Worsening sleep apnea, a potentially serious sleep disorder in which breathing stops and starts repeatedly. Earlier observational studies suggested that long-term use of testosterone could increase the risk of cardiovascular disease. Testosterone is also known to stimulate the growth of prostate cancer in men who have been diagnosed with this condition. Recent clinical trials, which provide more accurate information compared to observational studies, have provided some peace of mind regarding the risk of heart and prostate cancer.
For men who are clearly deficient in testosterone, there is no apparent increased risk of heart attack or stroke or a greater chance of developing a new prostate cancer from testosterone replacement therapy.
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 comorbidities basals.While TRT can increase serum levels of prostatic specific antigens in some men, it often stays within clinically acceptable ranges 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.
stroke, vascular occlusive events, venous thromboembolism). Future research will need to focus exclusively on evaluating large multiethnic cohorts of men using prospective trials to better elucidate the risk-risk relationship of TRT in relation 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 it is necessary to perform future research.
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. Available evidence indicates that, in general, TRT is considered safe for most men, with an inherently small risk of adverse effects in certain high-risk groups of 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.
A known risk is that testosterone can cause blood to become too thick, also known as a high hematocrit count, which can lead to a stroke, heart attack, or other conditions. This can be a particular problem if you are taking a dose that is too high for the body's metabolism. This can be prevented by maintaining an appropriate dose and performing blood tests to monitor blood and hormone levels. Prolonged TTh in hypogonadal men, regardless of baseline 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 notable reductions in mortality and serious cardiovascular events in men who received TTh. You can continue testosterone replacement therapy as long as it benefits your symptoms and doesn't cause health problems. TRT is intended as a long-term therapy.
If you stop taking testosterone, your levels will return to their initial values. Mendelian randomization suggests that the benefits of a prolonged increase in testosterone should be considered against adverse effects, in particular the increase in prostate cancer and hypertension. Some of these signs and symptoms may be due to other factors, such as medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. Consider the effects of hormone therapy as a second puberty, and puberty usually takes years to see all the effects.
Given the multifactorial nature of this disease, the apparent discrepancy between blood pressure and hypertension can be explained by an effect on other risk factors that lead to hypertension. Studies have shown that using a smaller needle and injecting it subcutaneously or subcutaneously is as effective as the intramuscular route, which involves inserting a larger needle into the muscle. In this document, we performed MRI and GRS analyses of the CFT to identify the effects of endogenous free testosterone in men in 461 health outcomes. This study then evaluated the effect of TRT on mortality in men in the group with low testosterone, which was divided into men who received and did not receive TRT.
Once you've reached men's testosterone levels, taking higher doses won't cause faster or more dramatic changes; however, they can cause more side effects or complications. Now that you've learned about the effects of masculinizing hormone therapy, as well as the risks and specific medication options, the next step will be to talk to your provider about what approach is best for you. The results with the expected beneficial effects were fractures anywhere, heel bone density, body fat percentage, percentage of body fat free of body fat, dementia, depression, grip strength and level of physical activity measured with an accelerometer placed on the wrist. Starting hormone therapy at age 40, 50, or older may cause less dramatic changes than those seen at the beginning of the transition at a younger age, due to cumulative lifetime exposure to estrogen and decreased responsiveness to hormonal effects as the age of menopause approaches.
However, the effects of testosterone and the consequences of supplementation on the human body are not clear. In the UK Biobank study, Mendelian randomization analyses were performed to deduce the effects of free testosterone in 461 results in 161 268 men.
