Hormone Therapy for Prostate Cancer Fact Sheet NCI

Men’s Health From Testosterone Replacement To Medication

But hormone therapy alone doesn’t cure prostate cancer, and many cancers become resistant to hormone therapy over time. Dr. Traci Kurtzer, a menopause specialist at the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago, agreed the push for testosterone started happening in recent years. Her patients inquire about testosterone therapy for multiple problems — to improve mood, energy, sex drive, brain fog and muscle mass. Historically, the concern for TRT was its effect on the prostate. Despite evidence that the prostate does enlarge slightly on TRT, no studies have shown any significant worsening of urinary symptoms while on therapy. Studies have also demonstrated no significant change in PSA while on therapy.

A healthy diet and regular exercise are necessary for good health and to ensure the maximum effectiveness of testosterone treatment. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor peptest bulk reviews or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Do not let anyone else use your testosterone enanthate injection (Xyosted). Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.

With TRT, you take a manufactured form of testosterone to regulate your levels. This can help improve the symptoms of low testosterone, like low libido and lack of energy. Certain existing health conditions make it unsafe, like prostate cancer and heart failure.

Testosterone replacement therapy can also have a negative effect on sperm production and impair fertility. Dr. Pastuszak would put this guy on hormone therapy as a « lifestyle intervention. » The treatment makes him feel better and improves his energy levels. He then has the energy to go to the gym and exercise, which will bring his weight down, and get his body producing testosterone again. In a case like this, testosterone therapy can break the bad health spiral long enough for a man to improve his health and eventually stop using testosterone.

The general trend indicated that higher doses of testosterone were more likely to result in azoospermia than lower doses, however a dose-response effect was not consistently seen. Older observational studies suggested that long term testosterone use could increase their risk of cardiovascular disease. Also testosterone is known to stimulate growth of prostate cancer in men diagnosed with the condition. Recent clinical trials, which provide more accurate information compared to observational studies, have provided some comfort around both the heart and prostate cancer risks. For men who clearly have testosterone deficiency, there is no apparent increased risk of heart attack or stroke or greater chance of developing a new prostate cancer from testosterone replacement therapy. Though testosterone therapy is common, there are some known risks and side effects.

If other conditions or medications cause testosterone levels to drop, doctors usually treat the underlying condition before recommending TRT. TRT, or androgen replacement therapy (ART), is a treatment that doctors give to males with testosterone deficiency who show symptoms of hypogonadism. You can stay on testosterone replacement therapy for as long as it’s benefiting your symptoms and not causing health issues.

It’s used mostly by aging men with low testosterone levels—a condition called hypogonadism—but is exploited by others looking to stop the normal testosterone decline that’s part of male aging and, in a sense, to relive their youth. Testosterone is a key male hormone that affects sex drive, bone mass, the production of red blood cells, and muscle size and strength. I don’t believe that testosterone increases the risk of biochemical recurrence or progression in men who have a history of prostate cancer. There are studies [with data] demonstrating that giving men testosterone after radical prostatectomy may decrease biochemical occurrence. In 1 study, Ahlering et al looked at a group of hypogonadal men after a radical prostatectomy who received testosterone supplementation.

The TTrials amounted to the largest study ever of testosterone treatment in older men, based on the number who participated (788). The placebo-controlled study was designed to provide definitive answers about the short-term benefits and risks of testosterone treatment, while addressing the limitations of prior studies. Those limitations included small numbers of men studied, the inclusion of men with normal testosterone levels, the use of too little or too much testosterone, a short treatment period, and non-validated outcome measurements. Testosterone is the main male hormone that maintains muscle mass and strength, fat distribution, bone mass, sperm productions, sex drive and potency. Very low testosterone levels can place you at higher risk for osteoporosis, obesity, diabetes and heart disease. For years, whether testosterone therapy raised the risk of cardiovascular disease was an open question.

Ultimately, like most medications, testosterone therapy is not without risk. The known risks include a decrease in fertility and sperm count; elevated blood counts (polycythemia), which can lead to blood clots if not monitored properly; acne; breast enlargement; and hot flashes. A relatively small number of men experience immediate side effects of testosterone supplementation, such as acne, disturbed breathing while sleeping (worsening sleep apnea), breast swelling or tenderness, or swelling in the ankles. Doctors also watch out for high red blood cell counts, which could increase the risk of clotting.

I think you have to first decide if you believe that testosterone increases the risk of prostate cancer. I was very happy to see when the AUA in 2018 put out in the testosterone guideline statement that clinicians should inform patients of the absence of evidence linking testosterone therapy to the development of prostate cancer. Ketoconazole (Nizoral), first used for treating fungal infections, also blocks production of androgens made in the adrenal glands, much like abiraterone. It’s most often used to treat men just diagnosed with advanced prostate cancer who have a lot of cancer in the body, as it offers a quick way to lower testosterone levels. It can also be tried if other forms of hormone therapy are no longer working. At this time, it is unclear whether TRT increases the risk of prostate cancer or symptoms of benign prostatic hyperplasia.