RESEARCH
Topics for Men
SAFETY
“...there is no clear evidence that elevations in endogenous testosterone levels promote the development of prostate cancer in humans.”
Testosterone and prostate cancer: an evidence-based review of pathogenesis and oncologic risk | Therapeutic Advances in Urology
“Testosterone replacement therapy does not increase PSA levels in men being treated for hypogonadism, except when it is given IM and even the increase with IM administration is minimal.”
“Prostate growth is exquisitely sensitive to variations in androgen concentrations at very low concentrations, but becomes insensitive to changes in androgen concentrations at higher levels.”
Shifting the Paradigm of Testosterone and Prostate Cancer: The Saturation Model and the Limits of Androgen-Dependent Growth | European Urology
“SC testosterone therapy in doses similar to those given via IM route results in comparable pharmacokinetics and mean serum testosterone levels. With appropriate training, patients should be able to safely self-administer testosterone esters SC with relative ease and less discomfort compared with the IM route.”
Testosterone Therapy With Subcutaneous Injections: A Safe, Practical, and Reasonable Option | Journal of Clinical Endocrinology & Metabolism
“…the evidence seems sufficient to think that androgen therapy does not increase the risk of subsequent discovery of hormone dependent prostate cancer.”
Testosterone replacement therapy (TRT) and prostate cancer: An updated systematic review with a focus on previous or active localized prostate cancer | Urologic Oncology: Seminars and Original Investigations
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"In men with hypogonadism and preexisting or a high risk of cardiovascular disease, testosterone-replacement therapy was noninferior to placebo with respect to the incidence of major adverse cardiac events."
Cardiovascular Safety of Testosterone-Replacement Therapy | The New England Journal of Medicine
AGING
“It’s normal for testosterone levels to decline as people age. The average drop is about 1% per year after age 30…but ongoing research shows decreases that are unrelated to aging.”
Why Are Testosterone Levels Declining? | Cleveland Clinic
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“andropause is characterized by insidious onset and slow progression…declining testosterone and other anabolic hormones in men from the mid-30s onward may influence the aging-related deteriorations in body function.” Andropause: Current concepts | Indian Journal of Endocrinology and Metabolism
SYSTEMIC DECLINES
“...the past 20 yr have seen substantial age-independent decreases in male serum T concentrations.... it remains unclear to what these apparent population-level decreases in T are attributable.”
Men's testosterone levels declined in last 20 years | Journal of Clinical Endocrinology & Metabolism
“It is well established that the incidence of prostate cancer is higher in black men. However, contrary to what one might expect, black men did not have a lower prevalence rate of hypogonadism (i.e. higher serum testosterone concentrations) in the current or previous analyses…the most significant differentiating factor between hypogonadal men and eugonadal men was BMI…medical conditions that occurred significantly more frequently among hypogonadal men than eugonadal men included increased BMI, hypertension, hyperlipidaemia, diabetes, and asthma or COPD.”
Prevalence of hypogonadism in males aged at least 45 years: the HIM study - PMC | International Journal of Clinical Practice
MALE WELL BEING
“Reported symptoms of late-onset hypogonadism are easily recognized and include diminished sexual desire and erectile quality, particularly in nocturnal erections, changes in mood with concomitant decreases in intellectual activity and spatial orientation, fatigue, depression and anger, a decrease in lean body mass with associated decreases in muscle volume and strength, a decrease in body hair and skin alterations, and decreased bone mineral density resulting in osteoporosis… presently, it is speculated that a low serum testosterone level may increase the risk for cardiovascular disease. Thus, testosterone is a key molecule in men's health, especially that of elderly men.”
The Relationship between Testosterone Deficiency and Men's Health | World Journal of Men’s Health
“We found testosterone undecanoate (TU) significantly improved obesity parameters (body weight, waist circumference, and BMI) and lowered total cholesterol, LDL cholesterol, triglycerides, fasting blood glucose, HbA1c , and blood pressure over the 5-year study. HDL cholesterol was increased. TU treatment resulted in a sustained improvement in erectile function and muscle and joint pain, which contributed to an improvement in long-term health-related quality of life…we found no evidence that long-term treatment with TU increases the risk of prostate carcinoma.”
Long-term testosterone treatment in elderly men with hypogonadism and erectile dysfunction reduces obesity parameters and improves metabolic syndrome and health-related quality of life | The Journal of Sexual Medicine
“Testosterone replacement therapy and off-label alternatives capable of restoring T levels appear as suitable to improve late onset hypogonadism, while also counteracting comorbidities related with metabolic diseases.”
Late-onset hypogonadism and lifestyle-related metabolic disorders | Andrology
“Testosterone plays a pivotal role in maintaining balance within the multi-dimensional psychological network of mood, behaviour, self-perception and perceived quality of life in men of any age… overall, the quality of life in older hypogonadal men can be positively influenced by testosterone substitution, as has been demonstrated in large placebo-controlled trials.”
Testosterone, mood, behaviour and quality of life | Andrology
ADJACENT TOPICS
“Burnout and stress are everywhere”
Burnout and stress are everywhere | American Psychological Association
“Over the past 50 years, human sperm counts appear to have fallen by more than 50% around the globe, according to an updated review of medical literature.”
