Better sex. Increased vitality. More muscle. Improved health. Greater mental agility. These are just a few of the life-enhancing benefits that men with low levels of testosterone can experience when they increase their testosterone level. If you've noticed a decrease in your sex drive; experienced erectile dysfunction; or felt tired, depressed, and unmotivated, this authoritative, up-to-date guide from an expert at Harvard Medical School will help you determine if you have low testosterone--a surprisingly common but frequently undiagnosed condition among middle-aged men.
The oldest and most strongly held prohibition against testosterone therapy is its use in men previously diagnosed with prostate cancer. The fear has been that even in men who have been successfully treated for prostate cancer, raising testosterone levels will potentially make dormant, or sleeping, cancer cells wake up and start growing at a rapid rate. Thus, the FDA requires all testosterone products to include the warning that T therapy is contraindicated in men with a prior history of prostate cancer.
However, attitudes about this are changing—and changing rapidly—over just the last few years. The reasons for this are several, including the ongoing reevaluation of the old belief that raising the concentration of testosterone is to prostate cancer like pouring gasoline on a ?re or feeding a hungry tumor. In addition, there is growing recognition that T therapy can provide important benefits to a man’s quality of life, so the delicate medical balancing act between potential risk and possible benefit is shifting.
A major push for consideration of T therapy in symptomatic men with a history of prostate cancer has come from the large population of men who have been treated for prostate cancer over the last twenty-?ve years. Many of these men had small or low-grade cancers and, after treatment, were assured that they were cured and had no trace of any remaining cancer in their body. Despite having been given a clean bill of health, they were then told that they could not receive T therapy. As these prostate cancer survivors have questioned the basis for the T therapy prohibition, many physicians have been forced to reconsider whether the old arguments learned from their former teachers still make sense.
Felix was a sixty-six-year-old patient of mine who had undergone radical Prostatectomy (the commonly performed operation to remove a cancerous prostate) ten years earlier. His prostate-specific antigen (PSA) blood test was undetectable, indicating no recurrence after all these years. But Felix was troubled by a complete lack of sex drive and felt tired all the time. Blood tests revealed a very low T level of 234 ng/dL. When Felix asked his urologist and oncologist whether his low T could be treated, both told him that T therapy was contraindicated because of his prior prostate cancer and warned him that T therapy might make his cancer come back.
“How does it make any sense,” Felix asked, logically, “that they are afraid of prostate cancer growing uncontrollably when at the same time they tell me I don’t have any cancer cells left in my body? If I don’t have cancer cells, how could they grow?”
There are more and more men like Felix coming into their doctors’ offices who have symptoms of low T and want to feel more normal. Over the last twenty-?ve years, we’ve seen an enormous increase in the number of men diagnosed and treated for prostate cancer. In fact, physicians have become so good at detecting these cancers early that at least 80 percent of men treated for prostate cancer can be considered true cures. So even if T therapy really did make prostate cancers grow, why couldn’t these cured men receive treatment?