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Dr. Abraham Morgentaler

๐Ÿ‘ค Speaker
944 total appearances

Appearances Over Time

Podcast Appearances

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

No, I think the data are quite clear that it does not cause blood clots. You know, we just had published over the last year or so the TRAVERSE trial. So TRAVERSE was the largest randomized control trial ever with testosterone. It involved more than 5,000 men randomized either to testosterone gel or placebo gel. Mean follow-up was 33 months, so a little bit less than three years.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

Mean time on treatment was a little bit less than two years. And that's a big study, 5,000 men. And the original intent of the study was to look at major adverse cardiovascular events, heart attacks, stroke, and death. And it turned out that was fine. There's no difference between testosterone and placebo. They also looked at prostate cancer, and there was no difference there either.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

Mean time on treatment was a little bit less than two years. And that's a big study, 5,000 men. And the original intent of the study was to look at major adverse cardiovascular events, heart attacks, stroke, and death. And it turned out that was fine. There's no difference between testosterone and placebo. They also looked at prostate cancer, and there was no difference there either.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

Mean time on treatment was a little bit less than two years. And that's a big study, 5,000 men. And the original intent of the study was to look at major adverse cardiovascular events, heart attacks, stroke, and death. And it turned out that was fine. There's no difference between testosterone and placebo. They also looked at prostate cancer, and there was no difference there either.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

But one of the things they also looked at was venothrombotic events, VTE, which is pretty much pulmonary emboli and DVTs, makes up most of it. And there was no difference there either. And we've had a number of observational studies too. A minority of them showed maybe some increased risk with testosterone. Most showed none. But the best is a large RCT, and there was no difference in that.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

But one of the things they also looked at was venothrombotic events, VTE, which is pretty much pulmonary emboli and DVTs, makes up most of it. And there was no difference there either. And we've had a number of observational studies too. A minority of them showed maybe some increased risk with testosterone. Most showed none. But the best is a large RCT, and there was no difference in that.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

But one of the things they also looked at was venothrombotic events, VTE, which is pretty much pulmonary emboli and DVTs, makes up most of it. And there was no difference there either. And we've had a number of observational studies too. A minority of them showed maybe some increased risk with testosterone. Most showed none. But the best is a large RCT, and there was no difference in that.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

So it doesn't cause increased blood clots. I'm pretty comfortable seeing that.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

So it doesn't cause increased blood clots. I'm pretty comfortable seeing that.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

So it doesn't cause increased blood clots. I'm pretty comfortable seeing that.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

Jose, I got to tell you that I was nervous most of my, almost all my career. And it's very hard to give up concepts that you were taught as a trainee. Very hard. You know, the smartest people that I knew in my training, and some of them were brilliant, taught me that testosterone is dangerous for prostate cancer. It was completely unchallenged. It was just... It was just one of the rules.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

Jose, I got to tell you that I was nervous most of my, almost all my career. And it's very hard to give up concepts that you were taught as a trainee. Very hard. You know, the smartest people that I knew in my training, and some of them were brilliant, taught me that testosterone is dangerous for prostate cancer. It was completely unchallenged. It was just... It was just one of the rules.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

Jose, I got to tell you that I was nervous most of my, almost all my career. And it's very hard to give up concepts that you were taught as a trainee. Very hard. You know, the smartest people that I knew in my training, and some of them were brilliant, taught me that testosterone is dangerous for prostate cancer. It was completely unchallenged. It was just... It was just one of the rules.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

And so when I first started treating my guys, I mentioned that I was doing biopsies to make sure they didn't have cancer, but it's still thought that they might develop it. But after a while, what happened is that, so for many years, at least in the Boston area, I was the only doctor. that was offering testosterone therapy to otherwise healthy men. They just had low levels of testosterone.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

And so when I first started treating my guys, I mentioned that I was doing biopsies to make sure they didn't have cancer, but it's still thought that they might develop it. But after a while, what happened is that, so for many years, at least in the Boston area, I was the only doctor. that was offering testosterone therapy to otherwise healthy men. They just had low levels of testosterone.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

And so when I first started treating my guys, I mentioned that I was doing biopsies to make sure they didn't have cancer, but it's still thought that they might develop it. But after a while, what happened is that, so for many years, at least in the Boston area, I was the only doctor. that was offering testosterone therapy to otherwise healthy men. They just had low levels of testosterone.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

They didn't have pituitary tumors. They had two testicles. And people were making me nervous, right? Like my urology, my patients would go for a second opinion. And they were told, that guy Morgenthaler is crazy. You're going to get cancer from that. And I had colleagues stop me. I had one colleague, one of my former teachers, stop me at the AUA meeting one year.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

They didn't have pituitary tumors. They had two testicles. And people were making me nervous, right? Like my urology, my patients would go for a second opinion. And they were told, that guy Morgenthaler is crazy. You're going to get cancer from that. And I had colleagues stop me. I had one colleague, one of my former teachers, stop me at the AUA meeting one year.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

They didn't have pituitary tumors. They had two testicles. And people were making me nervous, right? Like my urology, my patients would go for a second opinion. And they were told, that guy Morgenthaler is crazy. You're going to get cancer from that. And I had colleagues stop me. I had one colleague, one of my former teachers, stop me at the AUA meeting one year.

BackTable Urology
Ep. 188 Testosterone Therapy Today: Clinical Advances and Safety with Dr. Abraham Morgentaler

I was just out of practice a few years. out of training a few years, and he says, what you're doing is dangerous. You have to stop. And I was brought in. I gave grand rounds in my own hospital to the endocrinologists. And a day or two later, I get a call from the Human Subjects Committee, the IRB, from the chief of the IRB. He says, Abe, we'd like you to come and talk to the IRB.