California Longevity & Vitality Medical Institute

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TELOMERE TESTING AVAILABLE NOW
DR. BARTNOF'S PUBLISHED LETTER-TO-THE-EDITOR AT THE SAN FRANCISCO CHRONICLE ABOUT TESTOSTERONE DECLINE IN MEN DR. BARTNOF APPOINTED VISITING PROFESSOR OF MEDICINE DURING CHINA LECTURE TOUR
HARVARD UROLOGY PROFESSOR DESCRIBES MYTH ABOUT TESTOSTERONE LINK TO PROSTATE CANCER

Dr. Agnes Fournier has reported follow-up of 80,377 French women in menopause who had taken Bio-Identical Hormone Replacement Therapy (HRT) for an average of 8 years (up to a maximum of 12 years). The results showed that there was no increased risk of breast cancer among those who had used Bio-Identical estrogen and Bio-Identical progesterone (relative risk was 1). In contrast, among the few women who had used Non-Bio-Identical estrogen/progestin combination, there was a 69% increased risk (relative risk 1.69). Bio-Identical HRT for women is used more commonly in several western European countries. Dr. Fourniers update was published in the peer-reviewed medical journal Breast Cancer Research and Treatment (January 2008). She is a researcher at the National Institute of Health and Medical Research in France.
Many US physicians unfamiliar with medical publications about Bio-Identical HRT, often may comment that there are no studies. While Dr. Fourniers update is an observational study, the extremely large number of women enrolled (80,377) adds significant weight and statistical significance to the study.
Bio (life)-Identical (same) refers to replacing the exact shape and structure of a hormone that nature had originally designed for humans, but whose levels have declined with aging. This is in contrast to many patented hormones commonly prescribed in the U.S. that are not Bio-Identical, including those that were used in the U.S. Womens Health Initiative Study (PremPro or Premarin plus Provera). Premarin is derived from the urine of pregnant horses (PREgant MARe urINe) and contains equilin (horse estrogen), while Provera is a synthetic progestin with extra attachments on the progesterone rendering it non-Bio-Identical. An increased risk of breast cancer was found in 8,506 women enrolled in the U.S. Womens Health Initiative Study, and they were using Non-Bio-Identical estrogen (horse-derived Premarin) plus Non-Bio-Identical progestin (Provera). Those results were first reported in 2002.
The increased cancer risk among those using Non-Bio-Identical progestin is likely due at least in part, to an increase in the Ki67 cancer protein that develops with Provera usage, but not with Bio-Identical progesterone, as reported by Dr. Charles Wood in the same journal, Breast Cancer Research and Treatment in 2007.
Fournier A and others. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study.
Breast Cancer Research and Treatment. 2008 Jan;107(1):103-11.
Rossouw JE and others. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial.
Journal of the American Medical Association 2002 Jul 17;288(3):321-33.
Wood CE and others. The effects of estradiol with micronized progesterone or medroxyprogesterone acetate on risk markers for breast cancer in postmenopausal monkeys.
Breast Cancer Research and Treatment. 2007 Jan;101(2):125-34.

In the peer-reviewed medical journal Postgraduate Medicine (January 2009 with 196 references), Dr. Kent Holtorf, M.D. concluded Physiological data and clinical outcomes demonstrate that Bio-Identical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, Bio-Identical hormones remain the preferred method of HRT.
In the peer-reviewed medical journal Oncology Reviews (2008, 86 references), oncologist Dr. Khalid Mahmud, M.D. concluded, Natural estrogens, administered transdermally [on the skin], and natural progesterone may be the safest combination of female hormones.
Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?
Postgraduate Medicine. 2009 Jan;121(1):73-85.

