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Testosterone Replacement Appears Safe
Written by Jeanne Bohm, Ph.D.   

From the NetDoc medical news feed

A study  suggests that testosterone replacement therapy for men with low testosterone levels does not appear to adversely affect the prostate gland, contradicting other published reports, according to an article in the November 15 issue of JAMA.

Leonard S. Marks, M.D., University of California, Los Angeles, discussed the study results at a JAMA media briefing in New York.  Testosterone replacement therapy (TRT) in older men is commmon with more than 1.8 million prescriptions for testosterone products written in the United States in 2002. By 2005, there were 2.3 million prescriptions.
Serum testosterone levels decline with age, the effects of the decreased level include depression, sexual dysfunction, diminished lean body mass, muscle strength, and reduced bone mineral density,  a condition described as “male menopause.”

Some of the symptoms decrease after TRT, with most prescriptions given to men 45 years and older (the age where prostate disease is most common). Up to 4 million men, may be candidates for treatment, according to the researchers conducting the study.

In men with advanced prostate cancer, testosterone administration in many cases has been shown to worsen the disease. In addition, there have been men who were diagnosed with prostate cancer after receiving testosterone therapy. When TRT is intiated, careful monitoring for prostate disease is necessary. However, the effects of TRT on prostate tissue in men is not clear.

Dr. Marks and colleagues conducted a randomized controlled trial to assess the effects of TRT on prostate tissue in 44 men, 44 to 78 years old, with low serum testosterone levels (2003 - 2004). Participants were randomly assigned to receive 150 mg of  replacement testosterone or placebo every 2 weeks for 6 months. 40 of the participants had prostate biopsies performed both at baseline and at the end of study (TRT, n = 21; placebo, n = 19).

TRT increased serum testosterone levels to the normal range. In prostate tissue, TRT increased androgen concentrations only slightly compared with baseline levels or between the 2 groups. No treatment-related changes were observed in markers associated with prostate cancer or in severity of prostate disease. There were small treatment-related changes in prostate volume, serum prostate-specific antigen, voiding symptoms, and urinary flow.

The authors concluded that the prostate risks to men undergoing TRT may be minimal, particularly if the pretreatment biopsy is negative.


JAMA Media Release

Effect of Testosterone Replacement Therapy on Prostate Tissue in Men With Late-Onset Hypogonadism JAMA 2006;296:2351-2361.

About the Author:

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.




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