Dr. Campbell: New risks of testosterone therapy reported in men

RALEIGH, N.C. (WNCN) – Over the last decade, millions of American men have turned to testosterone therapy.

Many men currently use testosterone pills, gels or injections, hoping that the male hormone will boost their sex drive, stamina, as well as optimize their body weight and strength.

  1. Why has testosterone therapy become more common and who should get it?

As men age, they produce less and less testosterone. Testosterone levels peak in the late 20s. Many studies have shown that testosterone can improve sexual function, stamina, body weight and overall health in men who are proven to be testosterone deficient.

You can determine testosterone levels by having several blood tests done by your physician. Those with normal testosterone levels should not be treated with testosterone. The normal range is very wide from 300-1,100 and it is important to determine if you have any symptoms of testosterone deficiency as you decide with your doctor if you are a candidate for replacement.

Believe it or not, women also need testosterone. Women produce testosterone (but in much smaller amounts as compared to men). As women age, their production can also fall to low levels and they can also develop symptoms.

  1. How is testosterone therapy given?

Testosterone can be delivered in shots, gels, creams or implanted pellets. The only effective way to deliver testosterone with stable blood levels for men is via an injection or shot. In women, creams and gels are ideal. Pellets are widely used but there absorption is variable and not predictable.

  1. What did this new study tell us about the risks of testosterone therapy in men?

It’s been known for a while that the estrogen in birth control pills increases a woman’s risk of blood clots, and earlier studies have raised similar concerns for testosterone therapy for men. In this study, researchers reviewed data from nearly 19,000 men with confirmed blood clots (called Venous thromboembolism or VTE) and compared them to a control group of 100,000 other patients. They found that within the first six months of testosterone treatment, a man’s risk of blood clots increased 63 percent compared to those not taking the hormone.

It’s important to remember that this type of study only suggests an association—it does not prove cause and effect. I do think that this study should give us pause —testosterone could prove hazardous for men who already are at high risk for blood clots.

It is also important to note that multiple studies over the last several years have provided conflicting evidence on heart risks for testosterone therapy. It is important to carefully consider your risk vs. benefit with your doctor before beginning therapy.

  1. What should patients do if they think they may need testosterone?

It is critical to discuss testosterone therapy with your doctor and carefully review your underlying risk factors for VTE with your doctor, and weigh that risk against the potential benefit of testosterone therapy. Risk factors for venous thromboembolism include obesity, prolonged immobility, recent surgery, advanced age and prior episodes of blood clots.

It is important to carefully monitor blood work once you start on testosterone and to follow up regularly with your doctor. Look for a doctor who is certified in Age Management Medicine—they have received special training in hormone replacement therapy and are qualified to manage testosterone.

To get in touch with Dr. Campbell, you can head to his website, Facebook page or message him on Twitter.

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