There are at least 7 medical reports about shorter lifespan in men associated with lower testosterone. Many people are aware of the importance of men having healthy testosterone levels for normal libido, normal erections, normal energy, normal mood, normal memory, maintaining muscle, not gaining excess body fat; and not having accelerated skin wrinkling. However, many are not aware of the earlier risk of death now linked with lower testosterone levels. The number of studies continues to increase.
Professor Kay-Tee Khaw reported in the cardiology journal Circulation the results of 11,606 men who were tracked for up to 10 years starting in 1993. At that time, the men were 40-79 years of age and from the United Kingdom. Men with the highest testosterone levels (still in the normal range) had a significant 25% decreased risk of dying by 2003, when compared to men with the lowest level! Men with mid-range levels also lived longer than those in the lowest level. The most common cause of death was heart disease. All traditional factors for heart disease were considered, and the increased risk still existed. Professor Khaw concluded, Low testosterone may be a predictive marker for those at high risk of cardiovascular disease.
Khaw KT and others. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: EPIC-Norfolk Prospective Study. Circulation 2007, December 4;116(23):2694-701.
In the Rancho Bernardo Study in California, Dr. Gail Laughlin reported results of 794 men, ages 50-91 who were enrolled in the mid-1980s and were followed for an average 11.8 years (longest 20 years). In 2004, men with the lowest levels of testosterone in the 1980s were 40% significantly more likely to die than those with normal levels. Low testosterone increased heart deaths by 38% and lung deaths by 129%! Traditional risk factors for these diseases were considered in the analysis. Dr. Laughlin concluded, Testosterone insufficiency in older men is associated with increased risk of death over the following 20 years, independent of multiple risk factors and several preexisting health conditions. The report was published in Journal of Clinical Endocrinology and Metabolism.
Laughlin GA and others. Low serum testosterone and mortality in older men. Journal of Clinical Endocrinology and Metabolism 2008 January;93(1):68-75.
Snyder PJ. Might testosterone actually reduce mortality? Journal of Clinical Endocrinology and Metabolism 2008 January;93(1):32-33.
Asa Tivesten, M.D. reported that low testosterone in 3,014 elderly men from Sweden predicted a 65% increased risk of dying 4.5 years after starting the study. Dr. Tivesten concluded, Elderly men with low serum testosterone and estradiol have increased risk of mortality. The report was published in July 2009 in Journal of Clinical Endocrinology and Metabolism.
Tivesten A and others. Low serum testosterone and estradiol predict mortality in elderly men. Journal of Clinical Endocrinology and Metabolism 2009 July;94(7):2482-2488.
Molly Shores, M.D. reported that low testosterone in 858 male veterans from Washington State predicted an 88% increased risk of dying sooner compared to those men with normal levels. The men enrolled in the study in the late 1990s and were followed for up to 8 years. Traditional risk factors for diseases were considered, and the risk remained. Dr. Shores concluded, Low testosterone levels were associated with increased mortality in male veterans. The report was published in Archives of Internal Medicine.
Shores MM and others. Low serum testosterone and mortality in male veterans. Archives of Internal Medicine 2006 August 14-28;166(15):1660-5.
Dr. Torkel Vikan found that those men with the lowest free testosterone levels among 1,568 men from Norway had a 24% increased risk of dying sooner, when compared to those men with normal levels. The study was started in 1994, and the men were followed until 2007. Heart disease was a common cause of death; traditional risk factors for disease and dying were considered in the analysis. Dr. Vikan concluded, Men with free testosterone in the lowest quartile had a 24% increased risk of all-cause mortality. The report was published in European Journal of Endocrinology in July 2009.
Vikan T and others. Endogenous sex hormones and the prospective association with cardiovascular disease and mortality in men: the Tromso Study. European Journal of Endocrinology 2009 September;161(3):435-42.
Marcello Maggio, M.D. reported that low levels of 3 hormones (including testosterone) in 410 men from Baltimore predicted early death after 6 years. Compared to men with normal levels, those with low levels of testosterone, DHEA (adrenal hormone) and IGF-1 (reflecting levels of growth hormone) had a significant 144% increased risk of dying. Traditional risk factors for death were considered in the analysis; all men were at least 65 years. Dr. Maggio concluded, Age-associated decline in anabolic hormone levels is a strong independent predictor of mortality in older men. The report was published in Archives of Internal Medicine.
