* For clinicians considering TTh in men after prostate cancer treatment, several considerations should guide decision-making. Patient selection is critical with regular monitoring, with close attention to PSA velocity and testosterone levels. The benefits of treating hypogonadism, including improvements in energy, sexual function, bone density, body composition, and potentially cardiovascular health, must be weighed against the theoretical risk of promoting occult cancer cells in each individual patient. The current literature suggests that TTh can be safely...
Testosterone Treatment and the Risk of Prostate Adverse Events (2022) Jason A. Levy, DO, MS, Arthur L. Burnett, MD, MBA, Adrian S. Dobs, MD, MHS
INTRODUCTION
Definition Hypogonadism is a clinical syndrome that results from failure of the testis to produce physiologic concentrations of testosterone (T).1 Various thresholds exist to define low total T ranging from 230 to 350 ng/dL. Peak T levels typically are measured between 3 and 8 AM with total T level decreasing during the first 30 minutes of waking.2Serum T decreases with age and has shown to have an...
* Gaps in long-term data and areas for further research are identified, underscoring the need for careful application in clinical practice. This paper emphasises a multidisciplinary approach in patient selection, rigorous monitoring protocols, and fully informed decision-making. By presenting a comprehensive review of the evidence, we aim to clarify the role of TRT in improving quality of life for men in remission from prostate cancer, while ensuring that oncological safety remains the highest priority.
Table 1 Comparison of TRT Guidelines from BSSM, AUA, and EAU...
Testosterone replacement therapy and cardiovascular disease (2022) Jeremy M. Auerbach and Mohit Khera
The use of testosterone therapy has a complex history of apprehension and questions regarding its safety. Despite an eventual consensus that testosterone therapy was safe and effective, several studies relating to cardiovascular risks emerged in the last decade, rekindling skepticism regarding the safety of testosterone therapy. Given the utility of testosterone therapy in treating the symptoms of hypogonadism, it remains crucial to closely examine the safety of testosterone...
*Clinical safety and efficacy of Testosterone Enanthate Injection, USP is supported by clinical use with Canadian patients since 1956 without incidence
Looks like we are stuck with the generic Testosterone Enanthate manufactured by Hikma.
At least we still have the option for big pharma Depo-testosterone manufactured by Pfizer Canada Inc. or the generic Testosterone Cypionate manufacture by Taro Pharmaceutical Inc.
Downfall here is the TC is only available in the 100mg/mL strength in Canada...
Big pharma transdermal T patch Androderm manufactured by Allergan Inc. was discontinued back in 2018!
Big pharma brand name Andriol (oral TU) manufactured by Merck was also discontinued back in 2018 and more recently 2024 our beloved Delatestryl (testosterone enanthate) manufactured by Valeant has been discontinued.
The only oral TU available is the generic PMS-Testosterone and Taro-Testosterone capsules.
Come 2025 we may have the option to use the newer versions of oral TU Kyzatrex or Tlando which are available in the US as Marius Pharmaceuticals and Verity Pharmaceuticals are...
Looks like they may have beat out Verity Pharmaceuticals oral Tlando for dibs on the Canadian market!
RALEIGH, N.C., July 30, 2024 (GLOBE NEWSWIRE) --Marius Pharmaceuticals, a patient-centric healthcare company focused on developing innovative therapies for Testosterone Deficiency, is pleased to announce the submission of its New Drug Submission (NDS) for KYZATREX® (testosterone undecanoate) CIII capsules to Health Canada for approval. This submission marks the company’s first international filing, with an anticipated...
New Drug Submission filed by Lipocine's licensing partner Verity Pharma Over 700,000 total prescriptions written annually for testosterone replacement therapy (TRT) in Canada, representing large...
ir.lipocine.com
New Drug Submission filed by Lipocine's licensing partner Verity Pharma
Over 700,000 total prescriptions written annually for testosterone replacement therapy (TRT) in Canada, representing large commercial opportunity
SALT LAKE CITY, June 9, 2025 /PRNewswire/ -- Lipocine Inc. (NASDAQ: LPCN), a biopharmaceutical company leveraging its proprietary technology platform to enable effective oral delivery of therapeutics, today announced...
Canadian Urological Association clinical practice guideline on testosterone deficiency in men: Evidence-based Q&A (2021) Ethan D. Grober, MD; Yonah Krakowsky, MD; Mohit Khera, MD; Daniel T. Holmes, MD; Jay C. Lee, MD; John E. Grantmyre, MD; Premal Patel, MD; Richard A. Bebb, MD; Ryan Fitzpatrick, MD; Jeffrey D. Campbell, MD; Serge Carrier, MD; Abraham Morgentaler, MD
Introduction
As part of their ongoing commitment to education and best practice standards, the Canadian Urological Association (CUA) solicited the creation of a clinical practice guideline dedicated to...
COMMENTS DUE DATE: MARCH 31. THE DEA WANTS TO LIMIT YOUR ACCESS TO TELEMEDICINE EXECUTIVE SUMMARY: The DEA has proposed new rules to update the Ryan Haight Act, which could negatively affect telemedicine prescribing of non-narcotic medications in Schedules III, IV, and V. These rules would...
www.excelmale.com
We have always been far worse off than the US when it comes to the treatment of men for testosterone deficiency.
