There has been a paradigm shift in use of testosterone therapy due to prior misinformation.[1] For years medical students were taught that increased levels of testosterone increased the risk of developing prostate cancer. However, recent studies have proven otherwise, and it is probably better to have higher levels of testosterone than lower levels.

A study in the Journal of Clinical Endocrinology and Metabolism [2]showed a reduced risk of prostate cancer when testosterone was high. They examined 1000 male veterans age over 40 years old and followed them for 4 years. If they had an initial testosterone of <250, they were treated with testosterone therapy. The treated group totaled 400, and the rest of the vets were considered controls.

The results of the study were remarkable. The death rate (mortality) in those treated with testosterone was 10% while the mortality in those not treated was 20%. It is apparent that testosterone therapy decrease death rate, so more men lived longer.

The incidence of prostate cancer was also reduced when testosterone therapy was given. In those treated with testosterone, 1.6% developed prostate cancer, while in those not treated, 2.0% developed prostate cancer. This study thus showed that not only is testosterone therapy lifesaving, it also showed that prostate cancer is not induced by testosterone therapy.

This confirms a prior study reported in 2007 that showed a similar increase in longevity.[3] In this prospective study conducted over 10 years, 11,606 men ages from 40 to 79 years old were evaluated. Their conclusion was that high endogenous testosterone equated to low mortality from cardiovascular disease and cancer, while low testosterone predicts higher incidence of these conditions. They saw no increase in prostate cancer incidence in men treated with testosterone.

Both these studies and others[4],[5] thus confirm that the risk of developing prostate cancer does not increase with higher levels of testosterone. In fact, testosterone treatment with adequate monitoring may be safer than no treatment.[6]This is a paradigm shift in prior thought and one that many physicians still have not realized. Many are still recommending no testosterone therapy due to this prior fear. We can now state that studies confirm safety in taking testosterone therapy.

Testosterone therapy can improve the quality of life of a man. As a man ages, his testosterone levels drop resulting in symptoms of testosterone deficiency. These include fatigue, tiredness, mood changes[7], depression, irritability, reduced libido and potency[8]. The latter includes decreases in desire, fantasies, morning erections, erectile tension, and intensity of orgasms.

But testosterone therapy also improves the man’s health. Testosterone deficiencies are associated with higher risks of diabetes[9], heart disease[10], Alzheimer’s disease[11], cognitive decline[12],[13], frailty[14], loss of bone structure, and cancer; plus an increase in inflammation, which may be part of the root cause why all these problems happen. Testosterone therapy actually improves Alzheimer’s symptoms.[15] There’s no increased risk of stroke with testosterone therapy.[16]

Low testosterone is a big problem. Half of healthy men between the ages of 50 to 70 years old will have a blood testosterone level below the lowest level seen in healthy men who are 20 to 40 years old.[17] Many don’t embrace testosterone because of old myths. But now, we can give men reassurance that this therapy is safe and beneficial for improving their health and their quality of life as they age.

 

[1] Morgantaler A. Testosterone and Prostate Cancer: An Historical Perspective on a Modern Myth. Eur Urol. 2006 Jul 26

[2] Shores, MM, et al., Testosterone Treatment and Mortality in Men with Low Testosterone Levels, J Clin Endocrinol Metab. 2012, April

[3] Khaw KT, et al., Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men. Circulation. 2007;116:2694-2701

[4] Endogenous Sex Hormones and Prostate Cancer: A Collaborative Analysis of 18 Prospective Studies Endogenous Hormones and Prostate Cancer Collaborative Group . J Natl Cancer Inst 2008 100: 170-183

[5] Gould DC, Kirby RS. Testosterone replacement therapy for late onset hypogonadism: what is the risk of inducing

prostate cancer? Prostate Cancer Prostatic Dis. 2006;9(1):14-8.

[6] Feneley MR et al. Is testosterone treatment good for the Prostate? Study of safety during long term treatment. Journal of Sex Med 2012; June 6

[7] Burris A, et al., A long-term, prospective study of the physiologic and behavioral effects of hormone replacement in untreated hypogonadal men. J Androl 1992 Jul-Aug;13(4):297-304

[8] Caretta N et al. Erectile dysfunction in aging men: testosterone role in therapeutic protocols. J Endocrinol Invest. 2005;28 (11 Suppl Proceedings):108-11

[9] Kim C, et al., Endogenous sex hormones, metabolic syndrome, and diabetes in men and women. Curr Cardiol Rep. 2014 Apr;16(4):467

[10] Turhan S et al. The association between androgen levels and premature coronary artery disease in men. Coron Artery Dis. 2007 May;18(3):159-62.

[11] Gouras, GK, et al., Testosterone reduces neuronal secretion of Alzheimer’s beta-amyloid peptides. Proc Natl Acad Sci U S A, 2000, Feb 1;97(3):1202-5

[12] Alexander GM, Swerdloff RS, Wang C, et al., Androgen-behavior correlations in hypogonadal men and eugonadal men. II. Cognitive abilities. Hormones and Behavior 1998; 33(2):85-94

[13] Barrett-Connor E et al. Endogenous sex hormones and cognitive function in older men. J Clin Endocrinol Metab 1999 Oct;84(10):3681

[14] Hyde, Zoe et al. Low Free Testosterone Predicts Frailty in Older Men: The Health in Men Study. JCEM Vol 95, No 7.p 3165-3172.

[15] Tan RS A pilot study on the effects of testosterone in hypogonadal aging male patients with Alzheimer’s disease. Aging Male. 2003 Mar;6 (1):13-7

[16] Glueck, C et al. Testosterone, Thrombophilia, and Thrombosis Clin Appl Thromb Hemost.23 April 201

[17] Korenman SG, Morley JE, Mooradian AD, et al. 1990 Secondary hypogonadism in older men: its relationship to impotence. J Clin Endocrinol Metab. 71:963–969.