Conclusions : This meta- analysis shows that regardless of the administration method , TRT is the short-term safety and does not promote prostate cancer development or progression but long-term data are warranted with justifiable end points
Background : Testosterone replacement therapy ( TRT ) is a widely accepted form of treatment worldwide for aging men with late-onset hypogonadism syndrome .
Urologists have been concerned about the possibility of TRT causing prostate cancer .
The aim of this study was to assess the relationship between TRT and prostate cancer .
Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study.
CONTEXT The cause of declining testosterone ( T )  in aging men and their relationships with risk factors are unclear . OBJECTIVE The objective of the study was to investigate the relationships between lifestyle and health with reproductive hormones in aging men . DESIGN This was a baseline cross-sectional survey on 3200 community-dwelling men aged 40 - 79 yr from a prospect i ve cohort study in eight European countries . RESULTS Four predictors were associated with distinct modes of altered function : 1 ) age : lower free T ( FT ; -3.12 pmol/liter.yr , P < 0.001 ) with raised LH , suggesting impaired testicular function ; 2 ) obesity : lower total T ( TT ; -2.32 nmol/liter ) and FT ( -17.60 pmol/liter ) for body mass index ( BMI ; > or = 25 to < 30 kg/m(2 ) ) and lower TT ( -5.09 nmol/liter ) and FT ( -53.72 pmol/liter ) for BMI 30 kg/m(2 ) or greater ( P < 0.001 - 0.01 , referent : BMI < 25 kg/m(2 ) ) with unchanged/decreased LH , indicating hypothalamus/pituitary dysfunction ; 3 ) comorbidity : lower TT ( -0.80 nmol/liter , P < 0.01 ) with unchanged LH in younger men but higher LH in older men ; and 4 ) smoking : higher SHBG ( 5.96 nmol/liter , P < 0.001 ) and LH ( 0.77 U/liter , P < 0.01 ) with increased TT ( 1.31 nmol/liter , P < 0.001 ) but not FT , compatible with a re setting of T-LH-negative feedback due to elevated SHBG . CONCLUSIONS Complex multiple alterations in the hypothalamic-pituitary-testicular axis function exist in aging men against a background of progressive age-related testicular impairment . These changes are differentially linked to specific risk factors . Some risk factors operate independently of but others interact with age , in contributing to the T decline . These potentially modifiable risk factors suggest possible preventative measures to maintain T during aging in men
Conclusions : This meta- analysis shows that regardless of the administration method , TRT is the short-term safety and does not promote prostate cancer development or progression but long-term data are warranted with justifiable end points
Background : Testosterone replacement therapy ( TRT ) is a widely accepted form of treatment worldwide for aging men with late-onset hypogonadism syndrome .
Urologists have been concerned about the possibility of TRT causing prostate cancer .
The aim of this study was to assess the relationship between TRT and prostate cancer .