Adult-onset hypogonadism (AOH) is associated with sexual dysfunction, poor bone mineralization, decreased muscle mass, metabolic syndrome disorder, and cognitive suppression. Historically, testosterone has been contraindicated in men with a history of prostate cancer. However, there has been a modern resurgence in re-evaluating this belief. Not only can testosterone be safely utilized to alleviate AOH symptoms in prostate cancer survivors, it has been also touted as a treatment option for aggressive prostatic cancer. While much work remains in understanding the relationship between testosterone and prostate cancer, those who survive this disease should not be automatically turned away from an opportunity to be treated and restored.
Subscribe to Journal
Get full journal access for 1 year
only $32.38 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Zitzmann M, Nieschlag E. Hormone substitution in male hypogonadism. Mol Cell Endocrinol. 2000;161:73–88.
Dohle G, Arver S, Bettocchi C, Jones T, Kliesch S, Punab M. EAU guidelines on male hypogonadism. Arnhem, The Netherlands: European Association of Urology; 2016.
Bhasin S, Brito JP, Cunningham GR, Hayes FJ, Hodis HN, Matsumoto AM, et al. Testosterone therapy in men with hypogonadism: an endocrine society* clinical practice guideline. J Clin Endocrinol Metab. 2018;103:1715–44.
Kalyani RR, Gavini S, Dobs AS. Male hypogonadism in systemic disease. Endocrinol Metab Clin North Am. 2007;36:333–48.
Muller M, Grobbee DE, den Tonkelaar I, Lamberts SWJ, van der Schouw YT. Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab. 2005;90.2618–23.
Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab. 2006;91:843–50.
Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab. 2001;86:724–31.
Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2002;87:589–98.
Araujo AB, O’Donnell AB, Brambilla DJ, Simpson WB, Longcope C, Matsumoto AM, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the massachusetts male aging study. J Clin Endocrinol Metab. 2004;89:5920–6.
Stangelberger A, Waldert M, Djavan B. Prostate cancer in elderly men. Rev Urol. 2008;10:111–9.
Khera M. Androgen replacement therapy after prostate cancer treatment. Curr Urol Rep. 2010;11:393–9.
Walsh PC. Anatomic radical prostatectomy: evolution of the surgical technique. J Urol. 1998;160:2418–24.
Etzioni R, Tsodikov A, Mariotto A, Szabo A, Falcon S, Wegelin J, et al. Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer control Control 2008;19:175–81.
Barry MJ, Simmons LH. Prevention of prostate cancer morbidity and mortality: primary prevention and early detection. Med Clin North Am. 2017;101(Jul):787–806.
American Cancer Society. Key statistics for prostate cancer. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html. American Cancer Society, Atlanta, 2018.
Kaplan AL, Hu JC, Morgentaler A, Mulhall JP, Schulman CC, Montorsi F. Testosterone therapy in men with prostate cancer. European urology. 2016;69:894–903.
Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males. Eur J Endocrinol. 2008;159:507–14.
Bassil N, Alkaade S, Morley JE. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009;5:427–48.
Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol. 2009;55:310–20.
Bell MA, Campbell JD, Joice G, Sopko NA, Burnett AL. Shifting the paradigm of testosterone replacement therapy in prostate cancer. World J Mens Health. 2018;36:103–9.
Shea JL, Wong P-Y, Chen Y. Free testosterone. In: Advances in clinical chemistry. Elsevier; 2014. p. 59–84. https://linkinghub.elsevier.com/retrieve/pii/B9780128000946000029.
Livingston M, Kalansooriya A, Hartland AJ, Ramachandran S, Heald A. Serum testosterone levels in male hypogonadism: why and when to check-A review. Int J Clin Pr. 2017;71:e12995.
Woodworth A, McCudden C. Laboratory testing in pregnancy and reproductive disorders. In: Contemporary practice in clinical chemistry. 2nd ed. Washington, DC: American Association for Clinical Chemistry, Inc; 2011. p. 471–93.
Swyer GI. Post-natal growth changes in the human prostate. J Anat. 1944;78:130–45.
