testosterone replacement therapy

The short answer is: No, testosterone replacement therapy (TRT) does not cause prostate cancer, based on the best current evidence. For a long time, medical providers worried that higher testosterone levels might "fuel" prostate cancer, but modern research has shown that TRT does not significantly increase the risk of developing prostate cancer in men without a history of it. In fact, some studies suggest that very low testosterone levels might actually be associated with worse prostate cancer outcomes. 

With that said, TRT can sometimes make an undiagnosed prostate cancer grow faster if it's already there. That's why it's important to screen for prostate health first through checking a PSA level and possibly doing a prostate exam in high risk patients before starting therapy, and also monitoring during treatment. 

To Learn More about the studies on TRT and Prostate Cancer: 

1. The Registry of Hypogonadism in Men (RHYME) Study (2016) - Key Findings: In a group of over 999 men, TRT did not increase the risk of prostate cancer compared to men who weren't on TRT. 
2. Meta-analysis by Boyle et al. (2016, World Journal of Men's Health) - Key Findings: Reviewed over 25 studies and concluded that TRT was not associated with a higher risk of prostate cancer. 
3. Loeb et al. (2017, JAMA Oncology) - Key Findings: Men on TRT had no higher rate of aggressive prostate cancers compared to untreated men. In addition, some men on TRT actually had a lower risk of being diagnosed with prostate cancer

There has been long-standing controversy in the medical community about whether or not Testosterone Replacement Therapy directly increases the risk for blood clots. There was previously a black box warning related to the increased risk associated with use. As a result of the TRAVERSE trial, effective February 28, 2025, the FDA recommended changes to TRT labelling which included removing the Boxed Warning related to an increased risk of adverse cardiovascular outcomes for all testosterone products. 

TRT may potentially raise your blood pressure, though the effect varies by individual. Regular blood pressure monitoring is important while on TRT. 

Exogenous testosterone, over time, does decrease the bodies production of sperm, affecting fertility in some men. However, it does not necessarily lead to permanent infertility.  For men considering hormone therapy but still wishing to maintain fertility while on TRT we do offer options to help maintain and improve fertility while remaining on therapy, including protocols that utilize HCG.  There are also options for sperm banking prior to starting therapy should this be a significant concern. It's important to discuss options prior to starting TRT and, in some cases, if having children is a priority in the near future, it may be advisable to delay TRT until after conception. 

Blood donation, in what is known as therapeutic phlebotomy, has been widely used by many practitioners as a method for managing the elevated hematocrit levels that are often seen as a result of increased erythropoiesis secondary to TRT.  While phlebotomy may be indicated in a (very) few select patients, it is the opinion of Radiant Prime Wellness that this method is not routinely needed and may result in poorer outcomes. We prefer to manage our patient's lab values in other manners, such as through changes to dosage, frequency, or administration methods rather than through the use of phlebotomy.