Testosterone and cardiovascular disease – the controversy and the facts

Abstract

Since November 2013, there has been a flurry of articles written in the media touting the risk of cardiovascular (CV) disease in men treated with testosterone, based on two recent reports. Since first synthesized in 1935, testosterone therapy has demonstrated substantial benefits for men with testosterone deficiency (also called hypogonadism). Testosterone has an acceptable safety profile and literature spanning more than 30 years, suggesting a decreased CV risk with low levels of testosterone and benefits associated with testosterone therapy. However, nonmedical media outlets have seized on reports of increased CV risk, and published scathing editorials impugning testosterone therapy as a dangerous and overprescribed treatment. Here, we review these recent studies, and find no scientific basis for assertions of increased CV risk. This article is intended to provide the clinician with the facts needed for an informed discussion with men who suffer from testosterone deficiency and who desire treatment for their symptoms.

Keywords :

• Cardiovascular disease
• hypogonadism
• myocardial infarction
• testosterone
• testosterone deficiency
• testosterone replacement therapy

Declaration of interest

N Baum has been a speaker for Watson. A Morgentaler has received research funding from Auxilium, Warner Chilcott, Antares, and Lilly, been a consultant and advisor for Bayer, and a speaker for Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.