Huggins C. The etiology of benign prostatic hypertrophy. Bull N. Y Acad Med. 1947;23:696–704.
Andriole G, Bruchovsky N, Chung LWK, Matsumoto AM, Rittmaster R, Roehrborn C, et al. Dihydrotestosterone and the prostate: the scientific rationale for 5alpha-reductase inhibitors in the treatment of benign prostatic hyperplasia. J Urol. 2004;172:1399–403.
Messing EM, Manola J, Sarosdy M, Wilding G, Crawford ED, Trump D. Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N. Engl J Med. 1999;341:1781–8.
Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff R-O, et al. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet Lond Engl. 2002;360:103–6.
Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N. Engl J Med. 2003;349:215–24.
Huggins C, Hodges CV. Studies on prostatic cancer. I. The effect of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin. 1972;22:232–40.
Rove KO, Crawford ED. Traditional androgen ablation approaches to advanced prostate cancer: new insights. Can J Urol. 2014;21:14–21.
Rodriguez KM, Pastuszak AW, Khera M. The role of testosterone therapy in the setting of prostate cancer. Curr Urol Rep. 2018;19:67.
Yassin A, AlRumaihi K, Alzubaidi R, Alkadhi S, Al Ansari A. Testosterone, testosterone therapy and prostate cancer. Aging Male Off J Int Soc Study. Aging Male. 2019;22:219–27.
Denmeade SR, Isaacs JT. A history of prostate cancer treatment. Nat Rev Cancer. 2002;2:389–96.
Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol. 2006;50:935–9.
Endogenous Hormones and Prostate Cancer Collaborative Group, Roddam AW, Allen NE, Appleby P, Key TJ. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst. 2008;100:170–83.
Muller RL, Gerber L, Moreira DM, Andriole G, Castro-Santamaria R, Freedland SJ. Serum testosterone and dihydrotestosterone and prostate cancer risk in the placebo arm of the reduction by dutasteride of prostate cancer events trial. Eur Urol. 2012;62:757–64.
Morgentaler A, Rhoden EL. Prevalence of prostate cancer among hypogonadal men with prostate-specific antigen levels of 4.0 ng/mL or less. Urology. 2006;68:1263–7.
García-Cruz E, Piqueras M, Ribal MJ, Huguet J, Serapiao R, Peri L, et al. Low testosterone level predicts prostate cancer in re-biopsy in patients with high grade prostatic intraepithelial neoplasia: testosterone as predictor of PCA in patients with HGPIN. BJU Int. 2012;110:E199–202.
Risbridger GP, Ball EMA, Wang H, Mellor SL, Peehl DM. Re-evaluation of inhibin α subunit as a tumour suppressor in prostate cancer. Mol Cell Endocrinol. 2004;225:73–6.
Porcaro AB, Monaco C, Romano M, Petrozziello A, Rubilotta E, Lacola V, et al. Investigative Clinical Study on Prostate Cancer Part II: on the role of the pretreatment total PSA to free testosterone ratio as a marker assessing prostate cancer prognostic groups after radical retropubic prostatectomy. Urol Int. 2010;85:152–8.
Neuzillet Y, Raynaud J-P, Dreyfus J-F, Radulescu C, Rouanne M, Schneider M, et al. Aggressiveness of localized prostate cancer: the key value of testosterone deficiency evaluated by both total and bioavailable testosterone: AndroCan Study Results. Horm Cancer. 2019;10:36–44.
Massengill JC, Sun L, Moul JW, Wu H, McLEOD DG, Amling C, et al. Pretreatment total testosterone level predicts pathological stage in patients with localized prostate cancer treated with radical prostatectomy. J Urol. 2003;169:1670–5.
Salonia A, Gallina A, Briganti A, Abdollah F, Suardi N, Capitanio U, et al. Preoperative hypogonadism is not an independent predictor of high-risk disease in patients undergoing radical prostatectomy. Cancer. 2011;117:3953–62.
