LOS ANGELES - Many men use a testosterone supplement to treat symptoms linked to testosterone deficiency in older age, such as poor libido and deteriorating muscle strength.
However, such treatments appear to come with additional health risks for frail, elderly men who use the gel to increase their strength and mobility.
Researchers reported this week that a study designed to assess the risks and benefits of testosterone-replacement therapy in men age 65 and older who had mobility problems was stopped early - in December 2009 - because of a much higher rate of cardiovascular problems in the men receiving testosterone compared with those receiving a placebo gel.
The study, led by researchers at Boston University and funded by the National Institute on Aging, looked at 209 men, half of whom used testosterone gel daily for six months.
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The average age of the men in the study was 74. All of the men in the study had limited mobility and a high prevalence of chronic disease. However, among the 106 men using testosterone gel, 23 had cardiovascular-related events, compared with only five people in the 103-man placebo gel group.
The study is published online by the New England Journal of Medicine.
It's difficult to know just what to make of this study, the authors acknowledged. There was a broad range of cardiovascular events, including heart attack, stroke, death from suspected heart attack, exacerbation of congestive heart failure, atrial fibrillation, swelling, chest pain and other milder symptoms.
With such a diversity of events, it's hard to pinpoint how testosterone-replacement therapy may be responsible. The doses of testosterone used in the trial may have been higher than those in previous testosterone studies that did not find cardiovascular risks. Moreover, the trial was small and was stopped early.
The elderly men using testosterone did show increased strength in leg-press and chest-press strength, and in stair climbing while carrying a load.
As for younger and healthier men who use testosterone gel, it's doubtful this study can be applied to them, the authors said. Previous studies of testosterone gel in other groups of men have not shown significant increases in cardiovascular risks.
However, long-term studies on the risks and benefits of the therapy in men of all ages are lacking, according to a recent story in the Los Angeles Times.
Meanwhile, the availability of testosterone in gel form has led to a huge jump in prescriptions in the U.S.; 3.3 million prescriptions were filled in 2008, compared with 64,800 in 1999, one pharmaceutical-data company said.
