Organ system | Benefits | Harms |
---|---|---|
Erectile function/libido | Improvement | None |
Depression/mood/fatigue | Improvement | Aggressive behaviour |
Erythropoiesis | Increase in hematocrit | Increased risk of polycythemia, embolism |
Skeletal muscle | Increase in fat-free mass | None |
Bone metabolism | Prevention of osteoporosis | None |
Cardiovascular system | Improvement in congestive heart failure, exercise capacity | Increased risk of thromboembolic cardiovascular events |
Prostate | ||
Benign prostatic hyperplasia | None beyond manifestations of testosterone deficiency syndrome | Marginal increase in volume and prostate-specific antigen level |
Cancer (metastatic or high risk of recurrence) | Absolute contraindication | Recurrence and rapid progression |
Cancer (localized and treated) | None beyond manifestations of testosterone deficiency syndrome | Potential exacerbation of subclinical residual cancer |
Testicle | None beyond manifestations of testosterone deficiency syndrome | Atrophy or impairment of spermatogenesis |
↵* For additional details on the strength of the evidence, see Appendix 1 (available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.150033/-/DC1).