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  • Endocrinologie
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Androgénothérapie: Quels sont les risques?

Risks of androgen therapy

Andrologie volume 11, pages 160–164 (2001)Cite this article

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Les androgènes jouent, à toutes les phases de la vie, un rôle important chez l’homme. Un déficit peut amener à poser l’indication d’un traitement hormonal substitutif. Cette situation est très différente de l’androgénothérapie utilisée à visée anabolisante chez le sportif ou encore de celle des androgènes utilisés lors de la prise en charge d’une dysfonction érectile. Le risque prostatique d’un tel traitement est souvent évoqué, mais d’autres effets sont possibles et doivent être recherchés (risques hématologiques, hépatiques, métaboliques). A ce jour, personne ne peut répondre avec certitude si le traitement androgénique peut induire un cancer de la prostate. Par contre le danger de stimuler un cancer existant est réel et dans ces conditions, tout patient traité doit être examiné et le taux de PSA dosé avant et pendant le traitement tous les 6 mois.

Abstract

Androgens play an important biological role at all phases of a man’s life. The objective of treatment of androgen deficiency is to maintain physiological testosterone levels. Misuse and abuse of androgen as anabolic steroids are frequent in sportsmen and body-builders or for erectile dysfunction. The main concerns for the potential adverse effects of testosterone treatment are the prostate and the cardiovascular system (lipid metabolism). Liver function must also be monitored. There is no evidence, at the present time, that testosterone replacement therapy in hypogonadal men increases the risk of prostate cancer. Only sporadic cases have been reported. Because of the risk of stimulating an existing prostate cancer, each patient must be monitored every six months (PSA and DRE).

References

  1. BEHRE H.M., BOHMEYER J., NIESCHLAG E.: Prostate volume in testosterone-treated and untreated hypogonadal men in comparaison to age matched normal controls. Clin. Endocrinol., 1994, 40: 341–349.

    Article  CAS  Google Scholar 

  2. BROWN D.C., BUTLER G.E., KELNAR C.J.et al.: A double bind, placebo controlled study of the effects of low dose testosterone undecanoate on the growth of small for age, prepubertal boys. Arch. Diseases Childhood, 1995, 73: 131–135.

    Article  CAS  Google Scholar 

  3. CONWAY A.J., BOYLAN L.M., HOWE C.et al.: Randomized clinical trial of testosterone replacement therapy in hypogonadal men. Int. J. Androl., 1988, 11: 247–264.

    Article  PubMed  CAS  Google Scholar 

  4. DEMARK-WAHNEFRIED W., LESKO S.M., CONAWAY M.R.et al.: Serum androgens: associations with prostate cancer risk and hair patterning. J. Androl., 1997, 18: 495–500.

    PubMed  CAS  Google Scholar 

  5. EBLING D.W., RUFFER J., WHITTINGTON Ret al.: Development of a prostate cancer after pituitary dysfunction: a report of 8 patients. Urology, 1997, 49: 564–568

    Article  PubMed  CAS  Google Scholar 

  6. ECKARDSTEIN A. von: Androgens cardiovascular risk factors and atherosclerosis. In: Nieschlag E and Behre HM eds. “Testosterone: Action, deficiency, substitution.” Berlin Springer Verlag, 1998, 229–257.

    Google Scholar 

  7. ENDRES W.: Priapism in Fabry’s disease during testosterone treatment. Klinische Wochenschrift 1987, 65: 925.

    Article  PubMed  CAS  Google Scholar 

  8. GOULD D.C., PETTY R.: The male menopause: does it exist?: for: some men need investigation and testosterone treatment. West J. Med., 2000, 173: 76–78.

    Article  PubMed  Google Scholar 

  9. GUAY A.T., PEREZ J.B., FITAIHI W.A., VEREB M.: Testosterone treatment in hypogonadalmen: prostate-specific antigen level and risk of prostate cancer. Endocr. Pract., 2000, 6: 132–138.

    PubMed  CAS  Google Scholar 

  10. HOLMÄNG S., MARIN P., LINDSTEDT G.et al.: Effect of long-term oral testosterone undecanoate treatment on prostate volume and serum prostate-specific antigen concentration in eugonadal middleaged men. Prostate, 1993, 23: 99–106.

    Article  PubMed  Google Scholar 

  11. JIN B., TURNER L., WALTERS W.A.et al.: The effects of chronic high dose androgen or estrogen treatment on the human prostate. J. Clin. Endocrinol. Metab., 1996, 81: 4290–4295.

