|Benefits of Testosterone Therapy
The Nobel Prize in Chemistry was awarded to Butenandt and Ruzicka in 1939 for the synthesis of testosterone (1)
Since then, seventy years ago, thousands of medical studies have shown
benefits of testosterone for improving health and prolonging life.(2-27)
can prevent or reduce the likelihood of osteoporosis, type 2 diabetes,
cardiovascular disease, obesity, depression and anxiety and the risk of
Health benefits include positive effects on mood, energy levels, verbal
fluency, strength, increased muscle size, decreased body fat and
increased bone density.(2-27) Testosterone restores and enhances male
libido, and is a treatment for male sexual dysfunction.(33)
Low Testosterone Associated With Increased Mortality
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.(35) Low Testosterone levels is also linked to reduced cognitive performance and onset of Alzheimers in elderly men. (36)(37)
Above Left Image: Adam by Albrecht Durer 1507 Courtesy of Del Prado, Madrid Courtesy Wikimedia
Testosterone Benefits the Heart
Here are a few studies showing testosterone benefits the heart and circulation.
studied men with known coronary artery disease and showed they had
significantly lower levels of testosterone (J Med Invest 2003).(22) 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).(23)
Dr. Malkin also reported that testosterone improves the pumping action
of the heart in patients with Congestive Heart Failure,(24) and acts a protective factor against atherosclerosis and plaque formation in arteries. (J Endocrin 2003).
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.(25)
No Evidence of Adverse Effect on the Prostate
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.
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,
or 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. (28)
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(29)
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.(30)
For more information see my web page on Testosterone Safety and Benefits. (25 )
The ADAM Testosterone Questionnaire
This questionnaire is useful for detecting low testosterone levels. ADAM is short for Androgen Deficiency in the Aging Male.(43)(44)
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
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
Testosterone for Dry Eyes in Women
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.(31)(32) See Testosterone and Dry Eyes
Articles with Related Content:
PSA and Testosterone Part Two by Jeffrey Dach MD
PSA Screening for Prostate Cancer, the Failed Medical Experiment
Jeffrey Dach, M.D.
7450 Griffin Road, Suite 190
Davie Florida 33314
The Nobel Prize in Chemistry 1939 Presentation Speech The following account of Butenandt's work has been made.
Benefits of Testosterone
Suggests Depressed Men May Benefit from Testosterone Replacement
Therapy Belmont--January 1, 2003, Harvard Medical School affiliate
McLean Hospital -- A preliminary study published today in the American
Journal of Psychiatry suggests that transdermal testosterone replacement
gel, in conjunction with conventional antidepressants, may improve
mood, anxiety, libido and other aspects of depression in
difficult-to-treat men who fail to respond to antidepressants alone.
Researchers from McLean Hospital in Belmont, MA, conducted the study in
treatment-resistant depressed men with low testosterone levels.
Testosterone therapy: The answer for aging men? Date updated: April 14, 2006
Content provided by MayoClinic.com Mayo Foundation for Medical Education and Research (MFMER)
Urology Journal. Testosterone Replacement Therapy. Wayne J.G.
Hellstrom, M.D. Tulane University Medical Center New Orleans, LA
and Ageing: What Have We Learned Since the Institute of Medicine Report
and What Lies Ahead? M. M. Miner; A. D. Seftel Int J Clin Pract.
The possible relationship of
testosterone to risk of prostate cancer remains a concern; however, no
new evidence has emerged to suggest that testosterone replacement
therapy increases the risk. Recent studies have demonstrated that
hypogonadism in men may be more prevalent than previously thought, is
strongly associated with metabolic syndrome, and may be a risk factor
for type 2 diabetes and cardiovascular disease. Clinical studies have
shown that testosterone replacement therapy in hypogonadal men improves
metabolic syndrome indicators and cardiovascular risk factors.
Maintaining testosterone concentrations in the normal range has been
shown to contribute to bone health, lean muscle mass, and physical and
sexual function, suggesting that testosterone replacement therapy may
help to prevent frailty in older men. Based on current knowledge,
testosterone replacement therapy is unlikely to pose major health risks
in patients without prostate cancer and may offer substantial health
Treatments: Why, When, and How? American Academy of Family
Physicians.May 1, 2006 KATHERINE MARGO, M.D., University of Pennsylvania
School of Medicine, Philadelphia, Pennsylvania ROBERT WINN, M.D.,
Jefferson Medical College, Philadelphia, Pennsylvania
Science News Low Testosterone Levels Associated With Increased Risk Of Death In Men
(Aug. 17, 2006) — Men who have a low testosterone level after age 40
may have a higher risk of death over a four-year period than those with
normal levels of the hormone, according to a report in the August 14/28
issue of Archives of Internal Medicine, one of the JAMA/Archives
journals (Arch Intern Med. 2006;166:1660-1665.
