Martin M. Miner, MD

Martin M. Miner, MD

Miriam Hospital

Providence, Rhode Island

Martin M. Miner, MD, is founder and internist at the Lifespan Men’s Health Center and former chair of the Department of Family Medicine for Miriam Hospital in Providence, Rhode Island. He is also a clinical professor of family medicine and urology at the Warren Alpert Medical School of Brown University in Providence. Dr. Miner earned his MD at the University of Cincinnati College of Medicine in Ohio. He completed his residency at Brown University and spent time working with the Indian Health Service Corps and the Public Health Service. Dr. Miner presently holds memberships in the American Academy of Family Physicians, the Rhode Island and Massachusetts Academy of Family Physicians, and the American Urological Association (AUA), and is a Fellow of the Sexual Medicine Society of North America. He is president-elect of the Androgen Society and has participated as a member of the AUA in the development of guidelines for erectile dysfunction, Peyronie's disease, testosterone deficiency, and early screening for prostate cancer. He is the former president of the American Society of Men’s Health. Dr. Miner has published extensively in the areas of erectile dysfunction and cardiovascular disease, benign prostatic hyperplasia, and lower urinary tract symptoms, as well as male sexuality and hormone replacement therapy in men.

Disclosures:

Talks by Martin M. Miner, MD

TRAVERSE: Meaning of the Testosterone Safety Trials

TRAVERSE: Meaning of the Testosterone Safety Trials

Posted by | Sep 2024

Martin M. Miner, MD, reviews testosterone safety trials and recent data on the cardiometabolic effects of testosterone, addressing concerns from the FDA about off-label testosterone use among aging men. The TRAVERSE trial, conducted in response to these concerns, examines whether testosterone therapy increases the risk of myocardial infarction or stroke.

In this 12-minute presentation, Dr. Miner provides a comprehensive review of studies from 1940 to 2014, which found minimal evidence suggesting cardiovascular risks associated with testosterone. However, key studies released in 2013-2014 raised concerns about testosterone therapy, indicating a potential increased risk of non-fatal myocardial infarctions. In response, the FDA issued a directive in 2015, leading to the large-scale TRAVERSE trial, a double-blind, placebo-controlled trial that assessed testosterone gel effects over five years.

The TRAVERSE study is notable as the longest randomized, controlled trial on testosterone safety among hypogonadal men to date. Findings indicate that testosterone therapy poses low cardiovascular risk, improves sexual health, and has no significant impact on prostate cancer risk or progression. This suggests that normalized testosterone levels may reduce risks of mortality and adverse cardiovascular events, without elevating prostate cancer concerns.

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Challenging Case Discussion Panel: Men’s Health

Challenging Case Discussion Panel: Men’s Health

Posted by | Jul 2023

Martin M. Miner, MD, discusses a challenging case involving testosterone therapy, cardiovascular risk, and prostate cancer. He begins by providing information about a case study patient, highlighting obesity, low testosterone levels, and diminished libido. Dr. Miner then discusses data that find a connection between testosterone therapy and increased cardiovascular risk.

He notes a review of all articles from 1940 to 2014 researching this connection, finding only four studies indicating a connection and uncovering major flaws in their procedures. This leads him to question the link between testosterone therapy and increased cardiovascular risk while also describing the case study patient’s testosterone therapy treatment. Dr. Miner then reviews guidelines from the American Urological Association and the Endocrine Society. He references the case study patient once again, noting the patient’s development of cardiac events and questions whether the patient should return to testosterone therapy.

After reviewing additional data on this topic, Dr. Miner concludes that testosterone therapy has at least neutral effects on cardiovascular risk factors, although additional studies are needed. He transitions the discussion back to the case study patient, noting his new development of prostate cancer and reviewing data on testosterone therapy’s effects on prostate cancer. Dr. Miner opens the discussion up to panelists, who discuss testosterone levels, obesity management, and individualized urologic treatment.

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The Surge of Male Mortality

Posted by | Jul 2022

Martin M. Miner, MD, Co-Director of the Men’s Health Center and Chief of Family and Community Medicine for Miriam Hospital, and Clinical Professor of Family Medicine and Urology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island, discusses differences in mortality and life expectancy based on sex. He states that in most countries, males have shorter life spans than females. He then reviews the hypotheses for why males tend to have shorter life spans, including higher rates of cigarette smoking and drinking, which can lead to increased risk of heart disease. Dr. Miner reviews a research article stating that heart disease is the major condition associated with excess male mortality in the twentieth century. He determines that obesity is the most modifiable factor in cardiovascular disease and can be treated with a weight-centric approach, and weight loss treatment plans. He explains that the findings from the STEP trials with semaglutide show similar levels of weight loss to those presently attained with bariatric surgery. Lastly, he considers PDE5i therapy, which he explains may provide cardioprotective effects to improve survival with cardiovascular disease in males.

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Semaglutide as a Game Changer for Weight Loss

Posted by | Jan 2022

Mark A. Moyad, MD, MPH, the Jenkins/Pokempner Director of Preventive/Complementary and Alternative Medicine (CAM) at the University of Michigan Medical Center in the Department of Urology in Ann Arbor, Michigan, and Martin M. Miner, MD, Co-Director of the Men’s Health Center and Chief of Family and Community Medicine for Miriam Hospital, and Clinical Professor of Family Medicine and Urology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island, discuss the potential benefits of semaglutide, a newly approved weight-loss drug. Dr. Moyad begins by summarizing the damage done by past weight-loss drugs, noting that they inevitably came with a huge catch and were never heart-healthy. He then introduces semaglutide, a recently-approved drug which has been shown to result in 15% weight loss over 2 years. Dr. Miner elaborates, explaining that there have been 4 studies of semaglutide featuring over 4500 individuals and that it is extremely safe. He highlights that the smaller dose in diabetics has also been shown to improve renal and cardiovascular outcomes, and that these outcomes are now being studied in non-diabetics. Dr. Miner argues that these results suggest semaglutide is a game changer. Dr. Moyad then discusses potential catches, noting that while the side effect profile seems good, the cost is very high at nearly $900 per month, and it is not covered by most insurance. Dr. Miner suggests that the price will go down once some time has passed from the initial approval. He does highlight as a negative the fact that semaglutide is given once per week as a subcutaneous injection, and suggests that it will be beneficial if the oral version currently under investigation is found to be effective. Drs. Miner and Moyad also ponder the long term impacts of semaglutide and sustained weight loss on testosterone levels, blood pressure, and depression. Dr. Moyad concludes by discussing his curiosity about the potential impact of semaglutide in a urologic setting.

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