Could testosterone HRT help treat the male menopause?

Testosterone replacement therapy should be provided for men, according to academics who claim the male menopause is genuine. Just like in women, male sex hormones drop as they age, a study by the Harley Street-based Centre for Men’s Health has found. Men also suffer hot flushes, low libido, night sweats and joint pain, the experts claim. Otherwise known as the ‘andropause’ syndrome, symptoms can include weight gain, muscle weakness and depression. One in five men over the age of 50 are thought to suffer from testosterone deficiency, researchers found. And in a study of 2,000 men with the syndrome, the majority benefited from therapy, the Daily Telegraph reported last night.

Professor Malcolm Carruthers, chief medical officer at the Centre for Men’s Health, said: ‘This study proves the therapy’s effectiveness… but most importantly supports the safety of testosterone treatment over long periods.’

Prof Carruthers also called for improved testing of testosterone levels, fearing some men could remain within ‘normal levels’ yet still be deficient. ‘Contrary to orthodox theory, there is no threshold for testosterone levels. Resistance to the hormone could be caused by age, stress, obesity intake or genetic factors,’ he added.

Recent research has suggested men with low testosterone levels are likely to have a shorter life expectancy than those considered normal. Other studies have linked it to obesity and diabetes – although scientists say it is too early to tell if hormone therapy could ease those conditions.

The latest findings – published in the Journal of the Ageing – have been met with scepticism from some. Professor Jonathan Seckl, from Edinburgh University, told The Daily Telegraph: ‘It doesn’t appear to add much to a complex topic that cries out for a large, blinded, randomised clinical trial’. Professor Frederick Wu, of Manchester University, added that the findings were ‘potentially dangerous’ because they could lead ‘men to be treated, inappropriately, with testosterone’.

The male menopause has long been a source of controversy with many medics calling it little more than a myth. Some believe that because there is no sudden decline in testosterone levels, as with women, the phenomenon cannot be likened to a menopause. Instead, it is thought the reduction in sex hormones in men is more gradual, decreasing from the mid-30s. Others have suggested the male menopause is triggered by stress and anxiety of a midlife crisis.

UTMB study finds that testosterone therapy is not linked with blood clot disorders in veins

UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON A new study from The University of Texas Medical Branch at Galveston of more than 30,000 commercially insured men is the first large comparative analysis to show that there is no link between testosterone therapy and blood clots in veins. The study found that middle-aged and older men who receive testosterone therapy are not at increased risk of this illness. The findings are detailed in Mayo Clinic Proceedings.

Venous thromboembolism is a disease where blood clots form in the veins and cause blockages. The most common forms of VTE are deep vein thrombosis, which occurs often in the legs and pulmonary embolism, which is a clot in the lungs. VTE is the third most common cardiovascular illness, after heart attack and stoke.

"In 2014, the Federal Drug Administration required manufacturers to add a warning about potential risks of VTE to the label of all approved testosterone products," said Jacques Baillargeon, professor of epidemiology in the department of preventive medicine and community health and lead author of the study. "The warning, however, is based primarily on post-marketing drug surveillance and case reports. To date, there have been no published comparative, large-scale studies examining the association of testosterone therapy and the risk of VTE."

As a result of this conflicting evidence and the broad media attention it has received, there are many men with medically confirmed low testosterone who are afraid to receive testosterone therapy and there may be physicians who are reluctant to prescribe testosterone therapy based on this conflicting information.

The case-control study included 30,572 men 40 years and older who were enrolled in one of the nation's largest commercial insurance programs between Jan. 1, 2007 and Dec. 31, 2012. Cases were defined as men who had a primary diagnosis of VTE and received an anticoagulant drug or an intravascular vena cava filter in the 60 days following their diagnoses. Cases were matched with three control subjects on age, geographic region, diagnosis of low testosterone and diagnosis of any underlying pro-clotting condition.

The researchers found that having a prescription for testosterone therapy was not associated with an increased risk of VTE. In addition, none of the specific routes of administration examined -- topical creams, transdermal patches or intramuscular injections -- were associated with an increased risk. There were no differences between men who received the therapy 15, 30 or 60 days before being diagnosed with VTE.

"It is important to acknowledge, for a man who has medically-diagnosed low testosterone, that there are clear risks to not receiving testosterone therapy, including osteoporosis, sexual dysfunction, increased amounts of fat tissue, decreased lean muscle mass, possible metabolic syndrome and cardiovascular disease," said Baillargeon. "It's also important to note that further research needs to be conducted to rigorously assess the long-term risks of testosterone therapy.

These findings may help to inform the benefit-risk assessment for men with testosterone deficiency considering treatment.

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Other authors include UTMB's Randall J. Urban, Gwen Baillargeon, Gulshan Sharma and Yong-Fang Kuo; Abraham Morgentaler from Men's Health Boston at Harvard Medical School and Charles J. Glueck from Jewish Hospital at Mercy Medical Physicians in Cincinnati, OH.

Blueprint Health Launches Initial Patient Informational Presentation

BP Health is excited to announce the launch of its initial video targeted to patients interested in learning more about how the Blueprint Health program  and process works. You can view the video below: [embed]https://vimeo.com/132741738[/embed]