Sperm counts may be declining globally, review finds, adding to debate over male fertility | CNN
Topics for Women
SAFETY
“Cardiovascular disease is the real cause of death among climacteric women, and the protection against it (excluding strokes) provided by menopausal hormone therapy when used during the window of opportunity is unquestionable. This therapy has proven to maintain and improve the quality of life of the symptomatic women." Menopausal hormone therapy and breast cancer risk: 21 years from the WHI clinical studies | Gynecological and Reproductive Endocrinology and Metabolism
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"The benefit of hormone replacement therapy in reducing the likelihood of developing CHD appears to outweigh the risk of breast cancer for nearly all women in whom this treatment might be considered." Patient-specific decisions about hormone replacement therapy in postmenopausal women | Journal of the American Medical Association
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"Only 1 of the 25 studies, the HABITS trial, demonstrated an increased risk of recurrence [of breast cancer], which was limited to local or contralateral, and not distant, recurrence. None of the studies, including HABITS, reported increased breast cancer mortality associated with HRT." Hormone Replacement Therapy After Breast Cancer: It Is Time | The Cancer Journal
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"Transdermal preparations were not associated with risk of venous thromboembolism, which was consistent for different regimens... transdermal treatment was the safest type of hormone replacement therapy when risk of venous thromboembolism was assessed." Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases | British Medical Journal
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"The benefits of hormone replacement therapy (HRT) usually outweigh the risks. Recent evidence says that the risks of serious side effects from HRT are very low." Benefits and risks of hormone replacement therapy (HRT) | National Health Service​
AGING
"Estrogen based hormonal therapies are the most effective treatments for many of the symptoms and, in the absence of contraindications to treatment, have a generally favorable benefit risk ratio for women below age 60 and within 10 years of the onset of menopause." Management of perimenopausal and menopausal symptoms |British Medial Journal
"The great majority of studies showed interesting associations between improved skin physical parameters and hormone replacement, in particular estrogen use." Menopause and the effects of Hormone Replacement Therapy on skin aging: A Short Review | Gynecological and Reproductive Endocrinology and Metabolism
Prevention
“The totality of evidence shows that HRT can be of benefit for the primary prevention of CHD in postmenopausal women." Hormones and cardiovascular aging: from prevention to therapies | Gynecological and Reproductive Endocrinology and Metabolism
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"...data from the WHI with age stratification, newer randomized and observational data and several meta-analyses now consistently show reductions in CHD and mortality when HRT is initiated soon after menopause. HRT also significantly decreases the incidence of various symptoms of menopause and the risk of osteoporotic fractures, and improves quality of life." Hormone-replacement therapy: current thinking | Nature Reviews Endocrinology
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"...consideration might be given to HRT as a prevention strategy as treatment can reduce CHD and all-cause mortality." Hormone-replacement therapy: current thinking | Nature Reviews Endocrinology
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"Estrogen deficiency leads to rapid bone loss which is maximal within the first 2-3 years after the menopause transition and can be prevented by menopause hormone therapy (MHT). Not only, MHT prevents bone loss and the degradation of the bone microarchitecture but it significantly reduces the risk of fracture at all bone sites by 20-40%." Menopausal hormone therapy for the management of osteoporosis | Best Practice & Research Clinical Endocrinology & Metabolism
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"The US Preventive Services Task Force (USPSTF) Draft Recommendation statement on Menopausal Hormone Therapy: Primary Prevention for Chronic Diseases [recommending against the use of combined estrogen and progestin for the primary prevention of chronic conditions] perpetuates a major disconnect...major elements of the evidence relied upon have been misinterpreted or misstated...and will perpetuate egregious harm to the public health." Menopausal hormone therapy for primary prevention: why the USPSTF is wrong | Climacteric, The International Menopause Society
Testosterone
"Androgens affect sexual desire, bone density, muscle mass and strength, adipose tissue distribution, mood, energy, and psychological well-being. Consequently, imbalance in androgen biosynthesis or metabolism in women may have undesirable effects on any or all of these domains." Female androgen insufficiency: the princeton consensus statement on definition, classification, and assessment | American Society for Reproductive Medicine
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"In females, serum androgen levels are higher than serum estrogen levels, even though the main effects of these hormones in women are those mediated by estrogen. It is reasonable to assume that T, too, has important physiological effects in women." Changes in serum testosterone during the menstrual cycle – an integrative systematic review of published literature | Gynecological and Reproductive Endocrinology and Metabolism
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"The role of androgens in women’s health has been generally neglected...guidelines were developed to provide a well-balanced and evidence-based approach to the clinical management of androgen insufficiency in women and to identify critical issues and problems for further research." Female androgen insufficiency: the princeton consensus statement on definition, classification, and assessment | American Society for Reproductive Medicine
ADJACENT TOPICS
“Women in America are stressed—and psychologists aren’t surprised." Women say they’re stressed, misunderstood, and alone | American Psychological Association
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Perceived stress and rewards from social roles may influence cardiovascular risk factors in midlife women. Social Role Stress, Reward, and the American Heart Association Life’s Simple 7 in Midlife Women: The Study of Women’s Health Across the Nation | Journal of the American Heart Association
The sources provided are not intended to serve as an exhaustive review of the topics listed,
but rather as a starting point for those interested in exploring them further.