One potential side effect is spousal dissatisfaction. If a couple has grown ac- customed to a certain level of sexual activity (or lack thereof), a sudden change in interest on the part of one partner can be a cause of consternation for the other. So be careful to discuss this openly. (Perhaps the partner needs to be treated too!) One very rare side effect (and one that
I have never seen in clinical practice) is tes- ticular shrinkage. When it occurs it is easily treated. “Will I stop producing testosterone if I’m taking it?” Good question. What does it matter? You’re not producing enough of it anyway! “Will I get “’roid rage?” No. Steroid
aggressiveness occurs in steroid abuse, not therapeutic use, and only when the abuse is stopped and the body goes through with- drawal.
Risk Factors and Contraindications There are really only two contraindi-
cations to T replacement: active prostate cancer and a desire to get pregnant. Since exogenous T therapy will dramati- cally decrease sperm count, couples desiring to get pregnant should avoid T replacement (at least to optimum levels). Regarding prostate cancer, the literature is absolutely abundantly and irrefutably clear: Testosterone does NOT cause prostate cancer. Period. If it did, every 18-25 year old male would have prostate cancer! In fact, the opposite is true. The risk of prostate cancer is inversely related to T levels; low T levels are associated with increased cancer risk. In fact, in men who have been success- fully treated for prostate cancer, and the PSA levels stay normal for one year, adding T will actually reduce the risk of reoccurrence of the disease.
Summary Testosterone serves to maintain health
in every organ system in the body, and it has extensive and important protective and pre- ventive medicine benefits. With rare excep- tion there is no reason not to optimize levels.
Submitted by Paul D. Tortland, DO of Valley Sports Physicians and Orthopedic Medicine in Avon, CT. For more information, call 860- 675-0357 or visit
www.jockdoctors.com. See ad on page 3.
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