Salonia A, Abdollah F, Capitanio U, Suardi N, Briganti A, Gallina A, et al. Serum sex steroids depict a nonlinear u-shaped association with high-risk prostate cancer at radical prostatectomy. Clin Cancer Res. 2012;18:3648–57.
Monath JR, McCullough DL, Hart LJ, Jarow JP. Physiologic variations of serum testosterone within the normal range do not affect serum prostate-specific antigen. Urology. 1995;46:58–61.
Mohr BA, Feldman HA, Kalish LA, Longcope C, McKinlay JB. Are serum hormones associated with the risk of prostate cancer? Prospective results from the Massachusetts Male Aging Study. Urology. 2001;57:930–5.
Bhasin S, Woodhouse L, Casaburi R, Singh AB, Bhasin D, Berman N, et al. Testosterone dose-response relationships in healthy young men. Am J Physiol Endocrinol Metab. 2001;281:E1172–1181.
Khera M, Miner M, Bhattacharya R, Blick G, Kushner H, Nguyen D. 1379 PSA levels significantly rise after 3 months of testosterone replacement therapy in severely hypogonadal men in the TESTIM Registry in the US (TRIUS) cohort. J Urol. 2010;183. https://doi.org/10.1016/j.juro.2010.02.1008.
Cooper CS, MacIndoe JH, Perry PJ, Yates WR, Williams RD. The effect of exogenous testosterone on total and free prostate specific antigen levels in healthy young men. J Urol. 1996;156:438–41. discussion 441-442
Guay AT, Perez JB, Fitaihi WA, Vereb M. Testosterone treatment in hypogonadal men: prostate-specific antigen level and risk of prostate cancer. Endocr Pr J Am Coll Endocrinol Am Assoc Clin Endocrinol. 2000;6:132–8.
Gerstenbluth RE, Maniam PN, Corty EW, Seftel AD. Prostate-specific antigen changes in hypogonadal men treated with testosterone replacement. J Androl. 2002;23:922–6.
Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, et al. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N. Engl J Med. 1996;335:1–7.
Cooper CS, Perry PJ, Sparks AE, MacIndoe JH, Yates WR, Williams RD. Effect of exogenous testosterone on prostate volume, serum and semen prostate specific antigen levels in healthy young men. J Urol. 1998;159:441–3.
Emmelot-Vonk MH, Verhaar HJJ, Nakhai Pour HR, Aleman A. Lock TMTW, Bosch JLHR, et al. Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: a randomized controlled trial. JAMA. 2008;299:39–52.
Nair KS, Rizza RA, O’Brien P, Dhatariya K, Short KR, Nehra A, et al. DHEA in elderly women and DHEA or testosterone in elderly men. N. Engl J Med. 2006;355(Oct):1647–59.
Bhasin S, Bremner WJ. Clinical review 85: emerging issues in androgen replacement therapy. J Clin Endocrinol Metab. 1997;82:3–8.
Wang C, Harnett M, Dobs AS, Swerdloff RS. Pharmacokinetics and safety of long-acting testosterone undecanoate injections in hypogonadal men: an 84-week phase III clinical trial. J Androl. 2010;31:457–65.
Xu P, Choi E, El-Khatib FM, Yafi FA. Post-market single center experience with a subcutaneous auto-injector of testosterone enanthate (Xyosted). Eur Urol Open Sci. 2020;19:e129.
Lakshman KM, Basaria S. Safety and efficacy of testosterone gel in the treatment of male hypogonadism. Clin Inter Aging. 2009;4:397–412.
Mulhall JP, Trost LW, Brannigan RE, Kurtz EG, Redmon JB, Chiles KA, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200:423–32.
DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL, et al. Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin. 2014;64(Aug):252–71.
Riihimäki M, Thomsen H, Brandt A, Sundquist J, Hemminki K. What do prostate cancer patients die of? Oncologist. 2011;16:175–81.
Van Hemelrijck M, Adolfsson J, Garmo H, Bill-Axelson A, Bratt O, Ingelsson E, et al. Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden. Lancet Oncol. 2010;11:450–8.
