The Nobel Prize in Chemistry was awarded to Butenandt and Ruzicka in 1939 for the synthesis of testosterone. Since then, seventy years ago, thousands of medical studies have shown benefits of testosterone for improving health and prolonging life.
Testosterone can prevent or reduce the likelihood of osteoporosis, type 2 diabetes, cardiovascular disease, obesity, depression and anxiety and the risk of early mortality. Health benefits include positive effects on mood, energy levels, verbal fluency, strength, increased muscle size, decreased body fat and increased bone density. Testosterone restores and enhances male libido, and is a treatment for male sexual dysfunction.
Low Testosterone Associated With Increased Mortality
The 2007 EPIC study concluded that testosterone level is inversely related to cardiovascular disease risk and all-cause mortality. Thus, low testosterone may be a marker for increased risk of cardiovascular disease. Low Testosterone levels is also linked to reduced cognitive performance and onset of Alzheimers in elderly men.
Testosterone Benefits the Heart
Here are a few studies showing testosterone benefits the heart and circulation.
Dr. Dobrzycki studied men with known coronary artery disease and showed they had significantly lower levels of testosterone (J Med Invest 2003). He also showed that lower testosterone levels was associated with reduced pumping ability of the heart.
Dr. C.J. Malkin showed that testosterone therapy reduced the risk of death from abnormal heart rhythms (arrhythmias). Dr. Malkin also reported that testosterone improves the pumping action of the heart in patients with Congestive Heart Failure, and acts a protective factor against atherosclerosis and plaque formation in arteries. (J Endocrin 2003).
Dr. Eugene Shippen presented an impressive study at a medical meeting, in which testosterone therapy was used to successfully reverse diabetic gangrene of the lower legs and avoid amputation in many of the cases.
For more information on testosterone for aging males, see my web site testosterone information page.
No Evidence of Adverse Effect on the Prostate
Regarding a hypothetical question of prostate cancer risk from testosterone administration, there is no evidence for this in the medical literature. Here are three of many medical studies reporting no adverse effect on the prostate, and no evidence that testosterone causes prostate cancer.
Dr Morgentaler says: “It has been part of the conventional medical wisdom for six decades that higher testosterone in some way increases the risk of prostate cancer. This belief is derived largely from the well-documented regression of prostate cancer in the face of surgical or pharmacological castration. However, there is an absence of scientific data supporting the concept that higher testosterone levels are associated with an increased risk of prostate cancer.
Specifically, no increased risk of prostate cancer was noted in:
1) clinical trials of testosterone supplementation
2) longitudinal population-based studies
3) in a high-risk population of hypogonadal men receiving testosterone treatment.
Moreover, hypogonadal men have a substantial rate of biopsy-detectable prostate cancer, suggesting that low testosterone has no protective effect against development of prostate cancer. These results argue against an increased risk of prostate cancer with testosterone replacement therapy.” Testosterone replacement therapy and prostate risks: where’s the beef? Morgentaler A. Can J Urol. 2006 Feb;13 Suppl 1:40-3.
Dr Morales says: “No evidence exists that appropriate androgen administration with knowledgeable monitoring carries significant or potentially serious adverse effects on the prostate gland.” Monitoring androgen replacement therapy: testosterone and prostate safety by Morales A. J Endocrinol Invest. 2005;28(3 Suppl):122-7
Dr Rhoden says: “Despite decades of research, there is no compelling evidence that testosterone has a causative role in prostate cancer.” Risks of Testosterone-Replacement Therapy and recommendations for Monitoring. N Engl J Med 2004;350:482-92. Rhoden and Morgentaler.
For more information see my web page on Testosterone Safety and Benefits.
The ADAM Testosterone Questionnaire
This questionnaire is useful for detecting low testosterone levels. ADAM is short for Androgen Deficiency in the Aging Male.
1. Do you have a decrease in libido (sex drive)? Yes No
2. Do you have a lack of energy? Yes No
3. Do you have a decrease in strength and/or endurance? Yes No
4. Have you lost height? Yes No
5. Have you noticed a decreased “enjoyment of life” Yes No
6. Are you sad and/or grumpy? Yes No
7. Are your erections less strong? Yes No
8. Have you noticed a recent deterioration in your ability to play sports? Yes No
9. Are you falling asleep after dinner? Yes No
10. Has there been a recent deterioration in your work performance? Yes No
If you answered YES to questions 1 or 7, or any 3 other questions, you may have low testosterone. Next step is a testosterone blood test to determine your level. If low, then testosterone supplementation may be considered. It is important to work closely with a knowledgeable physician who can do a full evaluation, order the appropriate tests, and prescribe treatment.
Testosterone for Dry Eyes in Women
Among other things, some post-menopausal women have a chronic dry eye problem with redness and irritation of the eyes. This is called the evaporative dry eye and is usually a sign of testosterone deficiency, which can be confirmed by blood test for testosterone level, and rapidly resolves with topical testosterone cream in appropriate dosage. See Testosterone and Dry Eyes on my website.
To read more on Dr Dach’s work please visit his website at www.jeffreydach.com and if you have any questions or comments you can contact him via that website.
The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician — patient relationship. Although identities will remain confidential as much as possible, as I cannot control the media, I cannot take responsibility for any breaches of confidentiality that may occur. Jeffrey Dach, MD