TRT, not harmful

Nov 27, 2006 09:58 GMT  ·  By

Testosterone replacement therapy (TRT) increases blood testosterone levels to the mid-normal range and is becoming a widespread, growing practice.

Preliminary research suggests TRT for men with low testosterone levels seems to have little or no effect on the prostate gland, contrary to some reports that this therapy may be harmful and linked to prostate cancer.

In 2005, a total of 2.3 million prescriptions were written for TRT in the US alone. After 45, many men suffer from depression, sexual dysfunction, decreased muscle volume and strength and reduced bone mineral density, a condition named male menopause, due to lowered testosterone level with the age.

Many of these symptoms may be improved with TRT, but after 45 years prostate disease is also most common. In men with advanced prostate cancer, testosterone treatment often worsens the disease. So, prostate safety is a main concern when receiving supplemental testosterone as prostate cancer in men following TRT has been reported.

Even when there is no sign of prostate cancer, the possibility of stimulating it worries many. TRT prescription asks for careful monitoring of the prostate, even if there is little knowledge about tissue effect of supplemental testosterone on the prostate.

Researchers from the University of California, L.A., checked the tissue effects of TRT on prostate upon a sample of 40 men, aged 44 to 78, with signs of male menopause. The subjects participants followed either TRT (rising testosterone level to mid-level) or a placebo treatment (with no effects on testosterone level) every two weeks for six months. Prostate biopsies were done at the beginning and at the end of the study (TRT, n = 21; placebo, n = 19).

In prostate tissue, TRT increased testosterone concentrations very slightly compared with baseline levels between the 2 groups, with no other changes in prostate histology, tissue biomarkers, prostate volume, serum prostate-specific antigen, urinary flow, gene expression, or cancer incidence or severity.

The researchers conclude that TRT may not be linked to prostate disease as closely as once thought, but larger more conclusive studies for longer durations still need to be effectuated to confirm these findings. "? under the conditions herein, including the biopsy to detect cancer performed pretreatment, a degree of prostate safety is defined for men undergoing TRT."

"The prostate risks to men undergoing TRT may not be as great as once believed, especially if the results of the pretreatment biopsy are negative. However, establishment of prostate safety for large populations of older men undergoing longer duration of TRT requires further study".