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Robert Jansen, MD, on rethinking testosterone management
Jansen underscores the need for urologists to go beyond symptom treatment and focus on identifying root causes of testosterone deficiency.
In this video, Robert Jansen, MD, a urologist with Atlantic Urology Specialists in South Carolina, discusses the evolving role of urologists in managing men’s hormonal health, particularly in relation to testosterone therapy. He emphasizes a major shift in understanding testosterone’s broader impact—not just on sexual function but also on prostate cancer, longevity, cardiovascular health, and overall well-being. Traditional beliefs have long discouraged testosterone therapy in men with a history of prostate cancer, but emerging research, notably by Abraham Morgentaler, MD, FACS, suggests that testosterone does not necessarily promote cancer recurrence. In fact, low testosterone may be linked to more aggressive prostate cancer forms.
Jansen highlights that testosterone deficiency is also associated with reduced muscle mass, lower grip strength, and increased fall risk in older men, all of which impact longevity and quality of life. Furthermore, low testosterone levels are correlated with greater cardiovascular risk, poorer metabolic health, and depression. Despite these findings, routine screening for low testosterone is not yet common, though Jansen says he hopes this will change.
He also underscores the need for urologists to go beyond symptom treatment and focus on identifying root causes of testosterone deficiency. Often, reversible factors like thyroid dysfunction, sleep apnea, prediabetes, or poor lifestyle habits are overlooked. Urologists should address underlying issues through comprehensive evaluations and discussions about diet, sleep, stress, and environmental exposures. However, Jansen acknowledges the challenge of motivating patients to adopt healthier behaviors, despite their potential to transform lives. Ultimately, he said he believes that urologists must persist in uncovering and addressing the root causes to improve long-term health outcomes for men.
