Worsening sleep apnea, a potentially serious sleep disorder in which breathing stops and starts repeatedly. An official website of the United States government Official websites use. gov A. The gov website belongs to an official government organization of the United States.
Testosterone replacement therapy (TRT) has been used in millions of men worldwide to treat decreased libido and erectile dysfunction, and to improve strength and physical function. The estimated likelihood of long-term adverse effects of TRT remains virtually unknown, as high-quality evidence based on prospective randomized trials that recommend or does not recommend its use in most men with testosterone (TD) deficiency is generally lacking. Evidence to suggest that TRT increases the risks of cardiovascular morbidity and mortality is scarce, as results vary depending on the populations studied and their baseline comorbidities. Although TRT can increase serum levels of prostatic specific antigens in some men, it often stays within clinically acceptable limits and has not been shown to increase the risk of prostate cancer.
Current literature supports that TRT does not substantially worsen lower urinary tract symptoms and, in fact, may improve symptoms in some men. Limited evidence suggests that TRT may initially worsen obstructive sleep apnea in some men, but that this effect is not long-lasting. TRT may cause erythrocytosis in some men; however, long-term studies have not reported significant adverse effects (e.g., strokes, vascular occlusive events, or venous thromboembolism).Future research will need to focus exclusively on evaluating large multiethnic cohorts of men using prospective trials to better elucidate the risk-to-risk ratios of TRT with regard to cardiovascular diseases, prostate cancer, lower urinary tract symptoms, obstructive sleep apnea, erythrocytosis and other theoretical risks to be determined in men with or without cardiovascular risk equivalents. To date, few studies have addressed the potential long-term adverse effects associated with TRT.
This article will summarize current evidence, focusing on the possible risks associated with CVD, increased prostatic specific antigen (PSA) and prostate cancer, lower urinary tract symptoms (LUTS), obstructive sleep apnea (OSA) and erythrocytosis, with the objective of analyzing the literature on the safety of TRT and identifying areas where future research is needed. The estimated likelihood of long-term adverse effects of TRT is still essentially unknown, as there is a lack of high-quality general evidence to discourage its use in most men with TD. The outstanding studies covered in this article can be used to guide the physician on how to best manage patients receiving TRT, especially those with the comorbid conditions listed below. Similar to the possible increased risk of prostate cancer, it has long been postulated that TRT causes an increase in prostate volume and a worsening due to benign prostatic hyperplasia (BPH). Until now, the current literature has been heterogeneous, but it tends to show that TRT does not worsen LUTS and, in fact, may improve symptoms in some cohorts.
TRT will continue to offer the possibility of substantially improving the quality of life of many men around the world. World. Judicial and appropriate use of TRT will be imperative to minimize the theoretical risk of adverse events in high-risk populations. Future research should require a specific focus on evaluating large multiethnic cohorts of men using prospective trials to better elucidate the risk-risk relationship of TRT with regard to cardiovascular and metabolic diseases, prostate cancer, LUTS, OSA, erythrocytosis and other theoretical risks yet to be determined in men with or without cardiovascular risk equivalents.
Available evidence indicates that TRT is considered largely safe in most men, with a small inherent risk of adverse events in selected populations of high-risk men with multiple medical comorbidities. TD is associated with an increased risk of developing cardiovascular and metabolic diseases; however, the nature of the relationship remains unclear and recent evidence suggests that TRT may increase the risk of adverse cardiovascular events in men with significant comorbidities. TRT has been associated with occasional moderate increases in serum PSA, but within safe clinical parameters and without substantial convincing evidence to support an increased risk of prostate cancer. The LUT seems to remain stable or to improve slightly with the use of the TRT, offering a different point of view than previously held opinions.
There is still little data on TRT in relation to long-term outcomes of OSA; however, current evidence suggests that TRT may transiently worsen the objective parameters of OSA and then disappear. TRT appears to be associated with erythrocytosis, but data are lacking on the importance of this trend in relation to patient outcomes. Anthony Grech, University of Michigan - Family Medicine, Ann Arbor, MI, USA UU. John Breck, University of Michigan - Family Medicine, Ann Arbor, MI, USA UU.
Joel Heidelbaugh, University of Michigan, Family Medicine, Ypsilanti Health Center, 200 Arnet Suite 200, Ypsilanti, MI 48198, USA UU. Here you will find articles from Therapeutic Advances in Drugs, courtesy of SAGE Publications. Prolonged TTh in hypogonadal men, regardless of initial weight, resulted in improvements in body weight, waist circumference (WC), and body mass index (BMI). In addition, TTh lowered fasting blood glucose and HbA1c and improved lipid profiles.
Gradual decreases in blood pressure (systolic and diastolic) and pulse pressure occurred in men treated with testosterone in each group. There were significant reductions in mortality and serious cardiovascular events in men who received TTh. B. Percentage of weight changes in normal-weight, overweight or obese hypogonadal men, at the start of the study, treated with or without testosterone therapy.
C Changes in pulse pressure in normal weight, overweight or obese hypogonadal men at the start of the study treated with or without testosterone therapy. Other sources of variability introduced in total testosterone measurements include differences in fasting times, diets, and the time of day that participants' blood was drawn. The male hormone testosterone plays an important role in the development and maintenance of typical male physical characteristics, such as muscle mass and strength and the growth of facial and body hair. The beneficial effects on body composition, sexual function, hematocrit and BMD must be weighed against the detrimental effects on androgenic alopecia, prostate cancer, hypertension and spinal stenosis, and the beneficial effects not detectable on other important clinical endpoints.
Testosterone replacement therapy
prevents alterations in coronary vascular reactivity caused by castration-induced hormone deficiency.Testosterone replacement therapy, in the form of injections, pills, patches, or gels, can improve the signs and symptoms of low testosterone levels in these men. Finally, these results represent the lifetime effects of endogenous free testosterone and may not necessarily reflect the effects of exogenous testosterone treatment, which may vary in duration, age of onset, and dosage. Mendelian randomization suggests that the benefits of increasing testosterone in the long term should be considered against adverse effects, in particular the increase in prostate cancer and hypertension. In the UK Biobank study, Mendelian randomization analyses were performed to deduce the effects of free testosterone on the whole phenomenon in 461 results in 161,268 men.
However, the effects of testosterone and the consequences of supplementation on the human body are not clear. Your doctor will likely measure your testosterone levels at least twice before recommending testosterone therapy. The subsequent evaluation of the TOM trial sought to evaluate changes in gonadal hormones and markers of inflammation and coagulation to determine risk factors associated with potential cardiovascular events. For all statistically significant results, the effects observed with genetic variants of total testosterone were directionally consistent with CFT, and the results of all results are presented in Supplementary File 1, Tables 9 and 10. We evaluated the effects of testosterone (T) (Th) therapy in normal-weight, overweight and obese T-deficient men on anthropometric and metabolic parameters, compared to untreated men.
