A new study shows that testosterone gels can have some benefit for men who suffer from low testosterone levels.
In recent years a wave of prescriptions has seen men using testosterone gel in the hope that it would help them boost energy levels and increase their libido. Now the first study into the gels has released its results, writes Gina Kolata for The New York Times.
Groundbreaking study shows modest benefits of testosterone gel
This Wednesday The New England Journal of Medicine published the first results of such research. Scientists concluded that there were at best modest benefits, and they were mostly exhibited in sexual functioning.
Despite its cautious conclusion, the study is groundbreaking, said Dr. Eric S. Orwoll, a professor of medicine at Oregon Health and Science University, as it gives the scientific community the first reliable data on the effects of testosterone.
In recent years doctors have been prescribing testosterone to patients in what some call a frenzy.
“Frankly,” said Dr. Sundeep Khosla, a dean at the Mayo Clinic College of Medicine, “there is a lot of abuse.” Advertisements have encouraged men to seek out testosterone treatment, and some doctors have been prescribing it without running tests.
Medical community divided over recommended course of action
“What I hope is that this will bring a more conservative approach,” Dr. Orwoll said. “There is a lot of prescribing out there, and it doesn’t look like, for the average man, it will have a big effect.”
The study was led by the Perelman School of Medicine at the University of Pennsylvania and funded by the National Institutes of Health and AbbVie, which manufactures the testosterone gel AndroGel. 790 men aged 65 and older with low testosterone levels for their age were involved.
While testosterone levels naturally fall with age, these men showed particularly low levels. Those assigned AndroGel later displayed testosterone levels usually associated with men aged 19-40. Interestingly the improvements were only slight.
Those with sexual problems reported a slight improvement and those who were feeling down said that their mood improved slightly. However men who reported a lack of energy did not see any improvement.
Another worry is that use of testosterone gel could increase the risk of heart disease and prostate cancer, but this study was too short-term to address that issue. A planned study involving thousands of men that would have run for years was pulled because of health risks.
Large clinical trial being designed by gel makers
The concerns persist and the Food and Drug Administration has pressed the makers of testosterone gels to conduct a large clinical trial. Morry Smulevitz, a spokesman for AbbVie, said that the trial is currently being designed.
Returning to this latest study, the medical community are unsure whether to trumpet its conclusions. For Dr. William Bremner, a professor of medicine at the University of Washington, said that he would feel comfortable telling patients that testosterone treatment “is a reasonable thing to think about doing.”
However Dr. Joel Finkelstein, a professor of medicine at Harvard, was was more cautious. “Testosterone is clearly not a panacea,” he said. Finkelstein worries that a lack of data could expose men to long-term health risks if doctors start encouraging the use of testosterone gels.
Finkelstein wants there to be a large clinical trial before drawing any conclusions. “I think it’s necessary,” Dr. Finkelstein said.
