This led to the logical assumption that higher testosterone levels might fuel prostate cancer growth. He found that prostate cancer shrank when testosterone levels were lowered and accelerated when testosterone was added, via injections. For men with low blood testosterone levels and symptoms most likely caused by a low level, the benefits of hormone replacement therapy usually outweigh potential risks. Testosterone therapy may make sense for women who have low testosterone levels and symptoms that might be due to testosterone deficiency. General attitudes in the urologic community have long maintained that high testosterone exacerbates prostate cancer (PCa), low testosterone is protective, and raising testosterone levels in men with PCa will enable tumor growth. Liu et al.12 demonstrated that in a group of older males (mean age 59.8 years) that there was not a significant correlation of serum testosterone levels (total, free or bioavailable) with either prostate volume or International Prostate Symptom Score (IPSS).
In this clinical scenario, an argument can be made to continue testosterone therapy. Patients who are on long-acting IM testosterone (testosterone undecanoate) should have blood work tested once steady state levels have been achieved. The main driving force behind such a strategy is convenience for patients and clinicians, although such timing has no ability to define peak and trough levels. Although steady-state levels are generally reached within days following commencement, a longer interval takes into account the potential decreases in endogenous testosterone production when on exogenous testosterone. Patients who have been prescribed testosterone should have regular laboratory testing conducted to confirm that therapeutic levels of testosterone are maintained, especially given the suppression of LH by exogenous testosterone and the subsequent decrease in endogenous testosterone production by the testes. While the therapeutic aim of each of these alternative therapies is to increase endogenous testosterone production, clinicians must keep in mind that the benefits of exogenous testosterone therapy in testosterone deficient men cannot be extrapolated to the benefits provided by these alternative therapies. Two RCTs compared treatment of testosterone deficient males with SERMs versus testosterone versus placebo and found that sperm concentration was maintained (comparable to placebo) for males treated with the SERMs, but was significantly decreased for males on exogenous testosterone.401, 402 Finally, Helo et al. conducted a prospective, double-blind, RCT comparing the SERM clomiphene citrate versus the AI anastrozole in infertile males with testosterone deficiency.
Checking testosterone levels is as easy as having a blood test. Testosterone therapy is approved for the treatment of delayed male puberty and abnormally low production of testosterone secondary to malfunction of the testes, pituitary or hypothalamus. Men taking testosterone replacement must be carefully monitored for prostate cancer. Women with high testosterone levels, due to either disease or drug use, may experience a decrease in breast size and deepening of the voice, in addition to many of the problems men may have. When testosterone levels rise too high, the brain sends signals to the pituitary to reduce production. For example, did you know that testosterone is a key player in prostate cancer?
Your provider will likely have you get a blood test to check your testosterone level. Some symptoms may be a normal part of aging. Some men with low testosterone do not have any symptoms. Certain health conditions, medicines, or injury can lead to low testosterone (low-T). However, healthy habits that boost testosterone, like getting good sleep and exercising, certainly won't hurt.
The conversation about testosterone and prostate cancer has changed for the better. Some are still very much against giving testosterone to anyone with a history of prostate cancer. It suggests that a healthy, normal level of testosterone might actually be protective. The fear linking testosterone to prostate cancer didn’t come out of nowhere. Let’s clear up the confusion surrounding testosterone and prostate cancer so you can make decisions that feel right for you.
In randomized, placebo-controlled trials involving testosterone therapy this has been a rarely reported adverse event. A low or low/normal LH level points to a secondary (central) hypothalamic-pituitary defect, (hypogonadotropic hypogonadism), while an elevated LH level indicates a primary testicular defect (hypergonadotropic hypogonadism).168 In men with hypogonadotropic hypogonadism, the yield from adjunctive tests (e.g., prolactin measurement, pituitary imaging, iron studies) is increased. Screening questionnaires are not an appropriate tool to identify candidates for testosterone therapy. In conditions where LH is not produced in normal amounts (hypogonadotropic hypogonadism), testosterone deficiency may also result. A survey of 120 patients who were treated for infertility at the University of Illinois-Chicago found that the incidence of testosterone deficiency was 45% in men with non-obstructive azoospermia, 42.9% in men with oligospermia, and 16.7% in men with obstructive azoospermia.159
But today, many urologists believe it’s a safe option for men who’ve had successful treatment like surgery or radiation. Not only that, but the cancer they have is often a more aggressive type. This simple idea has opened up entirely new possibilities for men’s health. They use testosterone to grow, but only up to a certain point.

Gender: Female

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