The Safety of Androgens: Prostate and Cardiovascular Disease

11: Androgen deficiency and replacement therapy in men

“…Men with classical androgen deficiency have reduced prostate volume and blood prostate‐specific antigen (PSA) levels compared with their age peers 12 , 13 . As it is plausible that androgen deficiency partially protects against prostate disease, and that restoring androgen exposure increases risk to that of eugonadal men of the same age, 14 men using ART should have age‐appropriate surveillance for prostate disease. This should comprise digital rectal examination and blood PSA measurement at regular intervals determined by age and family history.…”

Hormonal male contraception

“…The safety of long‐term androgen administration mainly concerning potential effects on cardiovascular and prostatic disease are reviewed elsewhere ( Handelsman, 1998). Observational studies indicate that, despite the higher prevalence and severity of cardiovascular disease in men compared with women, among men lower blood testosterone concentrations are a risk factor for cardiovascular disease ( Alexandersen et al ., 1996 ).…”

Male Contraception

“…7 The safety of androgen administration concerns mainly potential effects on cardiovascular and prostatic disease As the explanation for the higher male susceptibility to cardiovascular disease is not well understood, the risks for exogenous androgens are not clear. 244 The long-term effects of exogenous androgens on the prostate also require monitoring since prostatic diseases are both age-and androgen-dependent. 13,200,213,243 Changes in blood cholesterol fractions observed during high hepatic exposure to testosterone and/or progestins, due to either oral first-pass effects or high parenteral doses, have unknown clinical significance, but, in any case, maintenance of physiologic blood testosterone concentrations is the prudent and preferred objective.…”