You can’t watch television for more than an hour without being exposed to pleas to use either Viagra or Cialis to deal with erectile dysfunction. Now testosterone is being pushed.
The Journal of the American Medical Association (JAMA), however, warned of severe dangers in using testosterone supplements.
The new research examined more than 8,000 male veterans with low testosterone. Researchers compared the rates of cardiovascular ills among those who had testosterone supplementation and those who had not had supplements. The study found that men who had used
testosterone were 29 percent more likely to die, have a heart attack or a stroke after three years of use.
This difference was seen even after the researchers took into account age, blood pressure, the presence of heart disease and other health factors.
Many middle age and older men turn to testosterone, not only for erectile problems but also for bodybuilding.
Dr. Anne Cappola, an endocrinologist at the University of Pennsylvania and author of an accompanying editorial to the JAMA study, said she prescribed testosterone “to those for whom it is indicated and may derive benefit,” according to guidelines from the Endocrine Society.
But, she said, “A large number of men are taking testosterone, and it is not clear that all are doing so based on the right indications. Men should be sure they are on testosterone for the right reasons.”
Testosterone supplementation, according to a recent ABC News report, is a billion-dollar industry. It saw a more than five-fold increase from 2000 to 2011, according to the study, with U.S. doctors writing 5.3 million prescriptions each year. Men take testosterone for a variety of reasons, from the hope that it will improve their sexual function to increasing their muscle mass and strength.
I wrote an article a year or so ago about men, as well as women, suffering from symptoms of menopause. Urologists have been prescribing testosterone therapy for male menopause, or andropause, the symptoms of which are quite similar to the symptoms suffered by women when their reproductive cycle comes to an end.
Like female menopause, male menopause can bring on mood swings, anger, and depression. Male menopause also can result in a decrease in muscle strength and body hair.
Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, although not involved in the JAMA study, said the Food and Drug Administration (FDA) “should insist on large, randomized, controlled trials to find out if this therapy is safe…”
Companies marketing testosterone supplements, naturally, defended their products. AbbVie, the company behind the popular AndroGel testosterone product, pointed to past studies suggesting that testosterone supplementation, in men with low testosterone, protects against metabolic syndrome and early death, ABC News reported.
“FDA-approved testosterone-replacement therapies have been used to treat men with low or no testosterone (hypogonadism), who have been diagnosed by a physician, for 20 years, with therapeutic risks well documented in the prescribing labels,” the company said in a statement to ABC News.
Meanwhile, Lilly, which markets Axiron testosterone gel, said it actively monitored all adverse events reported in men taking testosterone supplements.
Dr. Michael Ho, a cardiologist at the University of Colorado, who was the lead author of the JAMA study, said he was surprised when he found that the risks of testosterone supplementation seemed to be the same for men regardless of whether they had existing coronary artery disease. “This study provides some information about potential adverse effects. The study should help inform the discussion between patient and providers about the risks and benefits,” he said before making a decision.
So, without doubt, more research will be conducted.
