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Of these, 8 (17. Reasons for discontinuing testosterone are given in Table 5. Both testosterone-treated and control subjects were well matched at the onset of the study. This effect was confirmed in our study. There were no adverse effects of the increased hematocrit, but frequent monitoring was necessary to avoid critically elevated hematocrit levels, which occurred in one fourth of the subjects in this study. Polycythemia generally reverts to baseline after withholding testosterone therapy, although phlebotomy was occasionally necessary for a more immediate response. Whether the use of lower, more physiological, testosterone treatment regimens would result in less polycythemia has not been studied at this time. Although the mechanism involved remains uncertain, a similar effect has been noted in anephric mice. Exogenous testosterone has been suggested, Tamoxifen therapy, and successfully used, for the Tamoxifen PCT of refractory anemia in males (33). As prostate cancer has been associated with hormone-responsive growth (34), and as benign prostatic hypertrophy and declining Tamoxifen pills levels both occur in the aging population, there has long been a concern among clinicians that chronic testosterone replacement might have an adverse effect on the prostate. Recent studies indicate that the clinical course of prostate cancer is accelerated by testosterone, but the incidence is not increased by it (17, 29). In other words, testosterone does not appear to cause prostate cancer. Although prostate carcinoma is a clear contraindication for testosterone replacement therapy, there is no clinical evidence that testosterone accelerates BPH (17, 24, 35).

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