Although there has been some improvement in certain areas we are still lacking in many others.
*In 2013, a comprehensive Canada-wide needs assessment revealed that over 25% of Canadian physicians were uncomfortable with the diagnosis and treatment of TD and identified significant knowledge gaps related to patient management.4 To address...
Big pharma transdermal T patch Androderm manufactured by Allergan Inc. was discontinued back in 2018!
Big pharma brand name Andriol (oral TU) manufactured by Merck was also discontinued back in 2018 and more recently 2024 our beloved Delatestryl (testosterone enanthate) manufactured by Valeant has been discontinued.
The only oral TU available is the generic PMS-Testosterone and Taro-Testosterone capsules.
Come 2025 we may have the option to use the newer versions of oral TU Kyzatrex or Tlando which are available in the US as Marius Pharmaceuticals and Verity Pharmaceuticals are...
For all the GPs, endocrinologists, urologists and T-clinics it needs to be stressed to your patients that in Canada we use/rely upon the linear law-of-mass action Vermeulen (cFTV) for testing free testosterone as it replaced the known to be inaccurate direct immunoassays yet many are still not aware that the cFTV tends to overestimate free testosterone by 20-30%.
*In contrast we concluded that, although overestimating free T by 20–30%, the formula according to Vermeulen was independent of SHBG, total T, and albumin [221]. Taken into consideration the moderate bias level, but most importantly less influenced by the latter three variables, the Vermeulen formula, for the time being, still appears to be the most robust approximation and deserves our recommendation as a free T calculator for clinical use
Role of sex hormone‑binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) N. Narinx · K. David1, · J. Walravens · P. Vermeersch · F. Claessens · T. Fiers · B. Lapauw · L. Antonio, · D. Vanderschueren
Keep in mind this is Fier's camp (cFTV).
Nothing new that those in the know were already well aware of!
You heard it here first the one and only Nelson's ExcelMale!
Abstract
According to the free hormone hypothesis, the biological activity of a certain hormone is best reflected by free rather...
hting its relevance in preventing misdiagnosis and overtreatment of male hypogonadism. Recent findings While there is consensus on measuring total T – comprising sex hormone-binding globulin (SHBG)-bound, albumin-bound, and free T – as a first step in diagnosing male hypogonadism, evidence...
journals.lww.com
INTRODUCTION
Clinical practice guidelines on the diagnosis of male hypogonadism focus on clinical signs and symptoms of androgen deficiency, as well as biochemical assessment of low circulating testosterone (T). However, there is a longstanding debate, as well as a persisting controversy concerning biochemical assessment of serum T and in particular the use (and misuse) of free T. Free T, as advocated by the free hormone hypothesis, represents...
Unfortunately we do not have easy access to the most accurate assay for testing free testosterone the gold standard Equilibrium Dialysis and even then as of now there is no standardized ED assay let alone harmonized reference range for free testosterone.
The CDC has been working hard behind the scenes over the years on developing a standardized FT assay (ED-LC/MS/MS) and harmonized reference range for free testosterone.
Similar to what was done for harmonized TT.
* Assays that are standardized are designed to provide accurate results, traceable to “true” value-assigned certified reference materials and gold-standard reference methods.
Soon enough we will have a CDC Hormone Standardization Program (CDC HoSt) Certified Free Testosterone Procedure and a harmonized reference range for free testosterone!
Just a matter of time as this has been a painstaking wait!
WHAT PROGRESS HAS CDC MADE WITH STANDARDIZING TOTAL TESTOSTERONE AND ESTRADIOL TESTS?
Since HoSt began in 2010, CDC has had more than 350 participants in 15 countries. Participants have shown measurable improvements for both total testosterone (TT) and estradiol (E2). Specifically, the among-laboratory bias has decreased from 16.5% in 2007 to 2.8% in 2017 for TT and from 54.8% in 2012 to 13.9% in 2017 for E2. Not only has bias improved, but data...
Thursday, March 27, 2025 at 1:00 PM Eastern Daylight Time.
event.on24.com
Testosterone imbalances affect men, women, and children differently. In males, testosterone deficiency (hypogonadism) can lead to low libido, fatigue, and muscle loss, while excess may contribute to aggression and cardiovascular risks. In females, testosterone excess (hyperandrogenism), often associated with polycystic ovary syndrome (PCOS) or adrenal disorders, can cause excess hair growth, weight gain, and menstrual irregularities. In children...
* over the past 4 decades he has become a global leader in the biology of androgens, sarcopenia and aging related functional decline, his research has shaped clinical guidelines, its informed public health policy particularly around testosterone therapy, anabolic interventions and then the development of function promoting therapies
Pay attention to 25:40-34:36 of the presentation where he explains the importance of measuring free testosterone using a standardized Equilibrium Dialysis method!
* According to the company, the medication will be made available through telehealth and traditional provider options in the first half of 2026. Marius plans to work closely with physicians in Canada to “ensure appropriate patient access, education, and monitoring.”
Key Takeaways
Health Canada approved testosterone undecanoate for men with low testosterone due to medical conditions, available by mid-2026.
A phase 3 trial showed 88% of patients achieved normal...