This year’s Mark Dodge, M. D., Lectureship speaker represented excellence in patient care and a dedication to learning by sharing research findings on important questions regarding men and aging.
According to Dr. Shalender Bhasin, M.B., B.S., and the 39th annual Dodge lecturer, testosterone prescription sales have grown exponentially in the past decade, but research findings do not support general use in older men with low testosterone.
Testosterone prescription sales have grown exponentially in the past decade, but research findings do not support general use in older men with low testosterone, said Dr. Shalender Bhasin, M.B., B.S., in the 39th annual Mark Dodge, M.D., Lecture.
In his lecture Nov. 2 at the UMKC School of Medicine, “The Benefits and Risks of Testosterone Supplementation in Aging Men,” Bhasin provided an extensive review of recent research including three large random clinical trials.
Testosterone therapy is approved for men whose levels are greatly reduced by disease or ailments, but it appears that much of the recent increase in use has been for men whose testosterone levels are simply declining with age. And in those cases, Bhasin said, the research results are divided on whether, and how much, sexual, physical and cognitive functions can be improved through testosterone therapy.
Unknowns also remain on the long-term risk side of the equation, Bhasin said, including any increased chances for heart trouble or prostate cancer.
As a result, a policy promoting general use in older men with low testosterone does not seem indicated, said Bhasin, who led the Endocrine Society’s expert panel for the development of guidelines for testosterone therapy.
Over time, Bhasin said, more rigorous research could help reduce the unknowns. And in the meantime, physicians can consider prescribing testosterone therapy, case by case, for older patients “with appropriate discussion of the uncertainty of its risks and benefits.”
Bhasin also said societal questions needed to be addressed, involving what it means to be a man and to grow old, often with accompanying decline in sexual activity, vitality and cognitive function. And in his view, testosterone therapy and drugs such as Viagra have “a small but important role” to play as society tries to answer these larger questions.
Besides the Dodge Lecture, Bhasin, a professor of medicine at Harvard University, made presentations at Saint Luke’s Hospital and the University of Kansas Medical Center while he was in Kansas City.
Bhasin is an internationally recognized reproductive endocrinologist with expertise in testosterone biology, reproductive endocrinology and human aging. He is director of the Men’s Health: Aging and Metabolism Research Program and the Claude D. Pepper Older Americans Independence Center for Function-Promoting Therapies at the Brigham and Women’s Hospital in Boston.
The Dodge lecture series began in 1978 to honor Mark Dodge, M.D., a founding director of the Saint Luke’s Hospital Foundation for Medical Education and Research and an authority in internal medicine and endocrinology. Dodge’s insistence on excellence in care and dedication to learning made him an outstanding physician and sought-after adjunct professor. Friends in 1977 raised $130,000 to establish the lectureship. Before his death in 1980, Dodge was able to choose the first two lecturers in the series.