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Prostate health: Testosterone and beyond

Post by Labrix Clinical Services, LLC

Once an idea or cause and effect relationship has established itself in medicine, it can take years to
slowly educate and change thinking. Such is the case with testosterone and prostate cancer. It was long
ago postulated that testosterone supplementation increased a patient’s risk of prostate cancer; this
connection has been assimilated into medical dogma and is often stated as though it is fact. There are
some inherent flaws in this association however, including the fact that prostate cancer is most
common in older men, who presumably have lower testosterone levels than their younger
counterparts, and clinical trials with testosterone supplementation DO NOT demonstrate increased risk
of prostate cancer.

Dr. Morgentaler, a Harvard urologist, and his colleagues have published a multitude of studies
debunking the myth that testosterone therapy increases prostate cancer and, in fact, have found a
correlation between low testosterone levels and the potential for an increased risk of prostate cancer.
The hormonal connection to prostate health may not be testosterone at all, but rather the direct result
of rising estrogen levels that contribute to the proliferation of prostate cells, leading to BPH and/or
prostate cancer. Estrogen’s effect on the cells in the prostate is similar to its effect on breast cells or
the cells of the uterus ­ it promotes growth and proliferation. The same is true for progesterone, which
promotes the maturation and differentiation of cells in these tissues.

Evaluation of estrogen (estradiol) and progesterone levels for men becomes increasingly more
important as they age and/or begin to exhibit signs and symptoms of changes to the prostate.
Treatment with progesterone to balance the proliferative influence of estrogen, coupled with
treatments to promote estrogen metabolism or hinder the conversion of testosterone into estrogen,
are important components of both a prophylactic and therapeutic prostate health plan. Additionally,
testosterone supplementation should not be avoided in the name of prostate health.

1. Morgentaler A, Schulman C. Front Testosterone and Prostate Safety. Horm Res. 2009;37:197­203.
2. Dobs AS, Morgentaler A. Does Testosterone Therapy Increase the Risk of Prostate Cancer? Endocr
Pract. 2008 Oct;14(7):904­11.
3. Abraham Morgentaler, MD. Testosterone Replacement Therapy and Prostate Risks: Where’s the Beef? The Canadian Journal of Urology. 2006;13 (Supplement 1): 40­43.
4. Ernani Luis Rhoden and Abraham Morgentaler. Testosterone Replacement Therapy in
Hypogonadal Men at High Risk for Prostate Cancer: Results of 1 Year of Treatment in Men with
Prostatic Intraepithelial Neoplasia. Vol. 170, 2348­2351, December 2003.
5. D. Schultheiss, S. Machtens and U. Jonas Testosterone Therapy in the Aging Male: What About
the Prostate? Andrologia 36, 355­365 (2004)

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