COMMENTARY

Putting the 'T'rouble in Testosterone Therapy?

Charles P. Vega, MD

Disclosures

January 30, 2014

In This Article

Clinical Pearls

The popularity of testosterone testing and treatment has skyrocketed. Most adult men have some symptom common to TD.

Testosterone therapy can improve body composition and metabolic outcomes, such as insulin resistance and the serum lipid profile.

Data are mixed as to whether testosterone therapy improves mood and erectile dysfunction.

There is also evidence suggesting that exogenous testosterone may either improve or increase the risk for mortality.

In the current large study of men undergoing coronary angiography at the VA, testosterone therapy was associated with a higher risk for the combined outcome of myocardial infarction, stroke, or mortality.

Testosterone therapy should only be prescribed for men who truly need it, and these men require close follow-up to ensure that treatment goals are met and avoid overtreatment. Caution is warranted in recommending testosterone treatment to men at high cardiovascular risk.

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