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Posted: Friday, 02 May 2014 6:13AM

Doctor: Testosterone treatments may come with serious side effects



Testosterone has become the biggest men's health craze since Viagra, but it comes with a warning from the LSU Health Sciences Center.

LSU urologist Dr. Harold Fuselier says testosterone ads touting increased energy and sex drive are everywhere, and they're getting a lot of attention.

"It's just attracting a whole host of inquiries," says Fuselier. "And, also, what I think is a misuse of the drug."

He says the gels, creams and patches being offered are risky, with possible serious side effects.

A study of more than 55,000 men found a doubling of heart-attack risk among older men who used testosterone.

Testosterone therapy on cardiovascular outcomes and mortality are unknown. But, a recent randomized clinical trial of testosterone therapy in men with a high prevalence of cardiovascular diseases was stopped prematurely due to adverse cardiovascular events raising concerns about testosterone therapy safety.

"Those who did receive this did have many side effects from the testosterone, including an increased incidence of cardiac disease." Fuselier says.

And, the risks are not just for the older guys. Younger men who had a history of heart disease had a higher incidence of nonfatal heart attacks.

Dr. Fuselier says everybody wants to live a healthy and happier life, and the pharmaceutical industry is trying to answer those desires. But he's not a fan.

"I would not encourage them to try this drug, because there are some risks...especially with prostate growth and/or prostate cancer."

In addition, he says men who are on prolonged high-level testosterone replacement therapy can experience testicular shrinkage.

"When young men start taking it, it cuts off the supply of testosterone from the testicles. It also decreases the sperm from the testicles. So, some of these men become infertile. Also, when they stop the drugs, sometimes it's hard for the testicles to rebound. So, it may cause some permanent damage."

He's not subtle when it comes to his thoughts on the unprescribed treatments being offered.

"I think those are horrible," says Fuselier. "Any over the counter, some of the supplements that these health clubs or body builders give you to build your muscle mass...there's some danger in all those things."

He admits more study is needed. "There's not any real good, long-term data on the safety and efficacy of these drugs."

There is a large-scale study going on now, but it will be several years before that's completed. In the meantime, men concerned about low testosterone levels should seek medical advice.

"They should go to a doctor and have a frank discussion and should know the side effects....the potential benefit versus side effects and the disadvantages before instituting a long-term therapy."

And, he notes the therapy, may indeed, be long-term.

"I would not base it on one level drawn by the lab. Hormones, both male hormones and female hormones, are cyclical, especially in the morning. Early morning, they're usually higher than they are after midday or late in the evening. So, early morning testosterone is most important." 

 

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