Testosterone Replacement Therapy & Prostate Cancer

Testosterone is so strongly associated with manhood that the idea of "running low" can be frightening. Yet all men eventually have lower testosterone levels with age, and some men have medical reasons for testosterone underproduction. Testosterone replacement therapy can help raise these low levels, with positive effects. However, there are caveats--especially because of testosterone's impact on the prostate.

Identification

• Testosterone is well-known as the male sex hormone, which keeps a man's sex drive going strong and increases his sperm production. But testosterone also has other, non-sexual effects on the body; it keeps muscles strong and bones dense and keeps red blood cell production up. If naturally produced testosterone levels drop for whatever reason, then a man might consider undergoing testosterone replacement therapy to make sure that his body is getting the hormones it needs.

Reasons for Therapy

• There are several reasons that a man might have low testosterone levels. An injury to the testicles or surgery on the testicles are two obvious reasons, but chronic illness of any type can decrease testosterone production. Radiation and chemotherapy can also lower testosterone levels. All men will experience a lowering of testosterone levels with age; this process starts around the age of 40 and is sometimes called "andropause" or "male menopause." It's uncertain whether testosterone replacement therapy really benefits men who are undergoing andropause.

Therapy Methods

• Testosterone replacement therapy is available in several different forms. It can be injected by a doctor directly into the body or applied transdermally in the form of a patch worn on the scrotum or arm. There is also testosterone gel, which is rubbed into the skin and then absorbed into the bloodstream. Whatever method a patient uses, it may take up to six months for positive results to appear.

Prostate Effects

• There's no evidence that testosterone replacement therapy causes prostate cancer. However, if you already have prostate cancer that hasn't been detected, testosterone therapy can "feed" the tumor and help it grow. Testosterone replacement therapy can cause benign prostatic hypertrophy (BPH), a non-cancerous condition in which the prostate swells. BPH can cause side effects like impotence and urinary problems.

Prevention/Solution

• If you're thinking of starting testosterone replacement therapy, have a prostate cancer screening before you start. That way, you'll avoid the possibility of enlarging a prostate tumor, and you can start the replacement therapy with a clean bill of health (and if prostate cancer is detected, you'll have caught it early). Men who have already been treated for prostate cancer shouldn't undergo testosterone replacement therapy, even if they are in remission.