg decreased by 3% and mean Cmax increased by 2%, compared to direct skin-toskin transfer with placebo [see DOSAGE AND ADMINISTRATION ].
The Tamil movie Kumki , which revolves around a mahout and his trained elephant, shows his elephant in musth period towards the climax. Captive elephants are either trained for duties in temples (and in cultural festivals), or trained as a Kumki elephant which confronts wild elephants and prevents them from entering into tribal villages. Elephants trained for temple duties are of a gentle nature and cannot face wild elephants. In this movie, a tribal village wants to hire a Kumki elephant to chase away wild elephants which enter the village every harvest season. The mahout, who is in want of money, takes his temple-trained elephant to do this job, in the vain hope that wild elephants won't come in. But wild elephants start attacking the village on the harvest day. The temple-trained elephant gets into musth and thus fights with the wild elephants, kills the most notorious among the herd, and gets killed because of injuries sustained during the fight.