Three little letters which sadly, seem to have become almost as synonymous with Mixed Martial Arts as, well, these three little letters: MMA.

The use of TRT (Testosterone Replacement Therapy) by fighters has been a source of controversy for several years now. In fact, the main event of tomorrow’s UFC Fight Night main event in Brazil features two fighters at the center of that controversy: Vitor Belfort and Dan Henderson.

It’s not just the UFC though, of course. Last weekend I enjoyed a visit to a local (Seattle-area) MMA show and lo and behold… what was the first sponsor of the show to be found? Scantily clad women were handing out flyers, not for the nearest martial arts academy, or a local MMA-themed clothing line. No, they hailed a “Men’s Health” clinic promising the use of testosterone to “revive your vigor and maintain it!”

The fighters in tomorrow’s main event have incorporated TRT into their own fighting “vigor.” 43 year old Henderson has been granted a Testosterone Use Exemption (TUE) by athletic commissions in Nevada and elsewhere for most of his fights since 2007, with his latest bout a noteworthy exception (as Joe Rocha explained here).

Still, the practice is seen as cheating by many fans, who see it as the claim of hypogonadism as a loophole to the use of a performance enhancing agent.

The 36 year old Belfort has had a bit more of a problem, particularly since he tested positive for performance enhancing agents in Nevada back in 2006. As described by Marco Scolari here, Keith Kizer of the Nevada State Athletic Commission has gone on record stating it’s unlikely Belfort will ever  receive a TUE there.

“The testosterone usage is merely a symptom of much larger problems that fighters are dealing with right now in MMA,” Zach Arnold wrote last week at Fight Opinion. Arnold lists the four reasons that fighters use TRT:

1) previous and/or current steroid usage
2) damage from weight cutting
3) brain damage/concussions
4) abuse of pain killers/opiates

What of the fighter who may legitimately need TRT due to a preexisting medical condition? Arnold suggests that battle should be decided in the courts via the Americans with Disabilities Act, and goes into further detail here.

Dr. Jon Gelber of Fight Medicine has described long-term consequences of the therapy. Gelber noted on last week’s In The Cage With Bards that the International Olympic Committee has granted only a handful of TUE’s in the Olympic Games.

Yet, as many as one out of five UFC fighters on a given main card are being granted a TUE.

It has become impossible to reconcile.

If we want a clean sport, we need to say goodbye to this loophole. It will mean a sad goodbye to some of our favorite fighters, but maybe it’s a day that has to come.

MMA fighters need to be held the highest standards of fairness. If due to age or whatever condition, if an athlete can’t produce enough testosterone, leading them to they feel they can’t compete, then they’re probably right — and really shouldn’t.