Testosterone is the standard treatment for male hypogonadism, although contradictory data raise concerns regarding its cardiovascular safety. Scientists from Imperial College London, aimed to determine the consequences, have shown that testosterone replacement therapy appears safe for use in the short-to-medium term to treat a condition caused by deficiency of the male sex hormone.
Doctors and patients are concerned about the hazards due to a lack of consensus on testosterone’s safety. However, this research suggests that men who take testosterone to treat hypogonadism had no higher risk of heart attack, stroke, other cardiovascular events, or mortality in the short-to-medium term than men who do not take testosterone.
In a meta-analysis, scientists looked at 17 trials with over 3,500 participants, half of whom were given testosterone, and the other half were given a placebo. There was no significant difference in cardiovascular events or death rates between the testosterone and placebo groups (7.5 percent vs. 7.2 percent, respectively) (0.4 percent vs. 0.8 percent, respectively).
The testosterone treatment reduced some critical markers of cardiovascular health, including total serum cholesterol, high-density lipoprotein (HDL), and triglycerides, compared with placebo. However, there were no significant differences in serum low-density lipoprotein (LDL), blood pressure, the incidence of diabetes, and adverse prostate outcomes between the testosterone and placebo groups.
Dr. Channa Jayasena, from Imperial College London, senior author on the paper, said: “Most men who need testosterone treatment are 50 years or older, an age at which risk factors for heart problems become more common. Most current guidelines say that previous studies have contradictory results about the heart safety of testosterone treatment. Therefore, some men with symptomatic low testosterone are likely being deprived of treatment due to these concerns.”
“Our study is likely to supersede the previous evidence and suggests that, within the first year of treatment at least, testosterone treatment is not associated with heart problems. While our study does not look at the longer-term safety of the treatment, these findings will enable doctors to be more confident prescribing testosterone to men who need it.”
- Jemma Hudson, Moira Cruickshank, et al. Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis. DOI: 10.1016/S2666-7568(22)00096-4