Bioidentical Hormone Replacement Therapy Research Articles
Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions
Published by Mayo Clinic Proceedings, Diagnosis and Treatment Guidelines, 2016.
Authors: Abraham Morgentaler, MD (Chairman); Michael Zitzmann, MD (Cochairman); Abdulmaged M. Traish, PhD; Anthony W. Fox, MSc, MD; T. Hugh Jones, MD; Mario Maggi, MD; Stefan Arver, MD; Antonio Aversa, MD; Juliana C.N. Chan, MD; Adrian S. Dobs, MD; Geoffrey I. Hackett, MD; Wayne J. Hellstrom, MD; Peter Lim, MD; Bruno Lunenfeld, MD; George Mskhalaya, MD; Claude C. Schulman, MD; and Luiz O. Torres, MD.
An international panel of experts met in October 2015 in an attempt to put together a group of consensus statements on the benefits and safety of testosterone therapy. Following the summit, the panel made 9 resolutions: (1) Testosterone (T) Deficiency (TD) is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life; (2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology; (3) TD is a global public health concern; (4) T therapy for men with TD is effective, rational, and evidence based; (5) there is no T concentration threshold that reliably distinguishes those who will respond to treatment from those who will not; (6) there is no scientific basis for any age-specific recommendations against the use of T therapy in men; (7) the evidence does not support increased risks of cardiovascular events with T therapy; (8) the evidence does not support increased risk of prostate cancer with T therapy; and (9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes.
Misperceptions of Testosterone Replacement Therapy and Heart Disease Risk (video)
Recorded in Madrid, Spain, at the annual meeting of the European Association of Urology (EAU), March 2015.
Author: Dr. Abraham Morgentaler.
Harvard urologist A. Morgentaler, M.D., cites 46 studies that support the cardiovascular and metabolic benefits of testosterone replacement and four studies that do not. Morgentaler identifies and explains the flaws in the four negative studies and the edits that have been made in those studies to correct the untrue statements.
The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years
Published in American Journal of Public Health, February 2013.
Authors: Philip M. Sarrel MD, Valentine Y. Njike MD MPH, Valentina Vinante MD, David L. Katz MD MPH.
Objectives: We examined the effect of estrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years.
Methods: We derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women’s Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in estrogen use observed between 2002 and 2011.
Results: Over a 10-year span, starting in 2002, a minimum of 18,601 and as many as 91,610 postmenopausal women died prematurely because of the avoidance of estrogen therapy (ET).
Conclusions: ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality, but estrogen use in this population is low and continuing to fall.
No VTE Risk Seen With Testosterone Therapy
Published on MedPage and Mayo Clinic Proceedings, July 2015.
Authors: Jacques Baillargeon, PhD; Randall J. Urban, MD; Abraham Morgentaler, MD; Charles J. Glueck, MD; Gwen Baillargeon, MS; Gulshan Sharma, MD, MPH; Yong-Fang Kuo, PhD.
Several poorly designed observational studies implicated testosterone as a cause for venous thrombosis. During the past year, several well designed studies have begun to clear up this misinformation. Not only is there no increased risk of a clot while on testosterone therapy, there is solid evidence of the cardiac benefit of this treatment. Testosterone therapy also decreases the risk of osteoporosis and dementia.
Estrogen Replacement Therapy in Breast Cancer Survivors: a Matched-Controlled Series
Published in Menopause – The Journal of the North American Menopause Society, July 2003, Volume 10, Issue 4, pp 277-285.
Authors: David A. Decker, MD; Jane E. Pettinga, MD; Nancy VanderVelde, MD; Raywin R. Huang, PhD; Larry Kestin, MD; John H. Burdakin, MD.
In the selected patients, ERT relieved estrogen deficiency symptoms and did not increase the rate or time to an ipsilateral recurrence/new primary, contralateral new primary, local-regional recurrence, or systemic metastases.
Estrogen Replacement Therapy After Breast Cancer: A 12-Year Follow-Up
Published in Annals of Surgical Oncology, Dec 2001, Volume 8, Issue 10, pp 828-832.
Authors: George N. Peters, MD; Tomasina Fodera, MD; Jennifer Sabol, MD; Stephen Jones, MD; David Euhus, MD.
Use of ERT in a cohort of breast cancer survivors with tumors of generally good prognosis was not associated with increased breast cancer events compared with non-ERT users, even over a long follow-up period.
