Unless you have been imitating Rip Van Winkle for several years, you are aware that Testosterone Replacement Therapy (TRT) has exploded in the last decade.
However, there have been very few studies that have examined the long-term effects of taking testosterone on cardiovascular health and other vital functions concerning the health effects on men receiving the treatment.
But that has changed.
Recently, investigators from Brigham and Women’s Hospital (BWH) report the results of the Testosterone’s Effects on Atherosclerosis Progression in Aging Men (TEAAM) trial in the Journal of the American Medical Association (JAMA).
The three-year study finds that testosterone administration had no effect on the progression of hardening of the arteries in older men with low to low-normal testosterone levels and did not significantly improve sexual function or health-related quality of life.
Shehzad Basaria, M.B.B.S., MD, from Harvard Medical School in Boston, and colleagues studied the effect of testosterone administration on atherosclerosis progression in older men.
Three hundred eight men aged 60 years or older (patients had a mean age of 67.6 years), with low or low-normal testosterone levels, volunteered and were treated with up to 7.5 g of 1 percent testosterone (156 men) or placebo gel packets (152 men) daily for three years.
In testosterone-treated patients, doses were adjusted periodically to achieve testosterone levels between 500 and 900 ng/dL.
Additionally, 42% of participants had hypertension, 15% had diabetes, 15% had cardiovascular disease, and 27% were obese.
The researchers assessed sexual function using the International Index of Erectile Function, a validated 15-item questionnaire that assesses five domains of sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction).
They used the Medical Outcomes Study 36-item short form health survey (SF-36) to assess health-related QOL.
“The results of this trial suggest that testosterone should not be used indiscriminately by men,” said Dr. Bhasin, director of BWH’s Research Program in Men’s Health: Aging and Metabolism and director of the Boston Claude D. Pepper Older Americans Independence Center at BWH.
He added that “We find that men with low and low normal testosterone are unlikely to derive benefits regarding sexual function or quality of life, two reasons why men may seek testosterone therapy.
And although we find that testosterone did not affect the rate of hardening of the arteries, we need long-term data from large trials to determine testosterone’s effects on other major cardiovascular events.”
No Significant Difference
The researchers also observed no significant difference in the rate of change in intima-media thickness (a measurement of the thickness of the innermost two layers of the wall of an artery…0.010 mm/year in the placebo group versus 0.012 mm/year in the testosterone group; P = 0.89) or in the rate of change in the coronary artery calcium score, which is a cardiac CT scan for coronary calcium in a non-invasive way of measuring calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart muscle…(41.4 versus 31.4 Agatston units/year; P = 0.54).
In the individuals assigned to receive testosterone, changes in intima-media thickness or calcium scores had no link with a change in testosterone levels.
There was no major difference between-group sexual drive, erectile dysfunction, sexual function ability, partner intimacy, or health-related quality of life.
“Our research shows convincingly that testosterone therapy does not affect the rate of atherosclerosis progression, but we need much larger, randomized trials to determine if testosterone treatment impacts heart attack and stroke risk,” Bhasin told MedPage Today.
He added that if this is the case, the mechanism does not appear to be through the treatment’s impact on atherogenesis.
“Testosterone may be affecting some other mechanism, such as plaque stability or clotting within the blood vessel,” he said.
“Because this trial was only powered to evaluate atherosclerosis progression, these findings should not be interpreted as establishing the cardiovascular safety of testosterone use in older men,” the authors write.
“Our study has important implications for clinical practice, and for older men who are seeking testosterone therapy,” said Bhasin.
“Many men, as they age, experience a decline in testosterone and sexual function and vitality.
But our study finds that taking testosterone, when levels are in the low to low normal range, may not improve sexual function or quality of life.”
The study was supported by Solvay Pharmaceuticals/Abbvie Pharmaceuticals, which provided the testosterone and placebo gel.
Testosterone, a hormone primarily secreted by the testicles, plays a vital role not only in male reproductive tissues but also in muscle growth, bone mass, and body hair.
As men get older, their testosterone levels naturally decline – on average by 1 percent a year after age 40.
Previous studies that have aimed to examine rates of cardiovascular events in men taking testosterone have reported conflicting results but have raised concerns that testosterone therapy might increase a person’s risk of a heart attack or stroke.
Atherosclerosis, or the buildup of plaque in the arteries, is a critical risk factor for such cardiovascular events.
