If you’re thinking about TRT and concerned about your prostate, keep reading…
“Dr. Robbins – I did a blood test recently and my testosterone levels were on the low side. My total testosterone was 320, with the range being 250-960. My doctor suggested I get on testosterone replacement therapy. I’m 62 years old. I obviously feel that higher testosterone levels would be a good idea. But I’m worried about prostate growth and cancer. My father died of prostate cancer and there are prostate problems on my mother’s side as well with her brother. What do you suggest since you’re the hormone specialist? As much as I want higher testosterone, I obviously don’t want prostate problems.”
Yes, this is a real debate these days and one that I remember having almost 20 years ago with a Urologist and this was back in the day when TRT and all of this stuff was rarely prescribed like it is these days.
Hormone Replacement Therapies
These days, many people go to these hormone replacement clinics and get all sorts of drugs… Testosterone, growth hormone, various blockers for estrogen, DHT and so forth.
It’s a very big and lucrative business.
In your specific case, yes – it looks like you do have somewhat “low” testosterone, even though it’s still in the normal range.
Of course, how you feel matters as well – low libido, drive, muscle loss, belly fat, negative mood, etc.
Unfortunately, you didn’t say what your free testosterone levels are. What are your various female hormones are – such as estradiol and prolactin. Or your DHT (dihydrotestosterone) levels or PSA score for your prostate. Or, what about adrenal hormones such as DHEA and cortisol.
All of these hormones (and a few others) will easily affect your total testosterone, which is just ONE indicator of healthy hormone levels.
A good doctor would have tested all of these hormones before ever telling you to take testosterone.
But again, it’s a big, lucrative, money-making business.
So, in this case, I can’t just blindly give you an answer.
My Experience With Hormone Replacement
About 10 years ago my friend’s dad was given testosterone by his doctor because his levels were low.
He was 72 years old. In decent shape. Fairly healthy. So, the first couple of weeks he felt great. But by the end of the month, he started having some side effects.
By the end of the second month, he started losing his head hair. Mind you, at age 72 he had almost a full head of hair. So, I figured he had great hair genetics, and yet, the testosterone therapy triggered something.
By the third month, he noticed he had lots of urinating problems and his PSA score had almost doubled and hence, prostate growth.
The testosterone did give him more energy and feel better, but he got off the testosterone because the balding and prostate problems just weren’t worth it for him.
My point with this story is you never know how YOUR body will react.
However, having a family history of prostate problems or growth, such as BPH and prostate cancer is obviously a potential “warning” sign that you rightly should be concerned about.
After all, prostate cancer is the leading cause of cancer death in men.
Actually, lung cancer is – but that’s 95% related to smoking, which is obviously self-inflicted.
Now, looking over many clinical studies for TRT and prostate outcomes, the conclusion is that researchers do NOT know – especially regarding the long-term use of testosterone and prostate health.
IF you do have prostate cancer, it’s obviously NOT recommended that you take testosterone.
But it’s not mainly because testosterone is the problem – but because of its younger brother and sister, which I’ll talk about in a minute.
Now, some studies show that testosterone accelerates prostate cancer and some studies show it can actually help advanced prostate cancer in some men.
So, mixed outcomes.
Some studies show testosterone therapy can cause prostate growth and higher PSA levels and some studies show no correlation.
So again, mixed outcomes.
However, one thing is for sure – there are no long-term studies that give any definitive answers.
Is Testosterone The Cause Of Prostate Problems?
No, I don’t think it is or else young men would have prostate problems since that’s the peak of your testosterone levels.
YET, older men who have lower testosterone have prostate problems.
Even though the prostate does grow simply due to aging – there are other hormones that can contribute to prostate problems and it’s been clinically validated.
Hormones such as estrogens, DHT, cortisol, IGF, insulin, and others.
Now, what happens when you take testosterone – injections or creams? Well, it can easily convert to estrogens and DHT.
BOTH of which are known to cause cancer and prostate problems.
And this is why I said earlier with “testosterone younger sister and brother” are the real problems.
Real Picture Of Things Work…
A doctor or HRT clinic will give you testosterone. And usually, not the correct dose. Many times too high a dose.
Being older, having more body fat, and so forth, you end up converting the testosterone a lot more to estrogens and DHT.
Now you are having side effects, potential gynecomastia (man boobs), and yes, prostate problems.
So then the doctor or HRT clinic will proscribe you estrogen and DHT inhibitors, such as Arimidex and Proscar or their generic versions.
Now the estrogen and DHT come down, but it’s too low since these drugs are very powerful.
And now you’re having libido problems since estrogen and DHT affect sex drive.
In addition to more stress on your heart and brain since these hormones are neuro and cardioprotective when they are in a healthy range.
So what happens – well, now you need to start playing around with the various drugs and dosages to get everything to be just right for YOUR body and YOUR genetics.
This requires lots of office visits and blood tests.
All of this means LOTS of money out of your pocket and into the Doctor’s bank account.
Let me make it very clear, I would say 99% of doctors and HRT clinics will NEVER do any of these important things specific for YOUR and YOUR body and genetics.
It takes too much time and knowledge.
They’ll give you a cookie-cutter drug dosage and that’s it.
And if you can’t perform sexually because these hormones aren’t optimized correctly, then they’ll give you Viagra or Cialis … more drugs.
Eventually, after a few months or maybe a year or two, most men just give up due to all the hassle, pills, and costs.
But guess what, now your testicles are completely shut down and nothing works since you were taking testosterone.
So you’re worst than when you first started.
How do I know all of this? Because I’ve dealt with so many guys over years with these same horror stories.
Hormones and drugs are very powerful and you better know a very smart and caring doctor to help you.
If you can find one, great.
Do It Naturally
If you can’t, I suggest you do it naturally FIRST before you go the TRT drug route because once you start, it’s really hard to stop.
TRT can be very valuable when done correctly.
But first, try to raise your testosterone levels and optimize your hormones, naturally.
You won’t have any of the negative side effects. It’ll be good for prostate health, in addition to your libido and sexual performance.
Doing it naturally is something you can do for the rest of your life and it’ll improve your health, fitness, and longevity.
First, fix what’s causing the low testosterone.
Be consistent and patient, it takes time.
But if you still have issues a year later and your testosterone is low, THEN go find a really smart and caring doctor to help you with TRT specific for YOUR body and genetics.