Holzbeierlein JM, McLaughlin MD, Thrasher JB. Complications of androgen deprivation therapy for prostate cancer. Curr Opin Urol. 2004;14:177–83.
Gay HA, Sanda MG, Liu J, Wu N, Hamstra DA, Wei JT, et al. External beam radiation therapy or brachytherapy with or without short-course neoadjuvant androgen deprivation therapy: results of a multicenter, prospective study of quality of life. Int J Radiat Oncol Biol Phys. 2017;98:304–17.
Higano CS. Bone loss and the evolving role of bisphosphonate therapy in prostate cancer. Urol Oncol. 2003;21:392–8.
Shahinian VB, Kuo Y-F, Freeman JL, Goodwin JS. Risk of fracture after androgen deprivation for prostate cancer. N. Engl J Med. 2005;352:154–64.
Chang D, Joseph DJ, Ebert MA, Galvão DA, Taaffe DR, Denham JW, et al. Effect of androgen deprivation therapy on muscle attenuation in men with prostate cancer. J Med Imaging Radiat Oncol. 2014;58:223–8.
Kim HS, Moreira DM, Smith MR, Presti JC, Aronson WJ, Terris MK, et al. A natural history of weight change in men with prostate cancer on androgen-deprivation therapy (ADT): results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. BJU Int. 2011;107:924–8.
Braunstein LZ, Chen M-H, Loffredo M, Kantoff PW, D’Amico AV. Obesity and the odds of weight gain following androgen deprivation therapy for prostate cancer. Prostate Cancer. 2014;2014:230812.
Bosco C, Crawley D, Adolfsson J, Rudman S, Van, Hemelrijck M. Quantifying the evidence for the risk of metabolic syndrome and its components following androgen deprivation therapy for prostate cancer: a meta-analysis. PloS One. 2015;10:e0117344.
Mitsuzuka K, Kyan A, Sato T, Orikasa K, Miyazato M, Aoki H, et al. Influence of 1 year of androgen deprivation therapy on lipid and glucose metabolism and fat accumulation in Japanese patients with prostate cancer. Prostate Cancer Prostatic Dis. 2016;19:57–62.
Shahinian VB, Kuo Y-F, Freeman JL, Goodwin JS. Risk of the “androgen deprivation syndrome” in men receiving androgen deprivation for prostate cancer. Arch Intern Med. 2006;166:465–71.
Ehdaie B, Atoria CL, Gupta A, Feifer A, Lowrance WT, Morris MJ, et al. Androgen deprivation and thromboembolic events in men with prostate cancer. Cancer. 2012;118:3397–406.
Meng F, Zhu S, Zhao J, Vados L, Wang L, Zhao Y, et al. Stroke related to androgen deprivation therapy for prostate cancer: a meta-analysis and systematic review. BMC Cancer. 2016 ;16:180.
Vermeulen A, Kaufman JM, Goemaere S, van Pottelberg I. Estradiol in elderly men. Aging Male J Int Soc Study Aging Male. 2002;5:98–102.
Cohen PG. The hypogonadal-obesity cycle: role of aromatase in modulating the testosterone-estradiol shunt–a major factor in the genesis of morbid obesity. Med Hypotheses. 1999;52:49–51.
Singh R, Artaza JN, Taylor WE, Gonzalez-Cadavid NF, Bhasin S. Androgens stimulate myogenic differentiation and inhibit adipogenesis in C3H 10T1/2 pluripotent cells through an androgen receptor-mediated pathway. Endocrinology. 2003;144:5081–8.
Pitteloud N, Mootha VK, Dwyer AA, Hardin M, Lee H, Eriksson K-F, et al. Relationship between testosterone levels, insulin sensitivity, and mitochondrial function in men. Diabetes Care. 2005;28:1636–42.
Teloken C, Da Ros CT, Caraver F, Weber FA, Cavalheiro AP, Graziottin TM. Low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy: hypogonadism represents bad prognosis in prostate cancer. J Urol. 2005;174:2178–80.
