Analysis Rejects Linkage Between Testosterone Therapy And Cardiovascular Risk

Recommended by Dr. Michael White, Updated on May 4th, 2015
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Newswise BOSTON Fears of a link between testosterone replacement therapy and cardiovascular risk are misplaced, according to a review published in this months Mayo Clinic Proceedings. The therapy has come under widespread scrutiny in recent months, including by a federal Food and Drug Administration (FDA) panel convened last fall.

Theres no good evidence that we could find that testosterone therapy increases cardiovascular risk, says lead author Abraham Morgentaler, MD, of Director of Mens Health Boston and a urologist on staff at Beth Israel Deaconess Medical Center. Thats not to say its perfectly safe. But we cannot find evidence and the headlines that jumped out on recent retrospective studies appear to be too strong.

Importantly, and under-recognized among physicians, Morgentaler adds, review of the literature clearly reveals a strong relationship between higher serum testosterone concentrations as being beneficial for reduction in cardiovascular disease and cardiovascular risk factors.

Testosterone is a hormone that, during puberty, helps build a man's muscles, deepens his voice and increases the size of his reproductive organs. As adults, men rely on the hormone to keep muscles and bones strong and to maintain an interest in sex.

Testosterone levels generally begin a gradual decline after the age of 30, a drop that may be accompanied by a decrease in sex drive. In recent years, the use of testosterone replacement therapy has increased substantially, aided in part by patient-friendly formulations such as topical gels that are widely advertised on television.

Such advertisements, combined with two recent studies raising questions about cardiovascular risk associated with the treatment, were the backdrop to an FDA advisory panel on testosterone therapy convened in September 2014. The panel voted 20-1 in favor of conducting a large-scale study to assess cardiovascular risk associated with testosterone therapy; the panel also voted in favor of a change in labeling requirements restricting the indications for use of testosterone.

Testosterone has been presented as if there were a debate about whether it is good or evil, says Morgentaler. Rather, it is a long-accepted medical treatment for a medical condition recognized for centuries. Our intention was to cut through the confusion of loudly expressed opinions on non-scientific issues such as pharmaceutical advertising, anti-aging claims, and the importance of sexuality in older men to provide the most comprehensive review to date of the literature on testosterone and cardiovascular risk.

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Analysis Rejects Linkage Between Testosterone Therapy And Cardiovascular Risk

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