The comprehensive review of 72 studies, addresses the current controversy about testosterone replacement therapy and its potential health risks to men.
"We reviewed decades of research and found no compelling evidence that testosterone replacement therapy increases the incidence of prostate cancer or cardiovascular disease," said Abraham Morgentaler, MD, a urologist at BIDMC and associate clinical professor at Harvard Medical School. "Although it would be helpful to have data from long-term, large-scale studies, it must also be recognized that there already exists a substantial body of research on the effects of testosterone in men."
Low levels of testosterone affect an estimated 2 to 4 million men in the United States, a condition termed hypogonadism, and the prevalence of this condition increases with age. The symptoms include diminished libido and sense of vitality, erectile dysfunction, reduced muscle mass and bone density, depression, and anemia.
The causes of hypogonadism may be classified as primary, meaning inadequate function of the testes; secondary, inadequate pituitary stimulation of the testes; or a combination of primary and secondary causes, which is common in older men. Testosterone supplementation, in the form of injections, patches, gels and a buccal tablet, is designed to elevate a hypogonadal man's testosterone levels into the normal physiologic range and alleviate symptoms.
"Testosterone is only for men who have symptoms of low testosterone combined with a confirmatory blood test. Testosterone therapy can be beneficial and safe for these men as long as they are appropriately monitored by their physician," says Morgentaler.