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Adverse Events Associated with Testosterone Replacement

July 18, 2010 No Comments by Scott Isaacs MD
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It is well known that testosterone levels gradually decline as men age.  They start decreasing in middle age and continue to decrease as one gets older.  In some men, these decreases are more than others.   Some men maintain normal testosterone levels, even into old age.  Testosterone replacement therapy has been the accepted treatment for men with overtly low testosterone levels.

A study published in the July 8, 2010 issue of the New England Journal of Medicine, “Adverse Events with Testosterone Administration” by Dr. Shelhzad Basaria and colleagues showed an increased risk of cardiovascular events in older men who used testosterone gel.  This raises new questions and concerns about testosterone replacement therapy in men.   However, this was a small study, only 209 men, with an average age of 74 years old.  There were 23 patients who reported cardiovascular-related adverse events among those who took testosterone and only 5 in the placebo group.  The group who took testosterone showed benefits in increased muscle strength.  The study did not evaluate younger men or men with various causes of low testosterone.

The bottom line is that we need more information and better clinical studies to understand the safety and efficacy of testosterone in men of all ages, with a variety of causes of low testosterone.  All medications have risks and benefits, which should be carefully considered with your physician.

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