Testosterone therapy: Potential benefits and risks as you age

Hormone Therapy for Prostate Cancer Fact Sheet NCI

Shifren, who has been involved in clinical trials looking at testosterone therapy in women, said that the benefits for women with low libido aren’t terribly impressive. Typically, testosterone levels in men are around 15 times higher than in women. One important aspect of study design is the specific endpoints and objective measures used to identify outcomes.

The program also makes sure that everyone who received this medication understands the risks and benefits from this medication and receives the medication in a setting where they can be monitored for serious reactions. The company-funded randomized trial reported that testosterone levels in middle-aged and older men were roughly 15 percent higher in ashwagandha takers than in placebo takers after 8 weeks. But the researchers measured testosterone levels in the men’s saliva, which isn’t a method validated by the CDC. “Taking testosterone can cause proliferation of your red blood cells,” says Dubin. That may increase the risk of blood clots, though the data are mixed. To monitor the risk, “we check their blood every six months.” Using non-injectable forms (like gels or oral testosterone) or reducing the dosage can lower the risk of excess red blood cells. Now, there are several theories regarding how testosterone influences prostate cancer.

This enzyme, which is found in testicular, adrenal, and prostate tumor tissues, is necessary for the body to produce testosterone. Treatments that block the production of androgens throughout the body, known as androgen synthesis inhibitors. Like ADT, androgen synthesis inhibitors prevent androgen production by the testicles; unlike ADT they also prevent androgen production by the adrenal glands and prostate cancer cells. Even though only small amounts of androgens are produced outside the testicles, the low levels that are still produced can be enough to support the growth of some prostate cancers. The second-generation drugs bind to and block the androgen receptor more strongly and specifically than the first-generation drugs (6). Darolutamide is the only androgen receptor blocker that does not cross the blood-brain barrier in humans, which may result in fewer central nervous system–related side effects.

Early-stage prostate cancer with an intermediate or high risk of recurrence. Men who are having radiation therapy to treat early-stage prostate cancer that has an unfavorable intermediate or high risk of recurrence often receive ADT as well. And ADT may be used after prostatectomy in men who have high-risk node-positive disease (7, 8).

Treatment with these drugs can also be considered a form of medical castration. Hormone therapy is also called androgen deprivation therapy (ADT). The goal of this treatment is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cell growth.

The Evaluation and Management of Testosterone Deficiency AUA Guideline provides guidance to the practicing clinician on how to diagnose, treat and monitor the adult male with testosterone deficiency. The care of testosterone deficient patients should focus cysts on the testicles accurate assessment of testosterone levels, symptoms and signs as well as proper on-treatment monitoring to ensure therapeutic testosterone levels are reached and symptoms are ameliorated. Guidance is also given on the management of patients with cardiovascular disease, men who are interested in preserving their fertility and men who are at risk for or have prostate cancer.

Testicle shrinkage is prevented with hCG and should always be taken with testosterone. Human chorionic gonadotropin or hCGhCG is a drug that helps to stimulate the testes to produce testosterone naturally. It is prescribed with testosterone to prevent the testicles from shrinking during treatment. If testosterone is taken by itself, it interrupts the connection between the brain and testicles. The testes will stop producing testosterone and over time will begin to shrink. In some cases, the testicles will shrivel up to the size of raisins.

Testosterone therapy should be initiated only after two morning total serum testosterone measurements show decreased levels, and all patients should be counseled on the potential risks and benefits before starting therapy. Potential benefits of therapy include increased libido, improved sexual function, improved mood and well-being, and increased muscle mass and bone density; however, there is little or mixed evidence confirming clinically significant benefits. The U.S. Food and Drug Administration warns that testosterone therapy may increase the risk of cardiovascular complications. Other possible risks include rising prostate-specific antigen levels, worsening lower urinary tract symptoms, polycythemia, and increased risk of venous thromboembolism.

Harvard Health emphasizes that TRT should be tailored to the individual and revisited frequently to minimize risks and optimize outcomes. Endocrine Society is a global community of physicians and scientists dedicated to accelerating scientific breakthroughs and improving patient health and well being. For 100 years, the Endocrine Society has been at the forefront of hormone science and public health. Read about our history and how we continue to serve the endocrine community. An increase in PSA level greater than 25% or 1.4 ng/mL within any 12-month period should be repeated and, if confirmed, considered suspicious. The FDA discontinued testosterone solutions in 2017 due to the high incidence of abuse by athletes and bodybuilders. Injections of testosterone are also common and may be ideal for those who don’t eat breakfast, have absorption issues or have personal concerns surrounding gels and transference.