Maggio M and others. Relationship between low levels of anabolic hormones and 6-year mortality in older men: the aging study in the Chianti Area study. Archives of Internal Medicine 2007 November;167(20):2249-54.
Aapo Lehtonen, M.D. found that in a study of 310 men from Finland followed for 10 years, those who were still alive had a significant 14% increased level of testosterone when first enrolled, compared to those who had died. At the beginning of the study, the men were 71-72 years. The report was published in the medical journal Age and Ageing.
Lehtonen A and others. Serum testosterone but not leptin predicts mortality in elderly men. Age and Ageing 2008 July;37(4):461-4.
Many other published medical reports have linked low testosterone in men with a number of medical conditions. Those include: heart disease (blockages and heart failure); progression of neck artery blockages; stroke; high blood pressure; Alzheimers risk; high cholesterol and triglycerides; developing diabetes; developing pre-diabetes; developing metabolic syndrome; developing insulin resistance; erectile dysfunction; developing excess weight; developing osteopenia or osteoporosis (low bone density with increased risk of fracture); developing depression; and urinary abnormalities (more frequent urination, weaker stream, more difficulty starting stream).
Guder G and others. Low circulating androgens and mortality in heart failure. Heart 2009 October 28 [Epub].
Ponikowska B and others. Gonadal and adrenal androgen deficiencies as independent predictors of increased cardiovascular mortality in men with type II diabetes mellitus and stable coronary artery disease. Int. J. Cardiology 2009 April 21 [Epub]
Akishita M and others. Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors. Atherosclerosis 2009 November 12 [Epub]
Khaw K-T and Barrett-Connor E. Blood pressure and endogenous testosterone in men: inverse relationship. Journal of Hypertension 1988 April;6(4):329-332.
Moffat SD and others. Free testosterone and risk for Alzheimers disease in older men. Neurology 2004 January 27;62(2):188-193.
Pike CJ and others. Protective actions of sex steroid hormones in Alzheimers disease. Frontiers in Neuroendocrinology 2009 July;30(2):239-58.
Rosario ER and others. Androgen regulation of beta-amyloid protein and the risk of Alzheimers disease. Brain Research Reviews 2008 March;57(2):444-453.
Yeap BB and others. Lower testosterone levels predict incident stroke and transient ischemic attack in older men. Journal of Clinical Endocrinology and Metabolism 2009 July;94(7):2353-9.
Svartberg J and others. Low testosterone levels are associated with carotid atherosclerosis in men. Journal of Internal Medicine 2006 June;259(6):576-82.
Muller M and others. Endogenous sex hormones and progression of carotid atherosclerosis in elderly men. Circulation 2004 May;109(17):2074-9.
Hak AE and others. Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study. Journal of Clinical Endocrinology and Metabolism 2002 August;87(8):3632-9.
Rosano GMC and others. Low testosterone levels are associated with coronary artery disease in male patients with angina. International Journal of Impotence Research 2007;19:176-182.
Traish AM and others. The dark side of testosterone deficiency: III Cardiovascular disease. Journal of Andrology 2009 September-October;30(5):477-94.
Haring R and others. Prediction of metabolic syndrome by low serum testosterone levels in men. Diabetes 2009 September 58(9):2027-31.
Kapoor D and others. Androgen deficiency as a predictor of metabolic syndrome in aging men: an opportunity for intervention? Drugs Aging 2008;25(5):357-369.
Traish AM and others. The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. Journal of Andrology 2009 January-February;30(1):23-32.
Stellato RK and others. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care 2000 April;23(4):490-4.
Traish AM and others. The dark side of testosterone deficiency: I. Metabolic syndrome and erectile dysfunction. Journal of Andrology 2009 January-February;30(1):10-22.
Diaz-Arjonilla M and others. Obesity, low testosterone and erectile dysfunction. International Journal of Impotence Research 2009 March-April;21(2):89-98.
LeBlanc ES and others. The effects of serum testosterone, estradiol, and sex hormone binding globulin levels on fracture risk in older men. Journal of Clinical Endocrinology and Metabolism 2009 September;94(9):3337-46.
Isidori AM and others. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clinical Endocrinology (Oxford) 2005 September;63(3):280-93.
Shores MM and others. Low testosterone levels predict incident depressive illness in older men: effects o age and medical morbidity. Journal of Clinical Psychiatry 2005 January;66(1):7-14.
Shores MM and others. Increased incidence of diagnosed depressive illness in hypogonadal older men. Archives of General Psychiatry 2004 February;61(2):162-7.
Yassin AA and others. Lower urinary-tract symptoms and testosterone in elderly men. World Journal of Urology 2008 August;26(4):359-64.

