International expert consensus on testosterone safety

Nelson Vergel

Founder, ExcelMale.com
To address widespread concerns regarding the medical condition of testosterone (T) deficiency (TD) (male hypogonadism) and its treatment with T therapy, an international expert consensus conference was convened in Prague, Czech Republic, on October 1, 2015.


Experts included a broad range of medical specialties including urology, endocrinology, diabetology, internal medicine, and basic science research. A representative from the European Medicines Agency participated in a nonvoting capacity.


Nine resolutions were debated, with unanimous approval:
(1) TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life;
(2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology;
(3) TD is a global public health concern;
(4) T therapy for men with TD is effective, rational, and evidence based;
(5) THERE IS NO T CONCENTRATION THRESHOLD THAT RELIABLY DISTINGUISHES THOSE WHO WILL RESPOND TO TREATMENT FROM THOSE WHO WILL NOT;
(6) THERE IS NO SCIENTIFIC BASIS FOR ANY AGE-SPECIFIC RECOMMENDATIONS AGAINST THE USE OF T THERAPY IN MEN;
(7) THE EVIDENCE DOES NOT SUPPORT INCREASED RISKS OF CARDIOVASCULAR EVENTS WITH T THERAPY;
(8) THE EVIDENCE DOES NOT SUPPORT INCREASED RISK OF PROSTATE CANCER WITH T THERAPY; AND
(9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes.


These resolutions may be considered points of agreement by a broad range of experts based on the best available scientific evidence.


Morgentaler A, Zitzmann M, Traish AM, et al. Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions. Mayo Clin Proc. http://www.ncbi.nlm.nih.gov/pubmed/27313122

 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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