A comprehensive systematic review and meta-analysis by Julian Y.V. Borges, published on medRxiv in September 2024, delves into the safety and efficacy of oral testosterone therapy (specifically testosterone undecanoate) for men with hypogonadism. The study analyzed data from 21 studies encompassing 3,183 hypogonadal men.(medrxiv.org)
Key Findings:
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Safety Profile: Oral testosterone therapy demonstrated a safety profile comparable to other testosterone replacement therapies (TRT). No significant increase in liver toxicity was observed, even with long-term use. Cardiovascular safety results were mixed; some studies noted minor increases in systolic blood pressure, but there was no consistent evidence of a significant increase in major cardiovascular events. Prostate safety was consistent with existing TRT modalities, with only minor increases in prostate-specific antigen (PSA) levels noted.(medrxiv.org)
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Secondary Health Outcomes: The therapy showed potential benefits in improving bone density and reducing fat mass. There were also indications of cognitive benefits, though findings varied across studies. However, evidence regarding mortality reduction was inconclusive.(medrxiv.org)
Conclusion:
Oral testosterone therapy appears to be a safe and effective treatment option for hypogonadal men, offering potential benefits in bone health and cognitive function. Nonetheless, careful monitoring of cardiovascular health and prostate safety is advised during treatment. Further long-term studies are needed to fully understand its effects, particularly concerning mortality and cardiovascular outcomes.(medrxiv.org)
Reference:
Borges, J.Y.V. (2024). Oral Testosterone Therapy in Hypogonadal Men: A Comprehensive Systematic Review and Meta-Analysis of Safety, Efficacy, and Secondary Health Outcomes. medRxiv. Available at: https://www.medrxiv.org/content/10.1101/2024.09.22.24314162v1(medrxiv.org)