Yamamoto S, Yonese J, Kawakami S, Ohkubo Y, Tatokoro M, Komai Y, et al. Preoperative serum testosterone level as an independent predictor of treatment failure following radical prostatectomy. Eur Urol. 2007;52:696–701.
Thompson IM, Goodman PJ, Tangen CM, Parnes HL, Minasian LM, Godley PA, et al. Long-term survival of participants in the prostate cancer prevention trial. N. Engl J Med. 2013;369:603–10.
Liu Z, Liu J, Shi X, Wang L, Yang Y, Tao M, et al. Comparing calculated free testosterone with total testosterone for screening and diagnosing late-onset hypogonadism in aged males: a cross-sectional study. J Clin Lab Anal. 2017;31:e22073.
Lenfant L, Leon P, Cancel-Tassin G, Audouin M, Staerman F, Rouprêt M, et al. Testosterone replacement therapy (TRT) and prostate cancer: an updated systematic review with a focus on previous or active localized prostate cancer. Urol Oncol. 2020;38:661–70.
Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR. Low serum testosterone and mortality in male veterans. Arch Intern Med. 2006;166:1660–5.
Khaw K-T, Dowsett M, Folkerd E, Bingham S, Wareham N, Luben R, et al. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) Prospective Population Study. Circulation. 2007;116:2694–701.
Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008;93:68–75.
Fukui M, Kitagawa Y, Nakamura N, Kadono M, Mogami S, Hirata C, et al. Association between serum testosterone concentration and carotid atherosclerosis in men with type 2 diabetes. Diabetes Care. 2003;26:1869–73.
Corona G, Monami M, Rastrelli G, Aversa A, Tishova Y, Saad F, et al. Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med. 2011;8:272–83.
Rajan P, Sooriakumaran P, Nyberg T, Akre O, Carlsson S, Egevad L, et al. Effect of comorbidity on prostate cancer-specific mortality: a prospective observational study. J Clin Oncol J Am Soc Clin Oncol 2017;35:3566–74.
Lee JY, Lee DH, Cho NH, Rha KH, Choi YD, Hong SJ, et al. Charlson Comorbidity Index Is an Important Prognostic Factor for Long-Term Survival Outcomes in Korean Men with Prostate Cancer after Radical Prostatectomy. Yonsei Med J. 2014;55:316.
Park JW, Koh DH, Jang WS, Lee JY, Cho KS, Ham WS, et al. Age-adjusted Charlson Comorbidity Index as a prognostic factor for radical prostatectomy outcomes of very high-risk prostate cancer patients. PloS One. 2018;13:e0199365.
Guzzo TJ, Dluzniewski P, Orosco R, Platz EA, Partin AW, Han M. Prediction of mortality after radical prostatectomy by Charlson comorbidity index. Urology 2010;76:553–7.
Lin Y-T, Lee MT-S, Huang Y-C, Liu C-K, Li Y-T, Chen M. Prediction of recurrence-associated death from localized prostate cancer with a charlson comorbidity index-reinforced machine learning model. Open Med Wars Pol. 2019;14:593–606.
Ghanem AI, Khalil RM, Khedr GA, Tang A, Elsaid AA, Chetty IJ, et al. Charlson Comorbidity score influence on prostate cancer survival and radiation-related toxicity. Can J Urol. 2020;27:10154–61.
Kaufman JM, Graydon RJ. Androgen replacement after curative radical prostatectomy for prostate cancer in hypogonadal men. J Urol. 2004;172:920–2.
Agarwal PK, Oefelein MG. Testosterone replacement therapy after primary treatment for prostate cancer. J Urol. 2005;173:533–6.
Pastuszak AW, Pearlman AM, Lai WS, Godoy G, Sathyamoorthy K, Liu JS, et al. Testosterone replacement therapy in patients with prostate cancer after radical prostatectomy. J Urol. 2013;190:639–44.
Sarosdy MF. Testosterone replacement for hypogonadism after treatment of early prostate cancer with brachytherapy. Cancer. 2007;109:536–41.
