Testosterone
Question: I am a 57-year-old with benign prostatic
hyperplasia (BPH) and am currently on testosterone replacement therapy
injections. What are the things I need to watch for with this combination of
therapy?
Answer: BPH or "benign prostatic hyperplasia,"
is a medical term for an enlarged prostate. It is very common. Nearly all men
have some signs of BPH by age 80, though the severity of their symptoms varies.
The main symptoms are having a weak urine stream, waking up frequently at night
to urinate, feeling that you can't wait to urinate, and feeling that your
bladder hasn't emptied fully. Exactly why men develop BPH isn't clear, but
testosterone is definitely involved. In tissues, testosterone is turned into
dihydrotestosterone, and this derivative probably plays a role in BPH. In fact,
certain drugs, such as finasteride (Propecia, Proscar), which are used to treat
the symptoms of BPH, work by lowering tissue dihydrotestosterone levels.
However, BPH is complicated and serum testosterone level is probably not the
only factor that plays a role in the development or worsening of BPH.
If you are currently receiving
testosterone injections, it's likely that you have below normal testosterone
levels. This condition is likely not related to your enlarged prostate. A low
testosterone level can lead loss of libido, fatigue, and loss of facial hair.
It can be treated, as is the case with you, with testosterone injections. This
additional testosterone could increase the BPH symptoms. In rare cases, testosterone
injections will stimulate a preexisting but hidden prostate cancer. Talk with
your doctor about yearly checkups to address the question of prostate cancer,
and discuss any worsening of your BPH symptoms.
Question: What does it mean for a woman if her
testosterone level is high?
Answer: Testosterone is an androgen steroid
hormone that is usually linked to male sexuality. It stimulates the growth of
normal male sexual organs, leads to deepening of the male voice, stimulates
facial and pubic hair growth, and is essential in the sexual behavior of men.
Testosterone is made not only in the testes of men but also in the ovaries of
women and in the adrenal glands of both men and women.
Abnormally high testosterone
levels in women can lead to a variety of symptoms. Most often, women with high
testosterone levels develop male pattern hair growth (hirsutism), especially on
their faces and chests. More rarely, over time some women may experience
virilization, which is increased muscle mass, redistribution of body fat,
enlargement of the clitoris, deepening of the voice, male pattern baldness,
acne, and increased perspiration. It is important to note that some women
develop hirsutism without having a high testosterone level.
Increased testosterone levels in
women are most often caused by polycystic ovaries. Less commonly, when
testosterone levels are very elevated, ovarian cancer is a concern. Adrenal
gland problems may contribute as well.
If you think you might have a
high testosterone level, talk to your doctor to find out what is right for you.
Question: A friend of mine is taking a muscle
volumizer called "Andro Power." Is it good for you?
Answer: I wasn't able to find the exact
supplement you ask about, but it probably contains androstenedione as a main
ingredient. Androstenedione is a chemical that occurs naturally in our bodies.
Because our bodies can make hormones like testosterone from this chemical, many
athletic supplements are advertised as containing it. People take these
supplements believing that if you take androstenedione, your body will make
more testosterone, resulting in better workouts and more muscle mass.
Although more research is
needed, it looks like not only does taking androstenedione not work,
but it may cause harmful side effects. A recent research study found that 2
months of androstenedione use didn't increase testosterone levels or muscle
mass for males in their 20s. It did, however, increase levels of estrone (a
female hormone) and decrease levels of "good" cholesterol. Even
worse, some scientists think that high levels of estrone in males can cause
heart disease. Basically, the only results of taking androstenedione were bad
ones.
Despite the lack of research
studies to say that it works, some very well-known athletes (like Mark McGwire--home
run king) have used androstenedione. Their success leaves open the possibility
that it may provide a small benefit in certain circumstances. Because of this
possibility, androstenedione is currently banned from use in the Olympics, the
NFL, and the NCAA.
To summarize: It looks like
androstenedione--and any supplements that contain it--may cause harmful side
effects. This, plus the lack of any proven benefits, makes the use of any
supplements that contain androstenedione a really bad idea.
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