May Improve Mental Function. ScienceDaily (Jan. 14, 2008) — When we
think about the powers of testosterone, we usually do not consider
mental processes. However, research suggests that testosterone levels
may affect men’s cognitive performance, reports the January 2008 issue
of Harvard Men’s Health Watch.
Chapter 7 Testosterone, The Male Hormone Connection: Treating Diabetes and Heart Disease
Michael Klentze, M.D., Ph.D. Medical Director, Klentze Institute of Anti-Aging, Munich,
Testosterone for Men and Women By Steven F. Hotze, M.D., e-book.
State-of-the-Art Update on Testosterone Replacement: A Clinical and Pharmacological Approach Narinder Duggal Pharmacy Times
TESTOSTERONE REPLACEMENT FOR OLDER MEN? Gabe Mirkin, M.D.
With Testosterone: Endocrine Society Audioconference Spotlights IOM
Report, Practical Approach to Testosterone Therapy of Elderly Men
Endocrine News Volume 29, Number 1 - February 2004
PATIENT’S GUIDE to Low Testosterone (2003 Edition)
R. Cunningham, MD, Alvin M. Matsumoto, MD, Ronald Swerdloff, MD. From
the Family Physicians Inquiries Network. Do testosterone injections
increase libido for elderly hypogonadal patients? Krupa Shah, MD; Cathy
Montoya, MLS Baylor College of Medicine, Houston, Texas. The
Evidence-based answer, Yes, testosterone therapy is effective in
improving libido for elderly hypogonadal males.
An interview with Abraham Morgentaler, M.D.A Harvard expert shares his thoughts on testosterone-replacement
Rev Urol. 2003; 5(Suppl 1): S34–S40. New Advances in the Treatment of Hypogonadism in the Aging Male Christopher P Steidle, MD
Aging Male. 2004 Dec;7(4):319-24. Testosterone therapy--what, when and to whom?Jockenhövel F.
Drugs. 2004;64(17):1861-91. Androgen replacement therapy: present and future.Gooren LJ, Bunck MC.
Clin Endocrinol (Oxf). 2006 Sep;65(3):275-81. Testosterone treatment comes of age: new options for hypogonadal men. Nieschlag E.
(20) http://www.med.unc.edu/~mcoward/urology/Harrison's Aging-Related Changes in Male Reproductive Function.pdf
Internal Medicine > Part 14. Endocrinology and Metabolism >
Section 1. Endocrinology > Chapter 325. Disorders of the Testes and
Male Reproductive System > Aging-Related Changes in Male Reproductive
Journal of Andrology, Vol. 27, No. 2, March/April 2006
Review Testosterone Replacement Therapy for Older Men
MOSHE WALD*, RANDALL B. MEACHAM, LAWRENCE S. ROSS AND CRAIG S. NIEDERBERGER
Testosterone and the Heart
J Med Invest. 2003 Aug;50(3-4):162-9.
assessment of correlations between endogenous sex hormone levels and
the extensiveness of coronary heart disease and the ejection fraction of
the left ventricle in males.Dobrzycki S, Serwatka W, Nadlewski S,
Korecki J, Jackowski R, Paruk J, Ladny JR, Hirnle T.
Am J Cardiol. 2003 Nov 15;92(10):1241-3. Links
Effect of testosterone therapy on QT dispersion in men with heart failure.Malkin CJ, Morris PD, Pugh PJ, English KM, Channer KS.
Department of Cardiology, Royal Hallamshire Hospital, Sheffield, United Kingdom.
effects of testosterone on cardiac electrophysiology are poorly
described. In this study we report the effect of physiologic
testosterone therapy in 2 cohorts of men, the first with stable coronary
disease and the second with congestive heart failure. Testosterone
reduced QT dispersion in the heart failure cohort; no other effects were
Eur Heart J. 2006 Jan;27(1):57-64. Epub 2005 Aug 10. Links
therapy in men with moderate severity heart failure: a double-blind
randomized placebo controlled trial. Malkin CJ, Pugh PJ, West JN, van
Beek EJ, Jones TH, Channer KS. Testosterone replacement therapy improves
functional capacity and symptoms in men with moderately severe heart
Testosterone Information Page Jeffrey Dach MD
Replacement: The Male Andropause, Taken from a chapter in the book,
Resetting the Clock, by Elmer M. Cranton, M.D. and William Fryer
Effects of Testosterone Replacement for the Nonmotor Symptoms of
Parkinson Disease Michael S. Okun, MD; Benjamin L. Walter, MD; William
M. McDonald, MD; Joyce L. Tenover, MD; Joanne Green, PhD; Jorge L.
Juncos, MD; Mahlon R. DeLong, MD Arch Neurol. 2002;59:1750-1753.
