Is Hormone Replacement Therapy Safe? 2017’s Evidence

Is Hormone Replacement Therapy Safe? 2017’s Evidence

Hormone replacement therapy was a popular topic in 2017, with its use being associated with the treatment of menopause, aging, bone density, skin health, andropause, and erectile dysfunction. There have been claims that this type of therapy is ineffective, and has a chance to cause negative side effects in men and women. Despite these claims by media sources, the research consistently demonstrates that hormone replacement therapy is a viable option for helping men and women with either a hormone imbalance or hormonal deficiency experience relief from symptoms.

Important Studies

Hormone Therapy Does Not Contribute To Cancer and Mortality Risk

Hormone Therapy Does Not Contribute To CancerThe Women’s Health Initiative conducted a randomized study of over 27,000 women who underwent hormonal therapy to analyze the risks and benefits of estrogen and progestin therapy. Researchers examined data from two trials, which included postmenopausal women with an average age of 63 at enrollment, and explored the effect of treatment over five to seven years, with 18 years of cumulative follow-up. They focused on the effect of hormone therapy on mortality rates. The data showed that the hormone therapy helped decrease mortality rates, as well as also decreasing the instances of Alzheimer’s disease.

Testosterone Therapy for Men with Testosterone Deficiency is Effective, Rational and Evidence Based.

Recent media coverage of two high profile but flawed studies confused the situation concerning the safety of testosterone therapy.This faulty study prompted the US Food and Drug Administration to implement a label change on testosterone products to inform the public of the possibility of an increased risk of heart attack and stroke.

No such concerns were expressed by the European Medicine Agency. Several analyses of randomized controlled trials – the most effective and trusted scientific research method – uncovered multiple beneficial effects of testosterone therapy in men who demonstrate hypogonadism:

Important Studies - testosterone therapy

  • Improved sexual desire, erectile function, sexual activity, satisfaction, and orgasm quality.
  • Reduced BMI (body mass), and increased lean muscle mass
  • Increased bone density.
  • Reduction in blood pressure and improved cholesterol profile.

Notably, all these studies confirmed the safety and overall effectiveness of testosterone treatment. Long-term potential and safety has also been confirmed in real-life, long-term professional TRT studies, where men that worked in urology offices were treated with TRT for over 10 years; these studies showed progressive weight loss, decreased waist circumference, and an overall improvement in metabolic efficiency.

There is No Scientific Basis for Withholding Testosterone Therapy from Men on the Basis of Age

While testosterone levels are universally known to decline with age in both men and women, certain lifestyle habits such as being consistently sedentary, stress, unhealthy diet, obesity, metabolic syndromes, diabetes and other chronic diseases also greatly contribute to the declining testosterone levels.

The beneficial effects of testosterone therapy are seen in both younger and older men, and the key is that the individual has presented a clinical need through the demonstration of hypogonadism. These findings have significant clinical impacts, showing that this therapy can help those with reduced muscle mass and lower limb strength related to frailty and increased rate of falls.Men over the age of 75 who receive testosterone therapy have the greatest reduction in all types of mortality when compared to age-matched hypogonadal men who do not receive testosterone therapy

2017 was a year of debate and a lot of back and forth on the efficacy of testosterone and other hormonal treatments. The main takeaway from all of these studies is that if a patient demonstrates low hormone levels or an overall imbalance, hormone therapy (when done under supervision of a trained hormone professional) is safe, effective, and potentially life changing.

References:

  1. Corona G, Rastrelli G, Morgentaler A, Sforza A, Mannucci E, Maggi M. Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores. Eur Urol. 2017.
  2. Corona G, Giagulli VA, Maseroli E, et al. Testosterone supplementation and body composition: results from a meta-analysis of observational studies. J Endocrinol Invest. 2016;39(9):967-981.
  3. Laider A, Zitzmann M, Doros G, Isbarn H, Hammerer P, Yassin A. Incidence of Prostate Cancer in Hypogonadal Men Receiving Testosterone Therapy: Observations from Five Year-median Follow-up of Three Registries. J Urol. 2015;193(1):80-86.
  4. Corona G, Maseroli E, Maggi M. Injectable testosterone undecanoate for the treatment of hypogonadism. Expert opinion on pharmacotherapy. 2014;15(13):1903-1926.