But cardiovascular safety for TRT remains an open question
While earlier studies examining the impact of TRT on cardiovascular disease (CVD) risk in older men have been mixed, the TEAAM trial was not powered to weigh in on testosterone’s impact on CVD events in this population, the researchers warned.
As a result, the findings should not be interpreted as establishing the treatment’s safety in older men, they emphasized.
The TEAAM trial was designed to examine atherosclerosis progression and not cardiovascular events—further studies will be needed to determine the cardiovascular safety of testosterone use in older men.
The research team also notes that comparing patients using statins to those who are not could be another important direction for future studies.
Baseline characteristics among the treatment and placebo groups were similar: mean patient age at randomization was 67.6 years, 42% of participants had hypertension, 15% had diabetes, 15% had cardiovascular disease, and 27% were obese.
The authors reported that the rate of change in the CAC score was 41.4 Agatston units/year in the placebo group and 31.4 Agatston units/year in the testosterone group for an adjusted mean difference of ?10.8 Agatston units/year (95% CI ?45.7 to 24.2, P=0.54).
Study limitations included the high rate of loss to follow-up and the fact that the effectiveness of participant blinding was not assessed.
Bhasin said the failure to show a positive impact on these secondary endpoints has significant implications for the use of TRT in relatively healthy middle-aged and older men.
He said the dramatic rise in TRT use among relatively healthy, aging men with borderline low testosterone levels over the last decade had been primarily driven by the desire to improve sexual function and QOL.
“Testosterone is being used indiscriminately, and it shouldn’t be,” he said.
“Many middle-aged and older men are seeking this treatment to address sexual symptoms or to improve their quality of life. Our study clearly showed that the treatment has little impact in men whose testosterone levels are near normal.”
He noted that although several large, randomized trials evaluating TRT in older men are nearing completion, including the NIH’s Trial, they are not designed to determine CVD risk.
“We need a TRT test with cardiovascular event rate as the primary outcome, and it needs to happen fairly quickly,” he said.
Contact Us Now
- Testosterone's Surprising Link to Men's 'Love Hormone' Oxytocin - May 17th, 2018
- How to Build Muscle Quickly by Boosting Testosterone Levels - May 16th, 2018
- Five Facts About Testosterone (That Maybe You Didn't Know) - May 16th, 2018
- Skinny Bartender with Low Testosterone Becomes a Ripped Bodybuilder - May 9th, 2018
- New Research Proves Testosterone Replacement Therapy is Safe for the Heart - May 5th, 2018
- Testicular Cancer Survivors are at Risk for Low Testosterone - May 3rd, 2018
- Manhood Washed Away: You Could Unknowingly be Annihilating Your Testosterone - May 2nd, 2018
- Testosterone: Should You Take it to Regain Your Libido and Youthful Energy? - May 1st, 2018
- Testosterone Nasal Gel: A New Form of Testosterone Replacement Therapy - May 1st, 2018
- More Sex: A Better Way to Boost Your Testosterone Levels - December 15th, 2017
- Testosterone Replacement Therapy Boosts Aerobic Capacity - December 9th, 2017
- Testosterone Replacement Therapy (TRT) reduces the risk of serious adverse health consequences! - December 8th, 2017
- Oral Testosterone Pill Could Make Lipocine's share price SKYROCKET - December 2nd, 2017
- Amygdala and it's Relationship to Testosterone and Fear - December 1st, 2017
- Increased Testosterone DOES NOT cause prostate cancer to spread - November 18th, 2017
- Testosterone Cypionate and Testosterone Enanthate: The Real Facts - November 17th, 2017
- A Surprising Side Effect of Methadone Treatment: Suppressed Testosterone. - November 11th, 2017
- The testosterone industry globally is booming - November 10th, 2017
- Five Benefits of Testosterone that you need to know - November 4th, 2017
- Testosterone, Anxiety, and Depression - October 26th, 2017
- The Effects of Parenthood Upon Testosterone Levels - October 14th, 2017
- Baby Boomers find “The Fountain of Youth” in Testosterone - October 9th, 2017
- The Truth About Testosterone | The Dr. Oz Show - June 9th, 2016