11 YEARS OF TESTOSTERONE TREATMENT DECLARED SAFE
Michael Zitzmann, MD from the Center for Reproductive Medicine and Andrology at the University of Muenster in Germany has reported the safety and benefits of up to 11 years of testosterone replacement therapy in 183 male patients. His presentation was at Endo 09, the annual meeting of the U.S. Endocrine Society that was held in Washington, D.C. in 2009. The average age of the men when starting treatment was 37 years, with a range of 15-70 years. The testosterone used was a long-acting type injected into the muscle that is not yet available in the U.S., but has been approved in many European countries, Asian countries and Australia. In addition to the expected benefits of increased libido and erection function, Dr. Zitzmann reported that patients experienced decreased blood pressure (systolic or upper and diastolic or lower); decreased body mass index (weight divided by height); decreased waist circumference (with associated decrease in body fat); decreased LDL (bad) cholesterol; increased HDL (good) cholesterol; increased red cell counts that almost always remained in the reference range; and PSA (prostate specific antigen) tests that were normal (except for 1 patient who had an episode of prostatitis [infection]).
Dr. Zitzmann concluded, Intramuscular injections of testosterone undecanoate represent a feasible, safe and well tolerated modality of androgen substitution in hypogonadal men of a wide age-range, also on the basis of more than one decade of experience., facilitating a decrement of cardiovascular risk factors.
Zitzmann M and others. Intramuscular testosterone undecanoate for substitution in male hypogonadisman experience of 11 years elucidating beneficial effects on cardiovascular risk factors and simultaneously providing marked degree of safety. Abstract and poster P3-307 at Endo 09, annual meeting of the Endocrine Society; Washington D.C.; June 12, 2009.
In a related report, Dr. Farid Saad, PhD published a report about 8 years of testosterone replacement therapy in 22 men. Dr. Saad is Director of Scientific Affairs at Bayer-Schering in Berlin, Germany. He said that the study used testosterone undecanoate injections in the muscle. The effects of low testosterone were reversed in terms of muscle and bone loss, in addition to reversal of abnormal metabolic parameters (cholesterol, glucose). In addition sexual function (libido, erectile function) was restored. He also said the safety profile is excellent. He reported no abnormal increases in red cell counts and no adverse effects on lipids (fats, cholesterol). Also, prostate safety parameters are well within reference limits. He concluded that the testosterone replacement therapy is a valuable treatment option of androgen deficiency. Dr. Saads report was published in Asian Journal of Andrology.
Saad F and others. More than eight years hands-on experience with the novel long-acting parenteral testosterone undecanoate. Asian Journal of Andrology 2007;9(3):291-297.
BLOCKED TESTOSTERONE IN MEN PREDICTS SHORTER LIFE
Certain medical conditions may require physicians to prescribe drugs to block testosterone production in men. However, there are increasing reports that there are significant side effects due to low testosterone, including possible earlier death. Physicians, patients and patients families need to be aware of all the risks and benefits of blocking testosterone.
Blocked testosterone has been shown to increase the risk of: heart attack; earlier heart attack; developing excess body fat around the waistline and elsewhere; losing muscle mass; increased overall weight/obesity; developing pre-diabetes; developing diabetes; developing insulin resistance and metabolic syndrome; developing increased cholesterol, increased LDL (bad) cholesterol and increased trigylcerides; developing osteopenia/osteoporosis (weak bones with increased risk of fracture); developing depressed mood; libido decline; and erectile dysfunction.
Basaria S. Androgen deprivation therapy, insulin resistance, and cardiovascular mortality: an inconvenient truth. Journal of Andrology 2008 September-October;29(5):534-9.
DAmico AV and others. Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions [heart attacks]. Journal of Clinical Oncology 2007 June 10;25(17):2420-5.
Tsai HK and others. Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. Journal of the National Cancer Institute 2007 October 17;99(20):1516-24.
Saigal CS and others. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 2007 October 1;110(7):1493-500.
Basaria S and others. Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy. Cancer 2006 February 1;106(3):581-8.
Shahinian VB and others. Risk of fracture after androgen deprivation for prostate cancer. New England Journal of Medicine 2005 January 13;352(2):154-64.
Galvao DA and others. Reduced muscle strength and functional performance in men with prostate cancer undergoing androgen suppression: a comprehensive cross-sectional investigation. Prostate Cancer and Prostatic Diseases 2009(12):198-203.
Smith JC and others. The effects of induced hypogonadism on arterial stiffness, body composition, and metabolic parameters in males with prostate cancer. Journal of Clinical Endocrinology and Metabolism 2001 September;86(9):4261-7.
Taylor LG and others. Review of major adverse effects of androgen-deprivation therapy in men with prostate cancer. Cancer 2009 June 1;115(11):2388-99.
Saylor PG and others. Metabolic complications of androgen deprivation therapy for prostate cancer. Journal of Urology 2009 May;181(5):1998-2006.
Kintzel PE and others. Increased risk of metabolic syndrome, diabetes mellitus, and cardiovascular disease in men receiving androgen deprivation therapy for prostate cancer. Pharmacotherapy 2008 December;28(12):1511-22.
Shahani S and others. Androgen deprivation therapy in prostate cancer and metabolic risk for atherosclerosis. Journal of Clinical Endocrinology and Metabolism 2008 June;93(6):2042-9.
Hakimian P and others. Metabolic and cardiovascular effects of androgen deprivation therapy. BJU International 2008 December;102(11):1509-14.
Basaria S and others. Relation between duration of androgen deprivation therapy and degree of insulin resistance in men with prostate cancer. Archives of Internal Medicine 2007 March 26;167(6):612-13.
Braga-Basaria M and others. Lipoprotein profile in men with prostate cancer undergoing androgen deprivation therapy. International Journal of Impotence Research 2006;18:494-498.

