The role of testosterone replacement therapy following radical prostatectomy.

Hypogonadism is associated with a decreased serum testosterone level and numerous signs and symptoms, such as decreased libido, erectile dysfunction, decreased muscle mass, increased fat deposition, decreased ability to concentrate, and decreased bone mineral density Unlike women, who have a sudden loss of estrogen during menopause, men experience a gradual 1% to 2% decline in testosterone every year starting at age 30. There are several reasons for decreasing testosterone levels with age. As men age, they have a decline in Leydig cell numbers (primary failure), a decrease in gonadotropin-releasing hormone pulse amplitude (secondary failure), and an increase in sex hormone-binding globulin, all of which result in the reduction of available free or total testosterone Testosterone replacement therapy (TRT) is effective in treating the signs and symptoms of hypogonadism. These benefits include improvements in sexual function, muscle mass and strength, fat distribution, bone density, cognition, and mood Hypogonadism occurs frequently among men who have prostate cancer. Yamamoto and colleagues The association between testosterone replacement therapy and the development of prostate cancer In 1941, Huggins and Hodges [14] first demonstrated that a reduction in testosterone by castration caused metastatic prostate cancer to regress and that administration of exogenous testosterone promoted prostate cancer growth; however, current data have demonstrated that low testosterone levels are more likely to be associated with prostate cance