Androgen Society 2018

Description

Historically, the largest concern about testosterone has been that it will make prostate tissue grow, both benign and malign. As it turns out, modern data show it is not that simple. As explained by the saturation model, the prostate is only sensitive to testosterone at hypogonadal (i.e. low) testosterone levels. At higher testosterone levels, the prostate gets saturated with testosterone, which means that further elevations in testosterone level will not further stimulate the prostate.

Regarding prostate cancer, accumulating data show that testosterone therapy in men with a history of prostate cancer who have been treated with radical prostatectomy or radiation, does not increase risk of prostate cancer recurrence.

One common question among physicians is “what should I do with rising PSA”? Men who start testosterone therapy with very low testosterone levels will see a rise in PSA level during the first 3-6 months, thereafter it will stabilise and stay within the normal range. The level at which PSA stabilises should then be taken as a new baseline against which future monitoring should be compared. If PSA levels continue to rise after the first year of testosterone therapy or if it rises above the normal range, a prostate biopsy is indicated.

Another common concern is whether testosterone therapy can activate pre-cancerous (occult) prostate cells. About half of men aged 50 or older have prostate cancer microfoci. Studies show that testosterone therapy does not activate these prostate cancer cells. A meta-analysis concluded that regardless of the administration method, testosterone therapy does not promote prostate cancer development nor progression (1).

The question of whether men with a history of prostate cancer can be offered testosterone therapy is an active area of research. Dr Morgentaler says “Yes, if under close monitoring”. Studies show that testosterone therapy in men with a history of prostate cancer does not increase risk of metastatic prostate cancer nor death. This is also the experience Dr Morgentaler has had in his practice.

Another group is men who currently have low grade prostate cancer and are on active surveillance. A small study showed that men on active surveillance who received testosterone therapy have no prostate cancer progression compared to men on active surveillance who do not receive testosterone therapy (2).

The Androgen Society is the first professional medical society dedicated entirely to testosterone deficiency (hypogonadism) and its treatment. The mission of the Androgen Society is to promote excellence in research, education, and clinical practice regarding testosterone deficiency and its treatment. The Androgen Society provides a “home” for all the various disciplines involved with testosterone, including endocrinology, urology, sexual medicine, andrology, general medicine, epidemiology, and cardiology.

The take home message is that testosterone deficiency is an underrecognized and undertreated medical condition with significant negative health consequences, and that testosterone therapy is safe and improves sexual function and general health, as well as provides numerous other health benefits (reduced body fat, increased muscle mass and bone mineral density, improved glycemic control, reduced triglycerides etc.).


 

Speakers

Giovanni Corona, MD, PhD

Abraham Morgentaler
USA

Abraham Morgentaler

Description

The Androgen Society is the first international society dedicated entirely to the study of hypogonadism and its treatment. Founded in 2017, the Androgen Society is an international medical and scientific society dedicated to the study of hypogonadism, also called testosterone deficiency, and its treatment.

The mission of the Androgen Society is to promote excellence in research, education and clinical practice, bringing together experts and interested individuals from all disciplines within medicine, including endocrinology, urology, general medicine, sexual medicine, and epidemiology, among others.

Activities of the Androgen Society include annual meetings, newsletters, website and additional educational events as they may occur. The Androgen Society believes the important field of testosterone research will benefit from bringing together various medical disciplines, who customarily operate in isolation.

The Androgen Society originated from an international expert consensus conference about testosterone deficiency and its treatment held 2015 in Prague.1 There were 18 experts from 11 countries on 4 continents. Specialties included urology, endocrinology, internal medicine, diabetology, and basic science research. Experts were invited on the basis of extensive clinical experience with testosterone deficiency and its treatment and/or research experience.

The impetus for this expert consensus conference was to address the widespread misinformation and confusion about testosterone deficiency and testosterone therapy.2 The ultimate goal of this consensus conference was to document what is true or untrue about testosterone deficiency and testosterone therapy, to the best degree possible based on existing scientific and clinical evidence. The outcome was summarized in nine resolutions:

  • Testosterone deficiency is a well-established, significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life.
  • Symptoms and signs of testosterone deficiency occur as a result of low levels of testosterone and may benefit from treatment regardless of whether there is an identified underlying cause.
  • Symptoms and signs of testosterone deficiency should get more attention because of the limitations of measuring and interpreting testosterone levels in men.
  • Testosterone deficiency is a global public health concern.
  • Testosterone therapy for men with testosterone deficiency is effective, rational, and evidence based.
  • There is no scientific basis for any age-specific recommendations against the use of testosterone therapy in men.
  • The evidence does not support increased risk of cardiovascular events with testosterone therapy.
  • The evidence does not support increased risk of prostate cancer with testosterone therapy.
  • Evidence supports a major research initiative to explore possible benefits of testosterone therapy for cardiometabolic disease, including diabetes.

Hypogonadism is associated with significant adverse health outcomes and increased mortality. Clinical experience and high-level evidence indicates that testosterone therapy has substantial benefits for men with low testosterone.


 

Speakers

Abraham Morgentaler

Abraham Morgentaler

Abraham Morgentaler

 

Androgen Society 2018

ICA (INTERNATIONAL CONGRESS OF ANDROLOGY) 2017

ANDROGEN SOCIETY 2018

 

 

PROF T. HUGH JONES

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PROF Miller_01 (Miner_01)

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PROF Miller_02

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References

  • Morgentaler A, Zitzmann M, Traish AM, et al. Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions. Mayo Clin. Proc. 2016;91(7):881-896. Return to content
  • Morgentaler A, Zitzmann M, Traish AM, Fox A. International expert consensus conference on testosterone deficiency and its treatment held in Prague, Czech Republic. The aging male : the official journal of the International Society for the Study of the Aging Male. 2015;18(4):205-206. Return to content