Effectiveness of testosterone therapy in hypogonadal patients and its controversial adverse impact on the cardiovascular system

Abstract

Testosterone is the major male hormone produced by testicles which are directly associated with man’s appearance and secondary sexual developments. Androgen deficiency starts when the male hormonal level falls from its normal range though, in youngsters, the deficiency occurs due to disruption of the normal functioning of pituitary, hypothalamus glands, and testes. Thus, testosterone replacement therapy was already known for the treatment of androgen deficiency with lesser risks of producing cardiovascular problems. Since from previous years, the treatment threshold in the form of testosterone replacement therapy has effectively increased to that extent that it was prescribed for those conditions which it was considered as inappropriate. However, there are some research studies and clinical trials available that proposed the higher risk of inducing cardiovascular disease with the use of testosterone replacement therapy. Thus under the light of these results, the FDA has published the report of the increased risk of cardiovascular disease with the increased use of testosterone replacement therapy. Nevertheless, there is not a single trial available or designed that could evaluate the risk of cardiovascular events with the use of testosterone replacement therapy. As a result, the use of testosterone still questioned the cardiovascular safety of this replacement therapy. Thus, this literature outlines the distribution pattern of disease by investigating the data and link between serum testosterone level and the cardiovascular disease, also the prescription data of testosterone replacement therapy patients and their tendency of inducing cardiovascular disease, meta-analysis and the trials regarding testosterone replacement therapy and its connection with the risks of causing cardiovascular disease and lastly, the possible effects of testosterone replacement therapy on the cardiovascular system. This study aims to evaluate the available evidence regarding the use of testosterone replacement therapy when choosing it as a treatment plan for their patients.

Keywords:

• Male hormone
• androgen deficiency
• testosterone replacement therapy
• cardiovascular problems
• clinical trials
• meta-analysis

Acknowledgements

The authors acknowledge Dr. Akram Ashames, Assistant Professor, Ajman University, Ajman, UAE for his thoughtful suggestions, constant support, and motivation.

Declaration of interest

The authors report no conflicts of interest. The authors’ affiliation is as shown on the cover page. The institutions with which the authors are affiliated are academic institutions, and the authors take sole responsibility for the writing and content of the manuscript. The institution does not receive support from the Ministry of Education, UAE. None of the authors have been involved in legal or regulatory matters related to the contents of the paper.