Boston—Even though hypogonadal men on long-term testosterone therapy had increased prostate size, both their urinary and sexual functions were improved and their quality of life was better compared to those who were not, according to a new study.

The article in the Journal of Urology said the men on testosterone had fewer urinary symptoms such as frequent urination, incomplete bladder emptying, weak urinary stream, and waking up at night to urinate.

Background information in the report notes that, for most men, testosterone concentration declines gradually with age and doesn’t cause immediate major symptoms. Some men, however, experience a clinical condition called testosterone deficiency (TD), or male hypogonadism, which is attributed to insufficient levels of testosterone, and suffer a variety of symptoms, including erectile dysfunction, low energy, fatigue, depression, and an increased risk of diabetes, according to the study led by Boston University School of Medicine (BUSM) and Public Health researchers.

Working with urologists in Germany, the study team sought to investigate the effects of long-term testosterone replacement therapy on urinary health and sexual function, as well as quality of life (QoL) in men with diagnosed, symptomatic testosterone deficiency. To do that, they enrolled more than 650 men in their 50s and 60s in a study—some with unexplained testosterone deficiency and others with known genetic and autoimmune causes for their hypogonadism.

“It is thought that testosterone treatment in men may increase prostate size and worsen lower urinary tract symptoms,” said Abdulmaged Traish, PhD, professor of urology at BUSM, explaining the premise for the research.

While that proved not to be true, objective testing also showed that men treated with testosterone emptied their bladders more fully. Testosterone therapy (TTh) also increased the scores on assessment of patients’ erectile/sexual health and general QoL.

“Long-term TTh in hypogonadal men resulted in significant improvements in urinary and sexual function and in QoL. In untreated hypogonadal men, voiding and erectile functions deteriorated with continued follow-up,” the researchers point out.

“[Testosterone therapy] is well-tolerated with progressive and sustained improvement in urinary and sexual function and overall improvement in quality of life,” Traish added.

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