Study Finds No Convincing Evidence of Increased Cardiovascular Risk with Testosterone Therapy
Published on HCPLive Resources, 2015.
Author: Andrew Smith.
A review of research conducted over the past 75 years finds no definitive answers about the link between testosterone supplements and cardiovascular health, but it does find far more evidence of benefit than harm.
Testosterone Therapy and Cardiovascular Risk: Advances and Controversies
Published in Mayo Clinic Proceedings, 2015.
Authors: Abraham Morgentaler, MD; Martin M. Miner, MD; Monica Caliber, MSc; Andre T. Guay, MD; Mohit Khera, MD; Abdulmaged M. Traish, PhD.
This article reviews concerns raised by two studies regarding cardiovascular risks with testosterone therapy, alongside the extensive literature on the topic. Only 4 articles were identified that suggested increased cardiovascular risks with testosterone prescriptions, each with serious methodological limitations, while several dozen studies reported a beneficial effect of normal testosterone levels on cardiovascular risk and mortality. In summary, there is no convincing evidence of increased cardiovascular risk with testosterone therapy — on the contrary, there appears to be a strong beneficial relationship between normal testosterone and cardiovascular health.
Research on Benefits and Risks of Testosterone Replacement Affected by Poorly Done Studies
Published on Wiley Online Library by AlphaMed Press, 2014.
Authors: Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS.
This commentary notes the study in question was retrospective and observational in nature, a design fraught with confounding biases that are difficult to control. More studies are necessary before definitive conclusions can be made as to cause and effect, and treatment decisions should not be based solely on one study but rather on a trend of studies.
Testosterone Therapy May Lower Risk of Heart Disease
Published on RTT News, 2013.
Men who receive therapy for testosterone deficiency may be putting themselves at a lower risk for cardiovascular disease, according to research conducted at the Boston University School of Medicine. The study, published in the International Journal of Clinical Practice, noted that testosterone treatment helps restore normal lipid profiles.
Early Initiation of HRT ‘Halves Risk of Death or CVD’
Published on Pulse – At the Heart of General Practice, 2012.
Author: David Swan.
GPs should aim to initiate hormone replacement therapy as early as possible after menopause, as it can halve a woman’s risk of death or a serious cardiovascular event, say researchers.
Testosterone Keeps Women’s Brains Sharp
Published on MedPage Today, 2013.
Author: Todd Neale.
A testosterone gel applied daily may improve cognitive performance in postmenopausal women, a randomized trial suggested.
Testosterone Therapy May Improve Sexual Function for Women
Published on Inquisitr.com, 2013.
Clinicians have found that administering high doses of testosterone can significantly improve sexual functioning in women who have undergone a hysterectomy and an oophorectomy.
Estrogen Is a New Weapon Against Urinary Tract Infection in Post-Menopausal Women
Published on Science Daily, 2013.
Author: Karolinska Institutet.
Estrogen stimulates the production of the body’s own antibiotic and strengthens the cells in the urinary tract, according to a new study. The results show that estrogen supplements may help menopausal women ward off recurrent urinary tract infections.
Estrogen Can Reduce Risk of Liver and Heart Disease in Women
Published on BioOptics World, 2013.
Author: Lee Mather.
Research shows the beneficial effect that estrogen has on liver metabolism by revealing a new type of estrogen receptor, which controls estrogen-responsive genes that regulate cholesterol and fatty acid production.
Estrogen Replacement Therapy May Save Lives After All
Published on Forbes, 2013.
Author: Alice Walton.
Women should talk openly with their doctors about the benefits and risks of HRT, particularly of estrogen, and the timeframe in which it’s begun. Researchers conclude the mortality toll of estrogen avoidance is a clear, present, and ongoing — and worsening — danger, with more women dying from this omission every year.
Testosterone Therapy Does Not Hike Risk of Aggressive Prostate Cancer
Published on Renal and Urology News, 2013.
Author: Jody Charnow.
Testosterone replacement therapy (TRT) is not associated with aggressive prostate cancer and does not increase overall or disease-specific mortality, according to a study that also found TRT use is low among men in the United States.
Hormone Therapy Makes Menopause Easier
Published on Get Healthy by The Times, 2013.
“I knew I was in trouble when my 95-year-old patient suddenly got up to get a fan for me — I was sweating that much,” recalls a physical therapist for an area home health care agency, describing what pushed her to seek hormone therapy.
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