See testosterone for all it is - not just a male sex hormone Editor - Thank you to Carolyne Zinko for her story about Jed Diamond's description of irritable male syndrome ("Grumpy not-so-old men," Monday). Andropause (testosterone decline with symptoms) is more widespread than the public (and many physicians) realize. According to the New England Journal of Medicine (Rhoden, January 2004), low testosterone occurs among about 9 percent of men in their 40s, 30 percent of men in their 50s, 42 percent of men in their 60s and 70 percent of men in their 70s. Three larger studies published in peer-reviewed medical journals during the past two years have shown that men with low testosterone do not live as long as those with normal levels. The largest of those studies (EPIC, Great Britain) enrolled more than 11,000 men. While Diamond's research has focused mainly on the psychological aspects of andropause, there are several physical sequelae as well: osteoporosis (associated risk of bone fracture); prediabetes and diabetes; increased body fat (especially around the midsection, the so-called beer belly that is linked with heart disease); abnormal lipids (blood fat); increased atherosclerosis (decreased circulation); and earlier heart attacks. It is time for men (and their spouses, partners and physicians) to become aware that testosterone in men is not just a sex hormone but a total body hormone, essential for normal psychological and physical functioning and to help offset risks for chronic life-threatening diseases.

Bartnof is Founder and Medical Director of the California Longevity & Vitality Medical Institute in San Francisco.
Original Letter appears online:http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/02/13/DDM015S8GH.DTL&hw=Bartnof&sn=001&sc=1000