Pastuszak AW, Pearlman AM, Godoy G, Miles BJ, Lipshultz LI, Khera M. Testosterone replacement therapy in the setting of prostate cancer treated with radiation. Int J Impot Res. 2013;25:24–8.
Balbontin FG, Moreno SA, Bley E, Chacon R, Silva A, Morgentaler A. Long-acting testosterone injections for treatment of testosterone deficiency after brachytherapy for prostate cancer: Testosterone therapy for treating testosterone deficiency after brachytherapy. BJU Int. 2014;114:125–30.
Kaplan AL, Trinh Q, Sun M, Carter SC, Nguyen PL, Shih YT, et al. Testosterone replacement therapy following the diagnosis of prostate cancer: outcomes and utilization trends. J Sex Med. 2014;11:1063–70.
Kardoust Parizi M, Abufaraj M, Fajkovic H, Kimura S, Iwata T, D’Andrea D, et al. Oncological safety of testosterone replacement therapy in prostate cancer survivors after definitive local therapy: A systematic literature review and meta-analysis. Urol Oncol. 2019;37:637–46.
Pisansky TM, Thompson IM, Valicenti RK, D’Amico AV, Selvarajah S. Adjuvant and salvage radiotherapy after prostatectomy: ASTRO/AUA guideline amendment 2018-2019. J Urol. 2019;202:533–8.
Hatzoglou A, Kampa M, Kogia C, Charalampopoulos I, Theodoropoulos PA, Anezinis P, et al. Membrane androgen receptor activation induces apoptotic regression of human prostate cancer cells in vitro and in vivo. J Clin Endocrinol Metab. 2005;90:893–903.
Yassin A, Salman M, Talib RA, Yassin D-J. Is there a protective role of testosterone against high-grade prostate cancer? Incidence and severity of prostate cancer in 553 patients who underwent prostate biopsy: a prospective data register. Aging Male J Int Soc Study Aging Male. 2017;20:125–33.
Ahlering TE, My Huynh L, Towe M, See K, Tran J, Osann K, et al. Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy. BJU Int. 2020;126:91–6.
Krakowsky Y, Morgentaler A. 132 initial experience with testosterone therapy in selected men with advanced or metastatic prostate cancer. J Sex Med. 2018;15:S33–4.
Denmeade SR, Isaacs JT. Bipolar androgen therapy: the rationale for rapid cycling of supraphysiologic androgen/ablation in men with castration resistant prostate cancer. Prostate. 2010;70:1600–7.
Schweizer MT, Antonarakis ES, Wang H, Ajiboye AS, Spitz A, Cao H, et al. Effect of bipolar androgen therapy for asymptomatic men with castration-resistant prostate cancer: results from a pilot clinical study. Sci Transl Med. 2015;7:269ra2.
Umekita Y, Hiipakka RA, Kokontis JM, Liao S. Human prostate tumor growth in athymic mice: inhibition by androgens and stimulation by finasteride. Proc Natl Acad Sci USA. 1996;93:11802–7.
Sedelaar JPM, Isaacs JT. Tissue culture media supplemented with 10% fetal calf serum contains a castrate level of testosterone. Prostate. 2009;69:1724–9.
Schweizer MT, Wang H, Luber B, Nadal R, Spitz A, Rosen DM, et al. Bipolar androgen therapy for men with androgen ablation naïve prostate cancer: results from the phase II BATMAN study: high-dose testosterone in hormone-sensitive prostate cancer. Prostate. 2016;76:1218–26.
Teply BA, Wang H, Luber B, Sullivan R, Rifkind I, Bruns A, et al. Bipolar androgen therapy in men with metastatic castration-resistant prostate cancer after progression on enzalutamide: an open-label, phase 2, multicohort study. Lancet Oncol. 2018;19:76–86.
Conflict of interest
The authors declare that they have no conflict of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Choi, E.J., Xu, P., el-Khatib, F.M. et al. Hypogonadism and its treatment among prostate cancer survivors. Int J Impot Res 33, 480–487 (2021). https://doi.org/10.1038/s41443-020-00387-3
International Journal of Impotence Research (2021)