Several athletes competing at the recent USAT Age-Group National Championships in Omaha noticed a booth that might have seemed a bit out of place. It belonged to the local franchise of national chain NuMale Medical, "America's Most Trusted Mens' Wellness Center." The tagline on their website boasts, "Get your sex life back in just one visit. 98% of our patients get immediate relief from Erectile Dysfunction and Low Testosterone." NuMale offers several other services, but ED and TRT seems to be their primary focus. The pop-up banner they had in Omaha was exclusively focused on TRT (Testosterone Replacement Therapy) for Low-T (Low Testosterone), saying that NuMale could help you, "Feel Younger, Stronger, And Healthier Again." That sounds exactly like the reason that many folks pick up triathlon in the first place. There's just one problem. Testosterone Replacement Therapy is explicitly banned by WADA without a TUE, and TUEs for TRT are extremely rare, typically only given in the case of very rare and specific medical conditions like hypogonadism.
Simply put, TRT is doping; it's cheating. The presence of a company like NuMale at USATAGNC highlights a big problem, and that is one of ignorance. NuMale's advertising pitch was so blatant that it's hard for any reasonable person to think that they were intentionally trying to subvert the integrity of an event where USADA was present and where athletes were subject to post-competition drug testing. The simplest conclusion is that they genuinely believed that middle-aged male age-group triathletes were their target market, in spite of USADA's explicit statement that, "The use of T as an anti-aging medication for men is not justification for a TUE. Similarly, generalized fatigue, slow recovery from exercise and a decreased libido are not, in isolation, justification for the granting of a TUE for testosterone." So how did this happen?
I reached out to Rob Urbach, CEO of USA Triathlon to ask. He pointed me to an official statement put out on Twitter by USAT shortly after the race. "USA Triathlon is aware of concerns pertaining to expo vendor NuMale Medical, an Omaha-based company, at the Age Group National Championships. The Local Organizing Committee [LOC] has the ability to offer booth space to area businesses, however USA Triathlon did not receive this particular agreement. USA Triathlon remains committed to the highest anti-doping standards and we regret the perception this vendor's presence may have given. USA Triathlon and the LOC will coordinate more closely on these matters moving forward."
I followed up and asked if there wasn't anything more that he or USAT wished to say beyond what amounted to a very simple, "Oops, sorry about that; we'll do better next time." I asked him what sort of instruction - if any - does USAT give to the LOC as to what is and what is not allowed? What sort of specific changes - if any - does USAT plan on making as a result of this? Has USAT reached out to NuMale to make them aware that many of the services they offer are prohibited for virtually anyone competing in a USAT event? I noted that USADA is working to support CME courses specifically targeting doctors to make them aware of the WADA code, and that this was precisely the sort of thing that USAT could direct the physicians who work at NuMale to take advantage of. I sent my follow-up on August 15th and, as of now, have still not received any sort of reply.
USADA seems to recognize that ignorance - by both athletes and doctors - is a real problem and have set out to educate medical professionals that many common treatments are disallowed for clients of theirs that are athletes. Whether or not this will have any real impact on athletes who have virtually endless possible options for obtaining TRT and other disallowed OTC medication remains to be seen. But credit does go to USADA for at least trying to effect change. USADA has partnered with Stanford Medical School to develop an official CME (Continuing Medical Education) program called Health Pro Advantage designed to teach health professionals about the fundamentals of the WADA Code. According to the USADA site, "HealthPro Advantage was created as a resource for any physician interacting with athletes and for medical professionals in ALL FIELDS, from Orthopedics to Sports Medicine. The course is particularly valuable to medical professionals because they are on the front line treating and advising elite and/or recreational athletes governed by the World Anti-Doping Code, and are similarly subject to those anti-doping policies and rules. HealthPro Advantage is free for ALL HEALTH CARE PROFESSIONALS, and participants can earn a certificate for successfully completing the course modules, tests, and evaluation.
Ignorance is unquestionably a real problem. But "I didn't know" is simply not a valid excuse. USAT bears a greater responsibility than they have shown so far to educate athletes about all of the rules of competition. The presence of a company like NuMale at a major national championship is simply not acceptable. If we care about the integrity of our sport, we need to demand more than a casual promise to, "do better next time."