    Article  PubMed  CAS  Google Scholar 

  12. KENNY A.M., PRESTWOOD K.M., RAISZ L.G.: Short-term effects of intramuscular and transdermal testosterone on bone turnover, prostate symptoms, cholesterol, and hematocrit in men over age 70 with low testosterone levels. Endocr. Res., 2000, 26: 153–168.

    Article  PubMed  CAS  Google Scholar 

  13. LOUGHLIN K.R., RICHIE J.P.: Prostate cancer after exogenous testosterone treatment for impotence. J. Urol., 1997, 157: 1845.

    Article  PubMed  CAS  Google Scholar 

  14. LEMCKE B., ZENTGRAF J., BEHRE H.M.: Long term effects on testicular function of high dose testosterone treatment for excessively tall stature. J. Clin. Endocrinol. Metab., 1996, 81: 296–301.

    Article  PubMed  CAS  Google Scholar 

  15. MACKEY M.A., CONWAY A.J., HANDELSMAN D.J.: Tolerability of intramuscular injection of testosterone ester in oil vehicle. Hum. Reprod., 1995, 10: 862–865.

    PubMed  CAS  Google Scholar 

  16. MATSUMOTO A., SANDBLOM R.E., SCHOENE R.B.et al.: Testosterone replacement in hypogonadal men: effects on obstructive sleep apnea, respiratory drives, and sleep. Clin. Endocrinol., 1985, 22: 713–721.

    Article  CAS  Google Scholar 

  17. MORLEY J.E.: Testosterone treatment in older men: effects on the prostate. Endocr. Pract., 2000, 6: 218–221.

    PubMed  CAS  Google Scholar 

  18. NIESCHALG E., BEHRE H.M.: Pharmacology and clinical use of testosterone. In: Nieschlag E and Behre HM eds. “Testosterone: Action, deficiency, substitution.” Berlin Springer Verlag, 1998, 293–328.

    Google Scholar 

  19. NIESCHLAG E.: Testosteron, Anabolika und aggressives Verhalten bei Männern. Deutsches Ärzteblatt, 1992, 89: 2967–2972.

    Google Scholar 

  20. ROBERTS J.T., ESSENHIGH DM: Adenocarcinoma of the prostate in a 40-year-old body-builder. Lancet, 1986, 2: 742.

    Article  PubMed  CAS  Google Scholar 

  21. ROLF C. NIESCHALG E.: Potential adverse effects of long term testosterone therapy, Baillière’s Clin. Endocrinol. Metab., 1998, 12: 521–533.

    CAS  Google Scholar 

  22. RUCH W., JENNY P.: Priapism following testosterone administration for delayed male puberty. Am. J. Med., 1889, 86: 256.

    Article  Google Scholar 

  23. SNYDER P.J.: Effects of age on testicular function and consequences of testosterone treatment. J. Clin. Endocrinol. Metab., 2001, 86: 2369–2372.

    Article  PubMed  CAS  Google Scholar 

  24. STONER E.: Three-years safety and efficacy data on the use of finasteride in the treament of BPH. Urology, 1994, 43: 284–292.

    Article  PubMed  CAS  Google Scholar 

  25. VERMEULEN A.: Androgen replacement therapy in the aging male: a critical evaluation. J. Clin. Endocrinol. Metab., 2001, 86: 2380–2390.

    Article  PubMed  CAS  Google Scholar 

  26. WINKLER U.H.: Effects of androgens on hæmostasis. Maturitas, 1996, 24: 147–155.

    PubMed  CAS  Google Scholar 

  27. WU F.C.W., FARLEY T.N.M., PEREGOUDOV A.et al.: Effects of testosterone enanthate in normal men: experience from a multicenter contraceptive efficacity study. Fertil. Steril., 1996, 65: 626–636.

    PubMed  CAS  Google Scholar 

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  1. Service d’Urologie Andrologie et Transplantation Rénale, Hôpital Pellegrin, Le Tripode, Place Amélie Raba Léon, 33076, Bordeaux

    J. L. Pariente

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Communication au XVII Congrès de la Société d’Andrologie de Langue Française, 7–9 Décembre 2000, Bordeaux:

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Pariente, J.L. Androgénothérapie: Quels sont les risques?. Androl. 11, 160–164 (2001). https://doi.org/10.1007/BF03036641

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Basic and Clinical Andrology

ISSN: 2051-4190