We’re committed to maximizing successful health outcomes by providing healthcare practitioners with comprehensive support through our extensive product line, ongoing clinical education, and practice development programs. He also shared that this approach helped him avoid a prostate biopsy that had previously been recommended, which was a meaningful outcome for him. Free testosterone remained meaningfully higher than baseline, with some expected variability at follow-up. The American Urological Association recommends PSA screening and digital rectal exams before and during therapy, particularly for men over 40. Modern injectable, topical, and pellet forms carry minimal hepatic risk, but liver function should still be monitored periodically. Exogenous testosterone signals the brain to reduce its own production via the hypothalamic-pituitary-gonadal (HPG) axis. A 2018 study in the British Journal of Clinical Pharmacology found men on TRT had a nearly 4% higher risk of sleep apnea. Some men experience mood swings, irritability, or emotional sensitivity during the initial weeks of therapy. Keeping skin clean and discussing topical treatments with your provider can help. With an increasing population of aging males, who are living longer and healthier lives, solutions are being sought (and money made) for what were once considered common problems of senescence. Well-known to many prescribers of TRT is a risk of water retention and/or edema. Only a few case-reports describe a relationship between male breast cancer and TRT.38,39 The ratio of estradiol to androgens is the key factor in the development of gynecomastia rather than absolute increases in androgens themselves. Exogenous testosterone is known to cause an imbalance in the hypothalamic-pituitary axis. Case reports regarding testosterone supplementation leading to changes in hair patterns have been documented; however no randomized, placebo-controlled trials exist. However, studies that allow clinicians to uphold the vigorous standards of evidence-based medicine in the use of testosterone for LUTS have not yet been forthcoming. Urologists have known of testosterone's importance in prostate development and pathology for some time, but only more recently have we begun to better understand its effects on lower urinary tract symptoms (LUTS); and more importantly, that these symptoms are not always entirely due to bladder outlet obstruction (BOO). A thorough clinical examination (including history, examination and laboratory testing of testosterone) should be undertaken before considering the diagnosis of late-onset hypogonadism or instigating treatment for it. For the clinician, the results of these studies are promising but do not constitute high levels of evidence. Surprisingly, numerous retrospective or small, randomized trials have pointed to a possible improvement in male lower urinary tract symptoms (LUTS) in patients treated with testosterone. The use of testosterone to treat the symptoms of late-onset hypogonadal men has increased recently due to patient and physician awareness. Good communication between the patient, primary doctor, and urologist is essential. Testosterone can mildly stimulate prostate activity, leading to a slight boost in PSA production. A small increase in PSA after beginning TRT is fairly common and usually harmless. Regular PSA testing and prostate exams are still necessary to catch any potential issues early. Once that level is reached, extra testosterone does not cause additional stimulation or harm. Testosterone was treated like "fuel for the fire." However, newer studies have shown that this old idea is too simple and not completely accurate. Only a small fraction of patients show PSA patterns that require closer examination.
