The real dangers of testosterone therapy

For years, men have expressed concern that using testosterone treatment (hormone replacement therapy) will boost their risk of developing prostate cancer. The results of a new study, presented at the American Urological Association 2016 annual meeting, however, have shown that testosterone treatment doesn’t increase prostate cancer risk. In fact, other new research suggests such treatment may reduce the risk of aggressive prostate cancer.

Let’s make it clear from the beginning that testosterone therapy is appropriate for only a small percentage of men, including those who have been diagnosed with hypogonadism (below-normal T levels). Yet in reality, tens of thousands of men are being prescribed or are using testosterone therapy simply because they are experiencing symptoms of low T, symptoms that can be addressed effectively and safely by adopting simple lifestyle changes and thus avoiding the potential pitfalls of using testosterone therapy.

What does the testosterone treatment study show?

A total of 147,593 men with low total testosterone values were evaluated. Of these, 56,833 (40%) received testosterone therapy, consisting of intramuscular treatments (40%), topical therapy (38%), or both (22%). Follow-up of both treated and untreated men ranged from 2.8 years to 3.2 years. One percent (1,439) of the men were diagnosed with prostate cancer, and of these, 313 had aggressive forms of the disease.

An analysis of the data showed that:

• Incidence of prostate cancer per 1,000 person-years was 2.27 among men who received testosterone treatment and 2.60 among those who never received treatment
• Use of testosterone therapy was not associated with an increased risk of prostate cancer overall or aggressive prostate cancer when compared with not receiving testosterone therapy
• The lack of an association between receiving and not receiving testosterone therapy and prostate cancer risk remained regardless of which type of testosterone the men were administered

Does testosterone therapy reduce aggressive prostate cancer risk?

The authors of another recent study looked at the incidence of prostate cancer among 656 men with hypogonadism. More than half (360) of the men elected to undergo testosterone therapy while the remaining 296 declined and served as the controls. Seven (1.9%) of the men in the testosterone treatment group developed prostate cancer compared with 12 (4.1%) in the control group.

When the men underwent radical prostatectomy, the surgeons discovered the following:

• Among the men who had received testosterone therapy, the primary Gleason score was 3. All of the men had a tumor grade of 2 as well as negative surgical margins and lymph nodes.
• Among the men who did not receive testosterone therapy, the main Gleason score was 3 in 3 men, 8 in 4, and 5 in 1. Tumor grade was 2 in 5 men and 3 in 7. Seven men had positive lymph nodes and seven had positive surgical margins.

Based on these findings, the authors concluded that “Long-term treatment with testosterone in hypogonadal men may reduce the incidence of prostate cancer and protect against high-grade prostate cancer.”

What are the dangers of testosterone therapy?

While many men are lured by the ads and promises of better vitality in and out of the bedroom if they take testosterone therapy, the majority of men would fare much better if they focused on natural methods of raising their energy levels. Use of testosterone treatment is associated with serious side effects, including:

Risk of addiction. Use of the hormone can alter brain chemistry, causing men to experience withdrawal symptoms if they attempt to stop, including mood swings, restlessness, irritability, insomnia, reduced libido, depression, and cravings for more testosterone.

Heart attack and stroke. Testosterone therapy can cause polycythemia, a disease that increases red blood cell volume. This in turn thickens the blood and thus raises the risk of heart attack and stroke.

Stops natural testosterone production. Use of testosterone therapy causes the body to stop making its own supply of the hormone.

Other side effects. Men who take testosterone therapy often find they experience hair loss, acne, enlarged breasts, mood swings, worsening of sleep apnea, urinary symptoms, smaller testicles, and aggression.

While it’s good news that use of testosterone therapy does not appear to increase a man’s risk of prostate cancer and may even reduce the chances of getting an aggressive form of the disease, use of this hormone treatment should be limited to men with abnormally low testosterone.