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The purpose of testosterone treatment is to compensate for the age-related declines in testosterone and to maintain testosterone levels above the threshold, below which the prostate carcinogenesis process is triggered. 24 This explains why the untreated hypogonadal men in the study reported ended up with a higher prostate cancer incidence overall, as well as more aggressive prostate cancer than hypogonadal men who received testosterone therapy. 1 The higher incidence of prostate cancer and aggressiveness in eugonadal men compared to testosterone treated men could have occurred because testosterone treatment in the hypogonadal men achieved higher testosterone levels than those seen in eugonadal men, who despite being classified as eugonadal may have had suboptimal testosterone levels.