Men undergoing testosterone therapy face no higher risk of a heart attack during their initial year of treatment, according to the most comprehensive analysis of existing data to date. This research demonstrates that using testosterone replacement therapy in the short-to-medium term is likely safe for addressing conditions resulting from a lack of the male sex hormone.
Hypogonadism, a condition causing sexual dysfunction, bone and muscle weakening, and diminished quality of life, is typically treated with testosterone replacement therapy. Although current guidelines lack clarity regarding any potential increase in cardiovascular risk associated with this treatment, a safety warning from the US Food & Drugs Agency (FDA) contrasts with the European Medicines Agency's conclusion that insufficient evidence links testosterone to heart issues.
This uncertainty about testosterone's safety has left both doctors and patients hesitant about potential risks. However, recent findings presented at the ENDO 2022 congress and published in The Lancet Healthy Longevity suggest that men receiving testosterone for hypogonadism face no higher risk of heart attack, stroke, other cardiovascular events, or death in the short-to-medium term compared to those not undergoing such treatment.
In a meta-analysis of 17 trials involving nearly 3,500 participants, half receiving testosterone and half receiving a placebo, researchers found no significant increase in cardiovascular events or mortality rate between the two groups. Moreover, testosterone was associated with significant reductions in key cardiovascular markers such as total cholesterol, high-density lipoprotein (HDL), and triglycerides compared to the placebo. Notably, there were no significant differences in low-density lipoprotein (LDL), blood pressure, diabetes incidence, and prostate adverse outcomes between the two groups.
Dr. Channa Jayasena from Imperial College London, the senior author of the study, emphasized that these findings, focusing on the first year of treatment, suggest that testosterone therapy is not linked to heart problems. While the study does not assess the long-term safety of the treatment, it provides greater confidence for doctors in prescribing testosterone to men who require it.
