Testosterone and Cardiovascular Health: Safety of Treatment of Hypogonadism

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Controversy has arisen over the issue of the cardiovascular safety of testosterone.


The aim of this article is to examine the evidence as to the cardiovascular safety involved with the administration of testosterone.


A literature review was performed with regard to cardiovascular safety of testosterone.

Main Outcome Measure.

The main outcome measure was to evaluate the available evidence as to cardiovascular safety and risk of testosterone.


A handful of recently published and widely discussed manuscripts have suggested that administration of testosterone replacement therapy increases the frequency of adverse cardiovascular events. In contrast, there have been recent clinical reports suggesting that testosterone is either safe or actually reduces cardiovascular events and mortality. All of these studies—both those suggesting that testosterone has adverse effects, as well as those suggesting it has positive effects on the cardiovascular system—have limitations.


What is missing is a large, long-term, prospective, placebo controlled, double blind trial in which hypogonadal men receive either testosterone or placebo, testosterone levels are carefully monitored, and the primary outcomes are well-defined major adverse cardiovascular/cerebrovascular events.

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