Recent studies suggest a link between testosterone therapy and an increased risk in heart disease.
For example, a 2014 study reported that testosterone therapy might increase the risk of a heart attack in men age 65 and older, as well as in younger men who have a history of heart disease. A 2013 study found a higher frequency of death and heart problems in men who had coronary artery disease and received testosterone therapy. Also, a 2010 trial of testosterone in older men was stopped early because the men receiving testosterone therapy had a higher frequency of heart problems than did the men receiving the placebo.
However, two recent studies have also reported a lower risk of death in men who were receiving testosterone than in those who were not. Also, a recent analysis of studies published since these concerns were raised didn't find any reason to alter recommendations for testosterone treatment that have been in use since 2010.
As a result, further research is needed to determine the safety of using testosterone therapy to treat older men dealing with age-related declines in testosterone. Currently, the Food and Drug Administration (FDA) is investigating the risk of stroke, heart attack and death in men taking FDA-approved testosterone products.
Keep in mind that testosterone therapy carries various other risks, including contributing to sleep apnea, stimulating noncancerous growth of the prostate, enlarging breasts, limiting sperm production, stimulating growth of existing prostate cancer and blood clots forming in the veins. If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits. If you are taking testosterone, make sure your doctor is monitoring your response to treatment with regular blood tests.
Oct. 29, 2015
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- Amore M, et al. Partial androgen deficiency, depression and testosterone treatment in aging men. Aging Clinical and Experimental Research. 2009;21:1.
- Snyder PJ. Overview of testosterone deficiency in elderly men. http://www.uptodate.com/home. Accessed Feb. 17, 2014.
- Finkle WD, et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. PLOS One. 2014;9:1.
- Testosterone products: Drug safety communication — FDA investigating risks of cardiovascular events. U.S. Food and Drug Administration. http://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm384225.htm. Accessed Feb. 25, 2014.
- Bhasin S, et al. Testosterone therapy in adult men with androgen deficiency syndromes: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2006;91:1995.
- Vigen R, et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. Journal of the American Medical Association. 2013;310:1829.
- Basaria S, et al. Adverse events associated with testosterone administration. New England Journal of Medicine. 2010;363:109.
- Shores MM, et al. Testosterone treatment and mortality in men with low testosterone levels. Journal of Clinical Endocrinology and Metabolism. 2012;97:2050.
- Muraleedharan V, et al. Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes. European Journal of Endocrinology. 2013;169:725.
- FDA adding general warning to testosterone products about potential for venous blood clots. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm401746.htm. Accessed July 2, 2014.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 23, 2015.