For decades, testosterone therapy has been surrounded by skepticism particularly one major question: does it increase the risk of prostate cancer? Many doctors and patients have long worried that boosting testosterone might awaken hidden cancer cells or accelerate tumor growth.
However, new scientific evidence including a groundbreaking 2023 meta-analysis is changing that long-held belief.
Recent studies now show that testosterone replacement therapy (TRT) does not heighten the risk of developing prostate cancer. In fact, some research even suggests it may offer protective benefits.
This article unpacks the latest science, the myth behind the fear, and what this means for men considering hormone therapy.
What Is Testosterone Therapy?
Testosterone replacement therapy, or TRT, is designed to treat male hypogonadism a condition in which the body doesn’t produce sufficient testosterone. This may occur naturally with age, or result from injury, illness, or medication use.
Common signs of low testosterone include:
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Fatigue or low energy
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Decrease in muscle mass and strength
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Low libido and erectile dysfunction
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Depressive symptoms or mood swings
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Trouble concentrating or “brain fog”
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Loss of bone density
TRT can be administered through injections, gels, patches, pellets, or oral medications.
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The Prostate Cancer Myth
For many years, medical professionals believed that testosterone “fed” prostate cancer. This idea dates back to a 1941 study by Huggins and Hodges, which showed that reducing testosterone could shrink tumors in men with metastatic prostate cancer.
As a result, physicians feared that raising testosterone especially in older men might activate dormant cancer cells or increase cancer risk.
Yet, modern research reveals that those early assumptions were based on advanced, hormone-sensitive cancers — not on typical age-related testosterone therapy. The relationship between testosterone and prostate cancer is far more complex than previously thought.
What the Latest Research Reveals
2023 Meta-Analysis (Published in JAMA Network Open)
Researchers reviewed 38 clinical and observational studies covering more than 3 million men.
Key finding: Testosterone therapy was not linked to a higher risk of prostate cancer localized or advanced.
The results remained consistent across all age groups, therapy durations, and initial testosterone levels.
Other Major Studies
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A 2016 study in the New England Journal of Medicine found no increased prostate cancer risk in men receiving TRT compared to placebo.
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A 2020 analysis in European Urology tracked over 150,000 men and found no difference in prostate cancer rates between TRT users and non-users.
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Johns Hopkins University researchers observed that TRT users had a similar or slightly lower risk of aggressive prostate cancer.
Understanding the “Saturation Model”
The key to this new understanding lies in what scientists call the saturation model.
According to this concept, prostate cells respond to testosterone only up to a certain level the saturation point. Once that limit is reached (typically within normal testosterone levels), adding more hormone doesn’t further stimulate prostate growth or cancer development.
Simply put: normalizing low testosterone doesn’t “fuel” prostate cancer.
Potential Risks of TRT
Although TRT appears safe in terms of prostate cancer, it is not entirely risk-free. Men should discuss possible side effects with their healthcare provider before beginning therapy.
Potential risks and side effects include:
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Increased red blood cell count (polycythemia), which may raise stroke or clot risk
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Acne or oily skin
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Mild fluid retention
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Worsening sleep apnea in some men
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Reduced sperm production and smaller testicles
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Mood fluctuations
Regular check-ups including PSA tests, hematocrit monitoring, and testosterone level assessments are strongly advised during treatment.
Who Should and Shouldn’t Use TRT
TRT is best suited for men who have clinically confirmed low testosterone, based on both lab tests and consistent symptoms.
It is not recommended for:
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Men with active or untreated prostate cancer
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Those with severe sleep apnea or heart failure
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Men wishing to maintain fertility (TRT can suppress sperm production)
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Individuals without diagnosed hypogonadism
Rethinking Men’s Health
Fear of prostate cancer has led many physicians to avoid prescribing TRT and countless men to live with fatigue, low mood, and diminished vitality unnecessarily.
With new research affirming its safety, it’s time to shift from fear-based medicine to evidence-based care.
Men deserve access to accurate information, not outdated myths.
Read Next: The Testosterone Conversation I Wish I Had Sooner One Man’s Journey Back to Health and Why Every Man Over 40 Should Start Asking Questions.
Taking Action: What Men Can Do
If you suspect you may have low testosterone, here’s a proactive approach:
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Get tested: A simple morning blood test can measure total and free testosterone.
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Track your symptoms: Note changes in energy, libido, mood, and mental clarity.
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Consult a specialist: An endocrinologist or urologist experienced in TRT can guide you.
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Monitor your prostate: Discuss PSA testing and rectal exams before and during therapy.
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Stay updated: Research continues to evolve keep informed of new medical insights.
The Bottom Line
The belief that testosterone therapy causes prostate cancer is one of the most persistent myths in men’s health but at Ravoke, we highlight how modern science has finally caught up, revealing that properly monitored testosterone therapy does not increase prostate cancer risk and can, in fact, support overall men’s wellness. When prescribed and monitored properly, testosterone therapy does not increase prostate cancer risk.
For many men, restoring normal hormone levels can be transformative improving mood, energy, and overall quality of life.
If fear or misinformation has held you back, now is the time to approach the conversation with your doctor with confidence and clarity.
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