Specifically, the AUA does not recommend routine PSA testing in men years of age unless they are at higher risk (e.g., positive family history, African American race), at which point decisions regarding PSA testing should be individualized. Finally, a randomized trial of 76 men (mean age 50.6 years), who had at least 1 ejaculatory dysfunction symptom and at least 2 testosterone tests 182 For men who develop gynecomastia/breast symptoms while on treatment (e.g., breast pain, breast tenderness, nipple tenderness), a period of monitoring based on clinical judgment should be considered, as breast symptoms sometimes abate. Furthermore, the identification of other pituitary tumors or processes may have important clinical implications for the patient beyond testosterone deficiency.178 However, despite these limitations, several studies provide important insights into the impact of SERMs, AIs, and hCG on spermatogenesis. Clinicians should understand that of these agents, only hCG has been approved by the FDA for use in males, specifically to treat males with hypogonadotropic hypogonadism. For this reason, alternative therapies, including SERMs, AIs, and hCG, are commonly used to promote the endogenous production of testosterone. It is unclear if the transferred testosterone remained biologically active. Topical testosterone preparations (e.g., gels, creams, liquids) have the potential to result in transference to others. Given the availability of other approved testosterone therapies, the use of 17-alpha-akylated androgens is not appropriate. The general trend indicated that higher doses of testosterone were more likely to result in azoospermia than lower doses, however a dose-response effect was not consistently seen. Its job is to produce the fluid that helps transport sperm, and it relies heavily on testosterone to do so. Stay on top of latest health news from Harvard Medical School. Benefits include practical tips to keep you healthy and vibrant, up-to-date health news explained simply and clearly, and special promo codes to use for our online courses, special reports, and more. Sign up for HEALTHBeat and receive trusted health information delivered right to your inbox. For example, there are several testosterone gels available in 1%, 1.62%, and 2% formulations, each marketed under a different brand or generic name. The testosterone therapeutic space is relatively unique. For most pharmaceutical products, the usage, dosage, and application is consistent across brands, and identification by chemical compound is sufficient to communicate to the reader when to use a given medication. The AUA has a policy that all pharmaceutical and biological agents are referred to only by their chemical compound formulation in guidelines, white papers, and best practice statements and not by their brand or generic name. When testosterone levels are very low, cancer cells can adjust by finding new ways to grow and survive. New long-term research even suggests that men whose testosterone levels are properly restored and monitored by doctors may actually have lower cancer rates. Testosterone therapy does not appear to increase the risk of prostate cancer, but it can stimulate the growth of prostate cancer cells. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer.
