When men reach their 40s, their testosterone levels slowly fall. Many men are considering taking supplemental testosterone to raise their levels back to those of younger men, but one of the main reasons doctors have been reluctant to prescribe this hormone is the fear this would increase the risk of prostate cancer.
A study presented May 6 at the American Urological Association in San Diego, California should calm this concern. The study concluded that there was no increased risk of prostate cancer, and surprisingly, the risk of aggressive prostate cancer was actually lowered by 50% in men taking testosterone supplementation.
The researchers, from the US and Sweden, analyzed medical records of over 250,000 Swedish men, comparing the rate of prostate cancer in men taking testosterone and those not. Sweden is particularly suited for a study like this, as it is one of the few in the world that keeps detailed records on the entire population regarding cancer and medication.
The concern over testosterone triggering prostate cancer is because in men who already have prostate cancer, when they take medications to lower their testosterone, their cancers shrink. So it was expected that higher levels of the hormone might promote new cancers. But this appears not to be the case.
Testosterone and cardiovascular disease
The other principal concern about testosterone replacement is that it could increase the risk of cardiovascular disease, and, while the final answer is still not in, recent studies suggest there is no increased risk of heart attack, stroke, or early death in men taking supplementation. But this is still controversial, and larger scale studies are underway to give a final answer.
Candidates for testosterone therapy
It is important to note that the studies showing no increased risk of cardiovascular disease or prostate cancer were carried out in men who had documented low levels of the hormone before they started therapy. There are many men with normal levels who start taking testosterone—in an effort to gain muscle mass, improve sexual functioning, or slow aging, and we don’t know if these men will have the same good results as men who started out with low hormone levels.
Men who are candidates for testosterone are those who have documented low levels of the hormone in blood testing. Since the levels can vary day-to-day, repeat blood tests done on several different days are needed. If you want to consider supplementation, talk to your doctor (best a urologist or endocrinologist) and get tested to see if you are a good candidate.
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