Could a man's midlife crisis be more than a state of mind, but be linked to his endocrine system instead? Read Carolyne Zinko's review of Dr. Jed Diamond's book, "Irritable Male Syndrome," reflecting the negative psychological aspects of testosterone decline in men: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/02/09/DDJ215H812.DTL&hw=Jed+Diamond&sn=001&sc=1000
DR. BARTNOF APPOINTED VISITING PROFESSOR OF MEDICINE DURING CHINA LECTURE TOUR
Dr. Harvey S. Bartnof, Founder and Medical Director of California Longevity and Vitality Medical Institute, was recently appointed the honorary title Visiting Professor of Medicine at Liaoning Medical College in China. The title was bestowed during his recent Lecture Tour in China that spanned 3 provinces and 5 cities over a 2-week period in September, 2007. Dr. Wang Wei, Director at Jinzhou Central Hospital and Professor of Orthopedic Surgery at Liaoning Medical College, bestowed the honor and presented the Certificate immediately prior to Dr. Bartnofs 1 hour presentation to the medical and nursing staff there. His lecture was titled, Introduction to Age Management Medicine. Prior to Dr. Bartnofs award, there was an Opening Session that included remarks by Dr. Liu Hua, Director of Jinzhou Public Health Bureau and Professor of Ophthalmology at Liaoning Medical College; Dr. Bao Baili, Vice Director at Jinzhou Central Hospital; Dr. Wang Ruxiang, Secretary General of China Shenyang Academy of Anti-Aging Medicine; and Dr. Wang Wei. The Conference also was facilitated and coordinated by Dr. Zhang Baojun, Vice Director of Jinzhou Public Health Bureau.
During the same trip, Dr. Bartnof also was awarded the title of Visiting Professor at Shenyang Medical College in Shenyang, China. Professor Xiao Chun Ling, President at Shenyang Medical College, bestowed the honors to Dr. Bartnof during a meeting with the President and other faculty members, including Professor Pei Qing Shuang, Vice President of the college. Subsequent to their meeting, Dr. Bartnof presented a 1-hour lecture to 200 students in the division of Preventive Medicine. His lecture was entitled, Overview of Age Management Medicine.
Dr. Bartnof was an invited Speaker at the 2nd International China Conference on Anti-Aging Medicine, that was held in Dalian, China at the beginning of his lecture tour. During the 2-day Conference that was attended by mostly physicians, Dr. Bartnof presented 5 lectures, including: Introduction to Age Management Medicine; Bio-Identical Hormone Therapy for Female Menopause; Bio-Identical Hormone Therapy for Andropause; Somatropin (Growth Hormone) Therapy for Deficiency; Vitamins and Nutraceuticals for Age Management; and Case Histories of Men in Age Management. The Conference was sponsored by the China Shenyang Academy of Anti-Aging Medicine; Dalian Association for Science and Technology and its Executive Vice President Mr. Wu Jihua; and Jinzhou Enterologic Hospital and its Director Dr. Sun Qingsheng. The other invited Speakers from the United States were Neal Rouzier, M.D. and Ms. Caroline Rouzier, both from the Preventive Medicine Clinic in Palm Desert, California. The Conference Organizer was Dr. Wang Ruxiang, Secretary General of China Shenyang Academy of Anti-Aging Medicine, and his Staff. In June of 2006, Drs. Bartnof and Rouzier were invited Speakers at the 1st International China Conference on Anti-Aging Medicine that was held in Shenyang, China.
While in the city of Jinzhou, Dr. Bartnof toured Jinzhou Enterologic Hospital, a private institution. There he was awarded the title of Executive Consultant in Medicine by its Director, Dr. Sun Qingsheng. Also while in that city, Dr. Bartnof toured Jinzhou Womens and Infants Hospital, and was hosted by its Medical Director, Dr. Wang Giu Shuang.
Dr. Bartnof has welcomed the opportunity to teach physicians and other health providers in China about Age Management Medicine and State-of-the-Art practice of Bio-Identical Hormone Replacement Therapy. He is very grateful to the many hosting Chinese physicians, including Dr. Wang Ruxiang and Dr. Zhang Baojun, related Staff and Colleagues, and family members for their very kind hospitality that was extended to him during his stay in China. Dr. Bartnof is also very grateful to Ms. Jean Lee, Medical Student, for her excellence in translating English to Mandarin and vice versa at the 2nd International Chinese Conference on Anti-Aging Medicine, Dalian 2007.

HARVARD UROLOGY PROFESSOR DESCRIBES MYTH ABOUT TESTOSTERONE LINK TO PROSTATE CANCER
For 60 years, many physicians have believed that testosterone replacement therapy in men would increase the risk of prostate cancer. Abraham Morgentaler, M.D., an Associate Clinical Professor and Urologist at Harvard Medical School in Massachusetts, has published several reports in peer-reviewed medical literature that documents how the myth regarding testosterone and prostate cancer has occurred. Dr. Morgentaler concludes,
This historical perspective reveals that there is not now-nor has there ever been-a scientific basis for the belief that testosterone causes prostate cancer to grow. Discarding this modern myth will allow exploration of alternative hypotheses regarding the relationship of testosterone and prostate cancer that may be clinically and scientifically rewarding.

Morgentaler A. Testosterone deficiency and prostate cancer: emerging recognition of an important and troubling relationship. Eur Urol. 2007 Sep;52(3):623-5. Epub 2007 Apr 9.

Rhoden EL and Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. New England Journal of Medicine 2004 January.
LOW ESTROGEN IN WOMEN LINKED WITH EARLIER DEATH AND DEMENTIA

Rocca WA Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology. 2007 Aug 29; [Epub ahead of print]

-Rocca WA. Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol. 2006 Oct;7(10):821-8.