Defending Testosterone, Debunking the Myths

Abraham Morgentaler, MD

Disclosures

June 04, 2015

In This Article

The Truth About Testosterone and the Heart

My colleagues and I recently published a systematic review of the testosterone-related CV literature.[12] Only four studies reported negative concerns, including the two cited above. In contrast, several dozen studies showed the following:

  • Low testosterone levels are associated with increased mortality, atherosclerosis, and incident coronary artery disease;

  • Mortality is reduced by one half in testosterone-deficient men treated with testosterone therapy compared with untreated men;

  • Exercise capacity is increased with testosterone treatment vs placebo in men with known heart disease (angina, heart failure); and

  • There is uniform improvement in CV risk factors (fat mass, waist circumference, insulin resistance) with testosterone therapy vs placebo.[12]

Although no large, long-term controlled studies have definitively determined risk, the weight of evidence right now strongly favors the CV benefits of having a normal serum testosterone concentration, whether achieved naturally or with testosterone therapy.

Unfortunately, our culture is obsessed with risk, and "danger" makes headlines. In my view, individuals with anti-Pharma sentiments have exploited the perception of testosterone's risk to promote their own agendas. Plaintiff's attorneys advertise for men who had strokes or heart attacks to come forward to generate class action lawsuits.

Those who prescribe testosterone are judged skeptically by their peers

As a result of this bad press, many patients have decided to discontinue testosterone treatment, even those who have experienced years of benefits and no adverse effects. Many physicians have stopped prescribing testosterone therapy, and those who continue to do so are often judged skeptically by their peers.

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