The widespread use of testosterone injections and patches has come under fire. The use of testosterone for "low-T" nonetheless makes sense for many men.
In some circles, testosterone is almost a dirty word.
Long associated with illegal injections by baseball players accused of perjury and sleazy boxing club owners, testosterone supplementation really does have a downside. In men who don't need it, or when it is used in excess, supplemental testosterone can cause changes in the skin, aggressive behavior, and even dementia. However, used ethically and legally in a medical setting, testosterone can be exactly what a man needs to restore his sex life and in some cases his genitals.
Doesn't Testosterone Cause Prostate Cancer?
Synthetic testosterone has been around for a long time. The male sex hormone was first synthesized in 1935. Just six years later, in 1941, there was a report that testosterone injections could accelerate prostate cancer. This led to nearly 75 years of fear by doctors that giving men who need testosterone would also give them cancer. However, the cancer scare that began in 1941 was based on just one case, and the data for even that one case could be (and should be) interpreted in many different ways. The cancer scare regarding testosterone has never been well founded on clinical evidence. It has been based on the fact that no doctor wants to be that one physician who gave his or her patient prostate cancer. Nobody wants to be the first to make a fatal mistake.
Latest Concern Is About Cardiovascular Risks
While the fear of cancer in treating men with medically administered, limited doses of testosterone has subsided to some extent, there is a new fear that giving men testosterone will cause cardiovascular disease. Readers can find a link to an article about the US FDA warning about testosterone and heart problems below this article. The label on testosterone must now carry a warning about the potential of increased risk of heart attack and stroke. Additionally, in the US, doctors are no longer permitted to prescribe testosterone just because a man is older and his body is not making as much of the hormone. Now American doctors are required to document that a man has testicular or hypothalamic defect (a lesion in the hypothalamus in the brain, usually caused by accumulation of iron in the bloodstream) that is causing his body to make less testosterone. If there is a disease that interferes with the production of the hormone, then it is OK to give injections or the patch.
However, the medical regulatory agencies in Europe and Russia take a different view of the use of testosterone. The mere fact that an older man still wants to feel like a man is considered to be enough reason to give testosterone (in some cases, if he can pay for it). They argue that there is no consistent evidence that testosterone can cause "cardiovascular events," and in fact there isn't.
Lies and Truth About Testosterone
The study on which the FDA ruling was based involved 8709 men in the American Veterans Affairs hospitals who were diagnosed with low testosterone and who later had to have angiography for heart disease. The study found that, after three years, 25 percent of men who had been prescribed testosterone had some kind of cornary disease, compared to just 20 percent of men who did not. However, to get "interesting" and newsworthy results, the researchers used a controversial kind of data analysis that multipled coronary events by three and multiplied "non-events" by less than one. When the raw data were reexamined, independent researchers conclude that testosterone actually protected against heart disease rather than causing it. In fact, the risk of heart attack or stroke was 50 percent lower in men who used testosterone than in men who did not.
Even worse, two years later an investigation revealed that 10 percent of the "all male" sample were in fact women. At the time this article is being written, 29 medical societies have asked that the article be withdrawn from the Journal of the American Medical Association.
What Are the Real Benefits of Testosterone?
Dr Abraham Morgentaler, a physician who has been researching testosterone for 40 years and who has supervised testosterone replacement therapy in several thousand men, states that the research literature as a whole supports the use of testosterone in men who have low testosterone levels for any reason.
According to Morgentaler, testosterone replacement in men:
- Increases exercise capacity in men who already have known cardiovascular disease, such as angina or congestive heart failure.
- Eases the effects of "metabolic syndrome," including fat mass accumulation, insulin resistance, and waist size.
- Reduces the risk of death from all causes by 50 percent.
Morgentaler also points out several myths about testosterone. The facts are that:
- Testosterone therapy does not increase the risk of cancer in men. Estrogen therapy does increase the risk of cancer in women, but testosterone is not estrogen, and women are not men.
- Testosterone is not overprescribed. Epidemiologists estimate that up to 4 million men in the US alone can be diagnosed with hypogonadism (literal shrinking of the penis and testicles), and only 2 million men in total receive the hormone.
- Testosterone is not prescribed without lab work. A study came out that claimed that 25 percent of men who were prescribed testosterone had not had a lab test to prove that they needed it, but the study was based on insurance records, that is, what was billed to their insurance companies, not was in their medical records. Some insurance companies simply don't cover testosterone therapy and would not have a record of the blood test.
- Testosterone deficiency does not have to have a known cause for testosterone replacement to make good clinical sense. We don't know the cause of cancer, but we don't tell cancer patients they can't be treated. We don't know the full cause of heart disease, but we don't tell someone in the emergency room who is having a heart attack to go home and eat more broccoli. Even in the absence of a clear cause of low testosterone, and twice as many men just in the US have a clear cause for low testosterone as get replacement therapy, giving a man testosterone can improve his life.
There is clear evidence that testosterone helps men have stronger erections. It stimulates desire for sex, and as a result it helps lift depression. It helps men build muscle and lose body fat. It increases bone density. It even decreases the likelihood of prostate cancer in some cases.
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Testosterone patches and injections are the answer to the question of how to increase testosterone levels. Don't let anti-Pharma activists and naysayers dissuade you from getting the treatment you really need. Make sure that your prescription for testosterone is based on a blood test, and follow your doctor's directions, but do not avoid this major boon for male health. Achieving normal testosterone levels can make a huge difference in a man's life.