- What is Testosterone? What does Testosterone do? Find on - June 9th, 2016
- How Men Work | HowStuffWorks - May 28th, 2016
- 6 Ways to Increase Testosterone Levels Naturally - wikiHow - May 4th, 2016
- Testosterone: Common Questions | Testosterone Test: Total ... - May 4th, 2016
- Adrenalast Testosterone Booster | Boost Muscle Sexual ... - April 6th, 2016
- How to Lower Testosterone in Women | eHow - February 8th, 2016
- Testosterone Booster Reviews - Consumers Guides - February 8th, 2016
- A Harvard expert shares his thoughts on testosterone ... - February 8th, 2016
- Buy Steroids Online | Anabolic Steroids for Sale ... - February 8th, 2016
- Myokem Magnitropin, Testosterone Boosting King, Safe and ... - February 8th, 2016
- Does Andro 400 Work; does it increase testosterone? - February 8th, 2016
- All About Testosterone! - Bodybuilding.com - February 8th, 2016
- Low T - My life was falling apart because I had low testosterone - January 28th, 2016
- 5 Natural Testosterone Boosters - Healthline - November 2nd, 2015
- Testosterone - Low-T and Androgen Replacement Therapy - November 2nd, 2015
- Testosterone Replacement Beneficial for Modern Men? - October 26th, 2015
- How long does it take for Testosterone replacement treatments and therapy to work? - October 24th, 2015
- Testosterone Creams for Low Testosterone Treatment and Andropause - October 24th, 2015
- Effect of vitamin D supplementation on testosterone levels ... - October 17th, 2015
- Testosterone Therapy and Androgen Deficiency Guide - October 12th, 2015
- Fortesta Brand Testosterone Therapy - October 10th, 2015
- Testosterone nasal gel works best at three doses a day, study finds - October 4th, 2015
- Testosterone: The Test | Testosterone Test: Total ... - October 1st, 2015
- Testosterone: A Major Breakthrough for Menopausal Women - October 1st, 2015
- Testosterone (film) - Wikipedia, the free encyclopedia - October 1st, 2015
- Andropause: Age-Associated Testosterone Decline - September 30th, 2015
- High-Dose Testosterone Injections May Be a Viable Palliative Late-Stage Prostate Cancer Treatment - September 28th, 2015
- Low-T and Your Health - September 25th, 2015
- Testosterone and Geriatric Frailty - September 19th, 2015
- Seven Types of Drugs that Can Inhibit Sex Drive and Libido - September 19th, 2015
- Low Testosterone Treatment, Low T - AXIRON (testosterone ... - September 16th, 2015
- What Is Testosterone AndroGel - September 16th, 2015
- Testosterone Deficiency Strongly Linked to Heart Attack Risk in New Study - September 15th, 2015
- Testosterone - Steroids Profile - September 1st, 2015
- Testosterone Articles! - Bodybuilding.com - September 1st, 2015
- High and Low Testosterone Levels in Men MedicineNet - September 1st, 2015
- Nugenix Testosterone Booster NUGENIX GNC - September 1st, 2015
- Testosterone Transdermal Patch: MedlinePlus Drug Information - September 1st, 2015
- Testosterone Booster - Scientific Review on Usage, Dosage ... - September 1st, 2015
- You & Your Hormones | Hormones | Testosterone - September 1st, 2015
- Testosterone and Aggression: How T-Levels Impact Human Response to External, Social Threats - August 12th, 2015
- Could Civilization Have Been Formed as a Result of Declining Testosterone Levels in Males? - August 11th, 2015
- Testosterone Therapy Allows Man to Have the Body That He Was Meant to Have - August 8th, 2015
- Testosterone Injections for Low-T and Andropause - August 8th, 2015
- Health portal - August 3rd, 2015
- Physiology of Testosterone - August 1st, 2015
- Normal Testosterone Levels - Urology - MedHelp - July 26th, 2015
- Tribulus Terrestris Review Does It Raise Testosterone or ... - July 18th, 2015
- Lack of Energy May Mean Lack of Testosterone - DrAxe.com - July 18th, 2015
- How to Increase Testosterone Naturally: PaleoEdge - July 15th, 2015
- How to Deal with Testosterone Decline - Mercola.com - July 8th, 2015
- Testosterone Cypionate Watson :: Buy Testosterone ... - July 4th, 2015
- What Traders’ Testosterone Tells Us About Markets - June 11th, 2015
- Clomiphene Citrate (Clomid) in Men - A Testosterone ... - May 26th, 2015
- Bio-Identical HRT and Testosterone Therapy in Women ... - May 24th, 2015
- Depo-Testosterone Inj - Uses, Side Effects, Interactions ... - May 24th, 2015
- The Truth Behind Common Male Sex Myths - May 8th, 2015