Testosterone and Male Aging

Handelsman, David J.

doi:10.1001/jama.2017.0129

Cited by 38 publications

(7 citation statements)

References 26 publications

(32 reference statements)

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“…In the United States, older men have probably been targeted in addition to men requiring medically indicated treatment for low testosterone levels 12 Testosterone replacement therapy (TRT) prescriptions in the US decreased by 50% between 2013 and 2016,3 but remain well above the levels needed to treat pathological hypogonadism 4. Since the 1970s, use of anabolic steroids has spread from athletes to the general population,5 with a lifetime prevalence rate of 6.4% for men 6…”

Section: Introductionmentioning

confidence: 99%

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank

Luo

Yeung

Zhao

et al. 2019

BMJ

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Objective To determine whether endogenous testosterone has a causal role in thromboembolism, heart failure, and myocardial infarction. Design Two sample mendelian randomisation study using genetic variants as instrumental variables, randomly allocated at conception, to infer causality as additional randomised evidence. Setting Reduction by Dutasteride of Prostate Cancer Events (REDUCE) randomised controlled trial, UK Biobank, and CARDIoGRAMplusC4D 1000 Genomes based genome wide association study. Participants 3225 men of European ancestry aged 50-75 in REDUCE; 392 038 white British men and women aged 40-69 from the UK Biobank; and 171 875 participants of about 77% European descent, from CARDIoGRAMplusC4D 1000 Genomes based study for validation. Main outcome measures Thromboembolism, heart failure, and myocardial infarction based on self reports, hospital episodes, and death. Results Of the UK Biobank participants, 13 691 had thromboembolism (6208 men, 7483 women), 1688 had heart failure (1186, 502), and 12 882 had myocardial infarction (10 136, 2746). In men, endogenous testosterone genetically predicted by variants in the JMJD1C gene region was positively associated with thromboembolism (odds ratio per unit increase in log transformed testosterone (nmol/L) 2.09, 95% confidence interval 1.27 to 3.46) and heart failure (7.81, 2.56 to 23.8), but not myocardial infarction (1.17, 0.78 to 1.75). Associations were less obvious in women. In the validation study, genetically predicted testosterone (based on JMJD1C gene region variants) was positively associated with myocardial infarction (1.37, 1.03 to 1.82). No excess heterogeneity was observed among genetic variants in their associations with the outcomes. However, testosterone genetically predicted by potentially pleiotropic variants in the SHBG gene region had no association with the outcomes. Conclusions Endogenous testosterone was positively associated with thromboembolism, heart failure, and myocardial infarction in men. Rates of these conditions are higher in men than women. Endogenous testosterone can be controlled with existing treatments and could be a modifiable risk factor for thromboembolism and heart failure.

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Section: Introductionmentioning

confidence: 99%

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank

Luo

Yeung

Zhao

et al. 2019

BMJ

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“…The effects of testosterone on energy, physical performance, mood, and cardiometabolic factors continue to be explored, but in general, the treatment of hypogonadal younger men often improves symptoms related to testosterone deficiency. In contrast, testosterone treatment for middle-aged and older men with functional decline, even for those with clearly low serum testosterone levels, offers modest and inconsistent benefit . Despite such uncertainties, “low T” clinics and intensive direct-to-consumer advertising have contributed to a substantial recent increase in testosterone prescribing …”

Section: Summary Of the Clinical Problemmentioning

confidence: 99%

Evaluation and Treatment of Male Hypogonadism

Sargis

Davis

2018

JAMA

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Men with symptoms potentially consistent with hypogonadism are frequently encountered in clinical practice. The clinical features associated with true male hypogonadism are nonspecific and include impaired libido, erections, and fertility; reductions in lean muscle mass and bone density; loss of facial, axillary, and pubic hair; anemia; and changes in mood and vitality. The effects of testosterone on energy, physical performance, mood, and cardiometabolic factors continue to be explored, but in general, the treatment of hypogonadal younger men often improves symptoms related to testosterone deficiency. In contrast, testosterone treatment for middle-aged and older men with functional decline, even for those with clearly low serum testosterone levels, offers modest and inconsistent benefit. 1 Despite such uncertainties, "low T" clinics and intensive direct-to-consumer advertising have contributed to a substantial recent increase in testosterone prescribing. 2 Clinical Review & Education JAMA Clinical Guidelines Synopsis

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“…The only indication for testosterone in the treatment of women is low libido accompanied by distress in postmenopausal women [19] . Over the last 80 years of using testosterone as an alternative therapy, testosterone sales have been increasing [20] . In today's increasingly serious aging, testosterone plays an important role in the physical and mental health of both men and women [21,22] .…”

Section: Introductionmentioning

confidence: 99%

Association Between Sex Hormones Levels and Cancer Prevalence in Women, Especially Breast Cancer

Zhao,

Zhang,

Sun

et al. 2024

Preprint

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Background Estradiol and testosterone are the two most important sex hormones in the human body. Previous studies have shown that these two sex hormones have a certain relationship with the prevalence of cancer. In this study, we included a total of 3532 female subjects, the number of cancer was 366, which is 10.36% of the total study population, and the number of breast cancer was 97, with a prevalence of 2.75%. Methods Subject data were analyzed using logistic regression analysis, WQS and qgcomp analysis. Measures in the demographic characteristics data were described as mean (SD) to describe the distribution, and t-tests were used to determine differences between groups. Count data were expressed as N (%), and the chi-square test was used to determine differences between groups. The determining factor in the process of determining the critical value of ROC is the Yoden index.The point where the ROC index is maximum serves as the optimal cutoff point for the continuum variable. Results The results of multifactorial logistic regression analysis showed a negative correlation between testosterone levels and cancer prevalence, and a negative correlation between estradiol levels and breast cancer prevalence. Cancer prevalence and breast cancer prevalence were both lower in people with high estradiol and testosterone levels. Each quartile increase in the WQS index was associated with a 24% (OR:0.76,95% CI:0.63–0.91) reduction in the risk of cancer, and a 35% (OR:0.65,95% CI:0.44–0.96) reduction in the risk of breast cancer. Each quartile increase in the qgcomp index was associated with a 17% (OR:0.83,95%CI:0.70–0.97) reduction in cancer risk and a 39% (OR:0.61,95%CI:0.44–0.84) reduction in breast cancer risk. Conclusion Serum testosterone levels were more significantly and negatively correlated with cancer prevalence in women. Serum estradiol levels were more significantly and negatively correlated with breast cancer prevalence.

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Testosterone and Male Aging

Cited by 38 publications

References 26 publications

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank

Evaluation and Treatment of Male Hypogonadism

Association Between Sex Hormones Levels and Cancer Prevalence in Women, Especially Breast Cancer

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