Appropriate use of testosterone therapy does not appear to raise prostate cancer risk – Harvard Health

A study published online Dec. 27, 2023, by JAMA Network Open confirms prior research showing that testosterone replacement therapy (TRT) in men with documented low testosterone levels does not increase their risk of prostate cancer compared to men not using TRT.

Researchers recruited 5,246 men with hypogonadism (a condition in which the testes don't produce enough testosterone), no family history of prostate cancer, and prostate-specific antigen (PSA) levels of less than 3 nanograms per milliliter (ng/ml), a number associated with a low risk of prostate cancer. The researchers randomly divided the men into two groups.

For 14 months, the men used either a topical testosterone gel at a dose designed to maintain normal testosterone levels, or an inactive (placebo) gel. Researchers measured PSA levels and conducted digital rectal exams of the prostate at regular intervals over the next three years. By the end of that period, the number of men diagnosed with prostate cancer was equally low in both the testosterone and placebo groups. Those in the TRT group did see their PSA levels rise during the first year of using the gel. However, the increase was small, and PSA levels did not rise again after that, according to the researchers. The testosterone users also reported few symptoms of an enlarged prostate, such as frequent urination, difficulty urinating, and dripping.

The study was limited to men with hypogonadism who had a low risk of prostate cancer, so it's not clear how TRT may affect higher-risk men or those who use testosterone in higher amounts, for longer periods of time, or for treating other conditions.

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Appropriate use of testosterone therapy does not appear to raise prostate cancer risk - Harvard Health