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Testosterone Replacement Therapy Appears Safe for Prostate

Preliminary research suggests that testosterone replacement therapy for men with low testosterone levels appears to have little effect //on the prostate gland, contrary to some reports that this therapy may be harmful, according to a study in the November 15 issue of JAMA, a theme issue on men's health.

Leonard S. Marks, M.D., of the Urological Sciences Research Foundation and University of California, Los Angeles, presented the findings of the study today at a JAMA media briefing on men's health in New York.

Testosterone replacement therapy (TRT) in aging men is a widespread, growing practice. According to pharmaceutical industry estimates, more than 1.8 million prescriptions for testosterone products were written in the United States in 2002, a 30 percent increase over the previous year and a 170 percent increase over the previous 5 years. In 2005, a total of 2.3 million prescriptions were written for these products. Serum levels of testosterone decline with age, and many aging men with low levels of the hormone may experience depression, sexual dysfunction, diminished lean body mass, muscle volume and strength, and reduced bone mineral density, according to background information in the article. Such changes, in association with low testosterone levels, have been called "male menopause."

Aspects of the syndrome may be improved with TRT, and most testosterone prescriptions are currently written for men older than 45 years, a demographic in which prostate disease is most common. Between 2 and 4 million men, nearly all in this "prostatic age group," may be candidates for treatment, the authors write. In men with advanced prostate cancer, testosterone administration often worsens the disease. Thus, when aging men receive supplemental testosterone, a primary concern is prostate safety. Even in men with no sign of prostate cancer, the possibility of stimulating growth in subclinical disease exists. Instances of prostate cancer in men
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