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15 April 2018

Benefits of Testosterone Therapy in Men with Testosterone Deficiency

Benefits of Testosterone Therapy in Men with Testosterone Deficiency
The most widely known effect of testosterone therapy is improved sexual function. But testosterone therapy actually has a wide range of physiological effects in men, including increased muscle mass, decreased fat mass (both overall and belly fat), improved insulin sensitivity, reduced risk of the metabolic syndrome and type 2 diabetes, improved mood / depressive symptoms, energy, and quality of life, reduced lower urinary tract symptoms, and importantly, reduced risk of all-cause and cardiovascular mortality.

15 August 2017

Effective testosterone treatment reduces incidence of atrial fibrillation

Effective testosterone treatment reduces incidence of atrial fibrillation

Sharma, R., et al., Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Associated With Decreased Incidence of Atrial Fibrillation. J Am Heart Assoc, 2017. 6(5)

While the effect of testosterone treatment on heart disease is a topic of ongoing debate, a growing body of evidence is refuting the widespread belief that testosterone treatment supposedly is harmful in terms of heart disease risk.

Here we report the results of a study, published in the Journal of the American Heart Association, which investigated the effect of testosterone treatment on the incidence of atrial fibrillation - an irregular and often rapid heart rate that can increase risk of stroke, heart failure and other heart-related complications - in testosterone deficient men with documented low testosterone levels.

Key Points

  • Atrial fibrillation is the most common form of abnormal heart rhythm, causing significant morbidity, mortality, and financial burden, especially in older men.
  • Effective testosterone treatment that achieves large enough elevations in testosterone levels reduces the incidence of atrial fibrillation by up to 21%.
  • Ineffective testosterone treatment, which does not achieve large enough elevations in testosterone levels, does not confer benefits.

15 June 2017

Testosterone treatment and risk of blood clots - what is new?

Testosterone treatment and risk of blood clots - what is new?

In discussions about side effects of testosterone treatment, prostate cancer and heart disease get most attention. However, as we have described in several study reports published here in the “Research News” section, the widespread fear of prostate cancer and heart disease is unfounded and not supported by medical research.

The expected potential side effect of testosterone treatment - which in fact is a therapeutic effect in men with anemia - is an increased level of red blood cells, known as erythrocytosis or polycythemia. In the context of testosterone treatment, erythrocytosis and polycythemia are used interchangeably to refer to an abnormal increase of hemoglobin or hematocrit, which may increase blood thickness.

Elevated hematocrit is the most common side-effect of testosterone treatment. The consequences of a high hematocrit level is unclear, but it may theoretically be associated with an increased risk of blood clots. Here we summarize the results of an analysis of the effect of testosterone treatment on risk of blood clots, published in the Journal of Investigative Medicine.

Key Points

  • An expected potential side effect of testosterone treatment is an increased level of red blood cells, which manifests as increased levels of hemoglobin and hematocrit. This “side effect” is actually a desired therapeutic effect in men with anemia.
  • It has not been directly proven that testosterone-induced elevations in hematocrit may increase risk of blood clots.
  • Because it is theoretically plausible that high hematocrit levels may increase risk for cardiovascular events – including blood clots - regular monitoring of hematocrit during testosterone therapy is important.
  • Testosterone treatment may confer several other beneficial effects that counteract possible risks of high levels of hematocrit.

15 December 2016

Testosterone treatment is not associated with risk of adverse cardiovascular events – RHYME study

Testosterone treatment is not associated with risk of adverse cardiovascular events – RHYME study

Testosterone treatment is not associated with increased risk of adverse cardiovascular events: results from the Registry of Hypogonadism in Men (RHYME). Maggi M, Wu FC, Jones TH, et al. Int J Clin Pract. 2016;70(10):843-852.

It is well-documented that testosterone therapy effectively restores testosterone levels in hypogonadal men and improves many health outcomes, such as quality of life, libido, metabolic parameters and body composition.

However, a few conflicting studies raised concerns about the cardiovascular safety of testosterone therapy which in 2015 prompted the FDA to issue warnings to physicians and patients about potential cardiovascular risks of testosterone therapy. In contrast, the European Medicines Agency (EMA) acknowledged the flaws of the conflicting studies and concluded that there is no consistent evidence of harm associated with testosterone therapy, regardless of mode of delivery.

Here we present the cardiovascular results of the notable RHYME (The Registry of Hypogonadism in Men) study, which contrary to prior clinical trials, enrolled patients with a wide range of comorbid illnesses and cardiovascular risk factors. The aim was to evaluate the safety of testosterone therapy in a sufficiently diverse population to reflect real-world, clinical experience.

Key Points

  • In comparison to both untreated men and to age-matched population data, no increase in mortality or cardiovascular risk was observed with testosterone therapy, regardless of:
    • The type of testosterone administered (injectable vs. topical preparations).
    • Presence of other comorbidities.
    • Age of patients (no increased risk was seen in both younger and older hypogonadal men).
    • The type of hypogonadism being treated (primary vs. secondary).
  • These results strongly support the overall cardiovascular safety of testosterone therapy.
  • The RHYME study refutes FDA’s labelling caution for potential risks of deep vein thrombosis with testosterone therapy.

1 June 2015

Testosterone Therapy and Cardiovascular Risk - Advances and Controversies

Testosterone Therapy and Cardiovascular Risk  - Advances and Controversies

Morgentaler A, Miner MM, Caliber M, Guay AT, Khera M, Traish AM.
Testosterone therapy and cardiovascular risk: advances and controversies.
Mayo Clin. Proc. 2015;90(2):224-251.

One of the most debated issues related to testosterone therapy is its effects on cardiovascular risk, such as heart attack and stroke. This editorial summarizes key conclusions from a special review article written by the Androgen Study Group and published in Mayo Clinic Proceedings.



Key Points

  • Low levels of total, bioavailable, and free testosterone are associated with increased risk of development of cardiovascular risk factors, atherosclerosis and mortality.
  • Testosterone therapy has beneficial effects on a wide range of risk factors and risk biomarkers related to these clinical conditions.

11 March 2011

Low testosterone is common in men with cardiovascular disease and decreases

A study in the United Kingdom observed 930 men with confirmed coronary artery disease over an average of nearly 7 years to find out how many had testosterone deficiency and to examine whether low testosterone affected survival.


Last updated: 2019
G.MKT.GM.MH.02.2018.0506