Does Testosterone Therapy Affect the Prostate Adversely?

Because of longstanding concern that testosterone therapy might cause prostate cancer or worsen symptoms of benign prostatic hyperplasia (BPH), researchers tracked prostate outcomes in the TRAVERSE study, a randomized trial designed mainly to examine the cardiovascular safety of testosterone therapy (NEJM JW Gen Med Jul 15 2023 and N Engl J Med 2023; 389:107). About 5200 men (mean age, 63) with testosterone levels between 100 and 300 ng/dL received either transdermal testosterone or placebo; men with prostate-specific antigen (PSA) levels >3.0 ng/mL or severe BPH symptoms were excluded. PSA levels and urinary symptoms were monitored regularly during the trial, and indications for urology referral were prespecified.

During average follow-up o…