At 1 year, the 23 men randomized to 250 mg of testosterone enanthate every 4 weeks reported significant improvements in IPSS and maximal urinary flow rates compared with baseline and controls. In the most recent, randomized controlled trial, 52 men were randomly assigned to receive TRT.
#REDDIT HIGHC SERIES#
In fact, some series report an improvement in LUTS after 1 year of TRT. Similarly, the presence of hypogonadism in 312 men with reportable LUTS was not predictive of worsening International Prostate Symptom Scores (IPSS) or maximal urinary flow rates. Testosterone supplementation has been shown to increase prostate size by 12%, but lower urinary tract symptoms (LUTS) and urinary retention do not worsen in men on testosterone therapy. showed that TRT for 6 months improves serum androgen levels, but had little effect on prostate tissue androgen levels, tissue biomarkers and/or gene expression.
#REDDIT HIGHC TRIAL#
In a landmark randomized, double-blind, placebo-controlled trial of 44 hypogonadal men, Marks et al. As the population continues to age, both the incidence of BPH and late-onset male hypogonadism will continue to rise and practitioners will need to be comfortable with counseling men on the effect of TRT on the prostate. We know the prostate to be an androgen-dependent gland and conversely, anti-androgen agents can decrease prostate volume in patients with BPH. One of the major risk factors associated with the administration of testosterone supplementation is its effect on the prostate. The goal of this review is to highlight the risks and summarize the current literature on safety of TRT. Factors such as exacerbation of prostate cancer, male breast cancer, worsening benign prostatic hyperplasia (BPH), polycythemia and an increased risk of obstructive sleep apnea (OSA) should be considered when administering TRT to a patient. Any man who has a comorbidity that precludes TRT should be informed of all risks. While the beneficial effects of testosterone are rarely disputed and widely publicized, there is a paucity of the literature on the risks of testosterone use. These positive results have led to a drastic increase in the use of testosterone replacement for men with symptomatic hypogonadism, though long-term data is lacking on the safety.
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When replaced, many of the positive effects of testosterone are regained. Testosterone replacement therapy (TRT) is a reasonable treatment option often discussed for men with low testosterone levels and symptoms of hypogonadism. With this gradual decline, the beneficial effects of testosterone could be diminished and negatively affect physical and emotional well-being.
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The Baltimore Longitudinal Study of Aging reported the incidence of hypogonadism as 20% in men over 60 years of age, 30% in men over 70 years and 50% in men over 80 years of age.Īs men age, a decline in testicular production of testosterone are seen, as well as an increase in sex hormone binding globulin, both of which act to decrease bioavailable testosterone. Testosterone levels are known to decline as men age. Testosterone has many beneficial effects, including increasing bone strength and density, inducing hematopoiesis, driving sexual function and libido, providing a cardioprotective effect and increasing muscle strength.