It has been over 60 years since Hodges and Huggins described a relationship between serum testosterone levels and prostate cancer progression. Factors such as exacerbation of prostate cancer, male breast cancer, worsening benign prostatic hyperplasia (BPH), polycythemia and an increased risk of obstructive sleep apnea (OSA) should be considered when administering TRT to a patient. Testosterone therapy does not appear to increase the risk of prostate cancer, but it can stimulate the growth of prostate cancer cells. Testosterone therapy may make sense for women who have low testosterone levels and symptoms that might be due to testosterone deficiency. Two meta-analyses found no differences in cardiovascular events between TRT and placebo groups Fernandez-Balsells et al. 2010; Calof et al. 2005, while a more recent meta-analysis found that TRT increased the risk of cardiovascular events, although the data seemed to vary by source of research trial funding. Low endogenous T levels correlate with an increased risk of adverse CVD events, and endothelial dysfunction and increased atherosclerosis are means by which male hypogonadism may contribute to an increased risk of death Jackson et al. 2010. Evidence to suggest that TRT increases cardiovascular morbidity and mortality risks is poor, as results vary across study populations and their baseline comorbidities. This means that you’ll need the medication to continue having a normal level of testosterone in your body. TRT doesn’t fix or cure the underlying cause of low testosterone. They’ll ask about your medical history and do a physical exam. As of 2025, it’s not yet approved for males who naturally experience a decline in testosterone as they age. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. Men taking testosterone replacement must be carefully monitored for prostate cancer. As with any therapeutic intervention, clinicians should discuss the benefits and potential risks of hormone replacement therapy with men prior to initiating treatment, as well as discuss provisions for ongoing management and surveillance. While TRT is often a life-long treatment for many men, it is important to note that no randomized control trials to date have been large enough and adequately powered to detect differences in prostate cancer risk. Recent clinical trials, which provide more accurate information compared to observational studies, have provided some comfort around both the heart and prostate cancer risks. Millions of American men use a prescription testosterone injection or gel as forms of testosterone replacement therapy (often referred to as TRT therapy) to restore normal levels of the manly hormone. The committee put forward only a recommendation to screen men with BRCA1 and BRCA2 genetic mutations, which puts them at far higher risk of prostate cancer, every two years, between the ages of 45 and 61. Anabolic steroids are medications that are manufactured forms of testosterone. Healthcare providers prescribe them for certain conditions, such as male hypogonadism and certain types of breast cancer. Anabolic steroids have legitimate medical purposes. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-cautions-about-using-testosterone-products-low-testosterone-due. The supportive argument posits that by treating men with TRT, thereby increasing PSA levels and administering T to a steroid responsive cancer, a man’s risk of development of prostate cancer is significantly increased. It has been demonstrated in several trials that TRT increases serum PSA levels in some men, while androgen deprivation therapy can be used in the successful treatment of prostate cancer. While TRT for treatment of TD may cause elevations in serum PSA in some men within safe parameters (as outlined in the Endocrine Society Guidelines), it has not been definitively shown to lead to a significantly increased risk of prostate cancer Bhasin et al. 2010. The primary goal of this hormone therapy is to suppress testosterone levels, a hormone crucial for the cancer's growth. In one yearlong study, 65 men who took 3,300 IU of vitamin D daily increased their testosterone levels by 20% over those who didn't.
