Recognising the true value of testosterone therapy in health care

Authors

  • A Morgentaler Harvard Medical School
  • A Traish Boston University School of Medicine
  • RS Barua Kansas City VA Medical Center
  • P Dandona State University of New York
  • S Dhindsa Saint Louis University
  • M Khera Baylor College of Medicine
  • F Saad Bayer AG

Keywords:

testosterone therapy, hypogonadism

Abstract

There has been little recognition within the medical community of the health impact of testosterone (T) deficiency (TD), also known as hypogonadism, and the substantial benefits of testosterone therapy (TTh) on health and quality of life despite high-level clinical evidence. In a roundtable symposium, investigators summarized the contemporary evidence in several key clinical areas. TD negatively impacts human health and quality of life and is associated with increased mortality. Several studies have demonstrated that TTh in men with TD reduced all-cause and cardiovascular mortality. The longstanding belief that TTh is associated with increased prostate cancer (PCa) risk is contradicted by recent evidence, including multiple studies showing that TTh is associated with reduced PCa risk. Similarly, the weight of current evidence indicates the purported concern that TTh is associated with increased cardiovascular risk is incorrect. Normalisation of physiological T reduces myocardial infarction, stroke, and deaths compared with men whose testosterone levels failed to normalize. In diabetic men TTh improves insulin resistance, and a large 2-year controlled study in men with abnormal glucose tolerance showed a substantially reduced rate of diabetes among men treated with TTh compared with untreated controls. Long-term TTh in diabetic men resulted in progressive improvements in obesity and insulin requirements, including a substantial number who experienced complete remission of diabetes. Finally, TTh has been shown to reduce severe outcomes with COVID-19 infection. These lines of evidence argue strongly for the need for greater awareness in the medical community of the impact of TD on health, and of the health benefits of TTh.

Author Biographies

A Morgentaler, Harvard Medical School

Department of Surgery (Urology), Beth Israel Deaconess Medical Center, Harvard Medical School, United States of America

A Traish, Boston University School of Medicine

Departments of Urology and Biochemistry, Boston University School of Medicine, United States of America and Medical Affairs, Bayer AG, Germany

RS Barua, Kansas City VA Medical Center

Department of Cardiology, Kansas City VA Medical Center, United States of America

P Dandona, State University of New York

Division of Endocrinology, Diabetes and Metabolism, State University of New York, United States of America

S Dhindsa, Saint Louis University

Division of Endocrinology, Diabetes and Metabolism, Saint Louis University, United States of America

M Khera, Baylor College of Medicine

Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States of America

F Saad, Bayer AG

Medical Affairs, Bayer AG, Germany

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Published

2023-11-24

Issue

Section

Review