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Forest plot comparing PSA level change between patients receiving testosterone treatment via transdermal, oral PO and intramuscular IM routes versus control treatments. In 2 studies, testosterone was administered transdermally, and in 2 IM. In only 1 study was testosterone given orally, 24 and that study included 3 intervention groups and 1 control group.
Because the study found no difference in relevant PSA elevations between the 3 treatment groups, we pooled the data of the 3 intervention groups and compared the pooled data with the control group and obtained an OR. The results were similar when the analysis was performed for testosterone given transdermally and IM.
Forest plot comparing the number of patients with elevated PSA level after treatment between patients receiving testosterone treatment via transdermal, oral PO and intramuscular IM routes versus control treatments. Shigehara et al 21 reported no cases of prostate cancer in the testosterone or control groups with a treatment duration of 12 months.
A Man’s Guide To Testosterone Replacement Therapy | Illimitable Men
Marks et al 25 reported a prostate cancer rate of 9. The results of this meta-analysis showed that testosterone replacement was not associated with an increase in PSA level, although a slight increase was seen when testosterone was given IM. Although only 3 of the 15 studies reported the incidence of prostate cancer, there was no difference between the treatment and control groups in the 3 studies. Early studies suggested that the administration of testosterone could promote prostate cancer growth, 10 , 11 and later studies showed that reducing androgen levels to the castrate range reduced prostate cancer growth.
Andrade et al 2 also treated hypogonadal men with IM testosterone for 6 months and reported an improvement in body composition. Chiang et al 23 and Park et al 4 both reported that testosterone replacement improved quality of life and sexual function in men with testosterone deficiency. In other included studies, Bauman et al 19 reported that transdermal testosterone improved lean tissue mass in men with spinal cord injuries, and Merza et al 26 found that transdermal testosterone increased lean body mass and decreased bone absorption in men with borderline hypogonadism.
Interestingly, 2 of the included studies examined the effect of testosterone replacement in men with type 2 diabetes mellitus and whereas one 22 found that IM testosterone did not have an effect on insulin resistance or dyslipidemia, the other 20 showed that transdermal replacement had a beneficial effect on insulin resistance and lipid levels.
Importantly, Marks et al 25 showed that 6 months of IM testosterone enanthate normalized serum testosterone levels and had little effect on prostate tissue androgen levels or function. With respect to PSA levels, although not included in the meta-analysis, El-Sakka et al 34 showed no significant change in PSA level after 1 year of testosterone replacement in hypogonadal men with erectile dysfunction, with other studies reporting similar findings.
The contradiction that androgen deprivation can markedly reduce the growth of prostate cancer while administration of testosterone replacement does not affect prostate cancer incidence or growth has been addressed by the saturation model. A primary limitation of this study is the heterogeneity of the studies including the populations examined, testosterone replacement regimes, dosages, and length of therapy, and baseline PSA levels.
In addition, data in the studies included were not sufficient to estimate the risk of developing prostate cancer. The results of this study indicate that testosterone replacement therapy does not increase PSA levels in men being treated for hypogonadism, except when it is given IM and even the increase with IM administration is minimal. Data of the included studies were not sufficient to evaluate the risk of prostate cancer with testosterone replacement therapy; however, based on evidence in the literature it does not appear that the risk of prostate cancer is affected by testosterone replacement therapy.
The authors initiated the concept for the meta-analysis and are responsible for the content of the manuscript. The authors have no funding or conflicts of interest to disclose. Supplemental digital content is available for this article.
National Center for Biotechnology Information , U. Journal List Medicine Baltimore v. Medicine Baltimore. Published online Jan Author information Article notes Copyright and License information Disclaimer. All rights reserved. The work cannot be changed in any way or used commercially.
This article has been cited by other articles in PMC. Abstract Testosterone replacement therapy is used for the treatment of age-related male hypogonadism, and prostate-specific antigen PSA is a primary screening tool for prostate cancer. Selection Criteria and Data Extraction Inclusion criteria were as follows: randomized controlled trial or prospective nonrandomized study; intervention group received testosterone replacement therapy or androgen replacement therapy; control group did not receive testosterone and may have received placebo or conventional treatment; 18 or more years of age; male gender; no history of prostate cancer.
Quality Assessment The methodological quality of each study was assessed using the risk-of-bias assessment tool outlined in the Cochrane Handbook for Systematic Reviews of Interventions version 5. Open in a separate window. Kava BR. To treat or not to treat with testosterone replacement therapy: a contemporary review of management of late-onset hypogonadism and critical issues related to prostate cancer.
Curr Urol Rep ; 15 Short term testosterone replacement therapy improves libido and body composition. Arq Bras Endocrinol Metabol ; 53 — Postgrad Med ; :8— Oral testosterone undecanoate Andriol supplement therapy improves the quality of life for men with testosterone deficiency. Aging Male ; 6 — Long-term testosterone gel AndroGel treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men. J Clin Endocrinol Metab ; 89 — Many people having this treatment have radiotherapy as well. This combination is more likely to make you lose your sex drive or have erection problems.
This may happen during treatment and for a while afterwards. Most of these side effects are temporary, but treatments are available. These include hormone replacement and drugs to help you get and maintain an erection. Always use reliable contraception during your treatment.
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It is not advisable for your partner to become pregnant, as the treatment drugs could harm the baby. Because of this some doctors advise people to use a barrier method such as condoms, femidoms or dental dams if you have sex during treatment. This applies to vaginal, anal or oral sex.
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Generally, doctors advise a barrier method only for the time you are actually having the treatment and for about a week after your treatment. Advice like this can be worrying, but this does not mean that you have to avoid being intimate with your partner. Everything you wanted to know about the manly hormone Jacob Lund. There's no one thing that makes you a "real man," but your testosterone levels do play a pretty significant role. You could say it's what separates the men from the boys—literally.
But how? What is testosterone, really? Why do some body builders sweat their T levels and inject themselves with the hormone or steroids? Is it as important as we've been lead to believe and what happens if you have lower levels than the average man? With all these questions, we thought a primer on T was in order. Herewith, the answers to a few simple questions. Testosterone is a hormone produced primarily in the testicles and, to a lesser extent, the ovaries of females.
It regulates everything from sperm production and sex drive to muscle mass, a deeper voice and all your body hair whether you want it or not. The hormone also plays a role in your bone density, fat distribution and red blood cell production. In addition to the primary bodily functions above, T is responsible for pushing us through puberty. So without it, we'd all look and feel prepubescent. According to the Journal of Applied Physiology , testosterone also increases our potential for muscle growth, increasing our strength by forcing the body to increase protein synthesis.
Post-puberty, a man's body continues to produce testosterone well into adulthood, which ensures he can continue building muscle.