Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the prohibited list, a therapeutic use exemption may give that athlete the authorization to take the needed medicine. Criteria for granting a therapeutic use exemption are 1.) The athlete would experience significant health problems without taking the prohibited substance or method, 2.) The therapeutic use of the substance would not produce significant enhancement of performance, and 3.) There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method. Note hormone replacement therapy (HRT), . supplementing with prescribed testosterone in any form to raise testosterone levels due to natural decreases that occur with aging (even if to just elevate levels to within ‘normal’ ranges), is NOT considered a medicinal exception. Persons using HRT would not be eligible for WPA/NANBF/IPE competition.
Hormone replacement therapy has been shown to have other beneficial effects. In a study women taking estrogen through HRT showed that the estrogen positively affects the prefrontal cortex by boosting the working memory. This suggests that estrogen may play a key role in certain frontal lobe functions in women.  Women using HRT after menopause have no additional weight gain compared to women who do not use HRT.  Also women who use HRT with an estrogen component show positive effects in their sex life (mainly increasing their sex drive and sexual sensitivity) but the effects are inconsistent across women. These sexual improvements may dissipate after receiving some forms of HRT for extended periods of time. 
There is considerable controversy over the earliest age at which it is clinically, morally, and legally safe to use GnRH analogues, and for how long. The sixth edition of the World Professional Association for Transgender Health 's Standards of Care permit it from Tanner stage 2 but do not allow the addition of hormones until age 16, which could be five or more years later. Sex steroids have important functions in addition to their role in puberty, and some skeletal changes (such as increased height) that may be considered masculine are not hindered by GnRH analogues.