USRF Research

Effect of Testosterone Replacement Therapy on Prostate Tissue in Men With Late-Onset Hypogonadism

Commentaries by Expert Reviewers

Jacob Rajfer, M.D., Professor of Urology, UCLA School of Medicine
“Best of AUA, 2006” (From MedReviews, Summer 2006)

"In support of androgen replacement therapy in aged men, Marks and colleagues from the University of California, Los Angeles gave what this reviewer considered to be one of the most elegant talks about this topic.

Marks, in collaboration with experts from all over the United States, gave middle-aged patients placebo or testosterone daily for 6 months and performed prostate biopsies biopsies before and after cessation of testosterone therapy.

No difference in the incidence of carcinoma of the prostate was found between the placebo and testosterone therapy groups, and levels of testosterone and dihydrotestosterone within the prostate tissue also were no different between the 2 groups.

In addition, Mostaghel and colleagues21 found that the genes that promote or represent prostatic growth (eg, prostatespecific antigen [PSA]) were not stimulated more in the testosterone group than in the placebo group.

The investigators suggested that the effects of exogenous androgens are "buffered" by the prostate and that the long-held belief that exogenous androgens are stimulatory when given to aged men needs to be re-examined."


Alvaro Morales, M.D., Professor of Urology, Queens University,
Kingston, Ontario, Canada.
"Testosterone and Prostate Health," European Urology 50: 895, 2006

“Finally, to further complicate the picture, fascinating and convincing evidence has been presented lately demonstrating that ‘‘no prostate tissue changes attributable to T supplementation were found (in this study of men with low T receiving T supplementation).

Despite marked increases in serum levels, prostate levels of T and DHT were unchanged after 6months of treatment, gene expression was not altered, cell proliferation was not accelerated, and histologic cancers were not increased’’. Thus, it appears that the intraprostatic hormonal environment bears little resemblance to serum levels of androgens.

The implications of these findings, once confirmed, are of enormous significance.”


Michael O’Leary, M.D., Professor of Urology, Harvard Medical School, Boston.
"Highlights of 2006 AUA Meeting"

"Now what about the effects of testosterone in the prostate? This (paper) gets my personal vote, if I have to give one, as probably one of the best papers of all of the sessions that I reviewed."


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