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Another point I’d like to make for people worried about a link between high testosterone and prostate cancer is that it just doesn’t make sense. Prostate cancer becomes more prevalent in men as they age, and that’s also when their testosterone levels decline. We almost never see it in men in their peak testosterone years, in their 20s for instance. We know from autopsy studies that 8% of men in their 20s already have tiny prostate cancers, so if testosterone really made prostate cancer grow so rapidly — we used to talk about it like it was pouring gasoline on a fire — we should see some appreciable rate of prostate cancer in men in their 20s. We don’t. So, I’m no longer worried that giving testosterone to men will make their hidden cancer grow, because I’m convinced that it doesn’t happen.

Hagen et al. addressed this very question in a recent issue of the journal Fertility and Sterility (Low concentration of circulating antimullerian hormone is not predictive of reduced fecundability in young healthy women: a prospective cohort study Fertil Steril 2012; 98:1602-8). They followed a total of 186 young Danish couples that intended to discontinue contraception to become pregnant until they conceived or for six menstrual cycles. They calculated the fecundability ratio (FR) (., the monthly probability of conceiving) and time to pregnancy (TTP) was measured as the number of cycles from stopping birth control to pregnancy. They measured AMH levels and anticipated that those with low AMH levels would have a low FR and take longer to conceive. AMH levels were measured and were divided into 3 groups low (quintile 1), medium (quintile 2 -4) and high (quintile 5). The results are interesting.

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