Risks of Testosterone
J Urol. 2006 Feb;13 Suppl 1:40-3. Testosterone replacement therapy and
prostate risks: where's the beef? Morgentaler A. Division of Urology,
Harvard Medical School, Beth Israel Deaconess Medical Center, Boston,
Specifically, no increased risk of prostate
cancer was noted in 1) clinical trials of testosterone supplementation,
2) longitudinal population-based studies, or 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
Endocrinol Invest. 2005;28(3 Suppl):122-7. Monitoring androgen
replacement therapy: testosterone and prostate safety. Morales A. No
evidence exists that appropriate androgen administration with
knowledgeable monitoring carries significant or potentially serious
adverse effects on the prostate gland.
Risks of Testosterone-Replacement Therapy and Recommendations for Monitoring
Ernani Luis Rhoden, M.D., and Abraham Morgentaler, M.D. N Engl J Med 2004;350:482-92.
and dry eye in Sjögren's syndrome. Ann N Y Acad Sci. 1999 Jun
22;876:312-24. Sullivan DA et al. Our results demonstrate that
androgens regulate both lacrimal and meibomian gland function, and
suggest that topical androgen administration may serve as a safe and
effective therapy for the treatment of dry eye in Sjögren's syndrome.
deficiency, Meibomian gland dysfunction, and evaporative dry eye.
Sullivan DA et al. Ann N Y Acad Sci. 2002 Jun;966:211-22. Overall, these
results support our hypothesis that androgen deficiency may be an
important etiologic factor in the pathogenesis of evaporative dry eye in
women with Sjögren's syndrome.
Male Sexual Dysfunction, Endocr Pract. 2003;9 (No. 1) January/February 2003 77
ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS MEDICAL GUIDELINES FOR
CLINICAL PRACTICE FOR THE EVALUATION AND TREATMENT OF MALE SEXUAL
DYSFUNCTION: A COUPLE’S PROBLEM–2003 UPDATE AACE Male Sexual Dysfunction
Task Force Andre T. Guay, MD, Richard F. Spark, MD, Sudhir Bansal, MD
Androgel FDA approved topical version of testosterone.
Testosterone and Mortality due to All Causes, Cardiovascular Disease,
and Cancer in Men: European Prospective Investigation Into Cancer in
Norfolk (EPIC-Norfolk) Prospective Population Study 2/6/2008 Khaw KT,
Dowsett M, Folkerd E, et al. Circulation. 2007;116:2694-2701.The authors
concluded that endogenous testosterone concentrations are inversely
related to cardiovascular disease and all-cause mortality. Thus, low
testosterone may be a marker for increased risk of cardiovascular
Low Free Testosterone Levels Linked to Alzheimer’s Disease in Older Men
The Journal of Clinical Endocrinology & Metabolism Vol. 87, No. 11 5001-5007
Assessment of Serum Free Testosterone Concentration Predicts Memory
Performance and Cognitive Status in Elderly Men
Scott D. Moffat,
Alan B. Zonderman, E. Jeffrey Metter, Marc R. Blackman, S. Mitchell
Harman and Susan M. Resnick. These results suggest a possible beneficial
relationship between circulating free T concentrations and specific
domains of cognitive performance in older men.
The Male Andropause, by Michael B. Schachter M.D., F.A.C.A.M.
NATIONAL FEATURED ARTICLE TESTOSTERONE for MEN with DIABETES
Testosterone – Clinical Associations with the Metabolic Syndrome and
2 Diabetes Mellitus. T Hugh Jones. Consultant Physician and
Endocrinologist, Barnsley Hospital NHS Foundation Trust, and Honorary
Professor of Andrology, Academic Unit of Diabetes, Endocrinology and
Metabolism, University of Sheffield
Androgen Deficiency in Men. Daniel S. Tung, MD, and Glenn R. Cunningham, MD
The Endocrinologist Volume 17, Number 2, April 2007
Care 30:911-917, 2007 Clinical and Biochemical Assessment of
Hypogonadism in Men With Type 2 Diabetes, Correlations with bioavailable
testosterone and visceral adiposity. Dheeraj Kapoor, MD, et al.
Testosterone levels are frequently low in men with type 2 diabetes, and
the majority of these men have symptoms of hypogonadism.
The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 12 5920-5926
and Incidence of Androgen Deficiency in Middle-Aged and Older Men:
Estimates from the Massachusetts Male Aging Study. Andre B. Araujo et
2000 Sep;49(9):1239-42.Validation of a screening questionnaire for
androgen deficiency in aging males. (ADAM) Morley JE, Charlton E et al.
Jeffrey Dach, M.D.
4700 Sheridan Suite T.
Hollywood, Fl 33021
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Jeffrey Dach, M.D.
7450 Griffin Road, Suite 190
Davie Florida 33314