A meta-analysis of more than 3400 patients with hypogonadism from 17 clinical trials found that there was little evidence that testosterone therapy increased the risk of cardiovascular events such as short-term arrhythmias, heart attacks and strokes.
The incidence of cardiovascular events in testosterone treated subjects (120/1601, [7.5%]) was not significantly higher than that in placebo group (110/ 1519, [7.2%]). The number of deaths during treatment in the testosterone therapy group (6/1621 deaths, [0.4%]) was less than that in the placebo group (12/1537 deaths, [0.8%]), but the number was too small to determine whether testosterone reduced the risk of death.
Although the cardiovascular safety of testosterone therapy needs a longer-term analysis, the current research results on the short – and medium-term safety of testosterone therapy should reassure men suffering from hypogonadism all over the world.
The most comprehensive treatment analysis so far shows that testosterone replacement therapy is safe in the short and medium term for diseases caused by male sex hormone deficiency.
The results showed that the risk of heart attack, stroke and other cardiovascular events in men with hypogonadism treated with testosterone was not higher than that in men without testosterone.
Testosterone replacement therapy is the standard treatment for hypogonadism. Hypogonadism can lead to sexual dysfunction, bone and muscle weakness, and decreased quality of life. Risk factors for the disease include aging (testosterone levels decrease with age), obesity (BMI ≥ 30kg/m2) and diabetes.
Although testosterone therapy has been widely used, its cardiovascular safety is still unclear due to inconsistent research results. This is because most previous clinical studies relied on aggregate data rather than individual participant data, and did not publish the details of individual adverse events.
Worldwide, testosterone is increasingly used to treat hypogonadism, but the information about its safety is contradictory, which may lead to many patients not receiving testosterone therapy. Ongoing research should help determine the long-term safety of testosterone therapy, but at the same time, our findings provide much-needed evidence for the short – and medium-term safety of testosterone therapy. Our findings may have important implications for the treatment of male patients with hypogonadism worldwide.