Cardiovascular Risk Associated with Male Testosterone Therapy Public Deposited

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Last Modified
  • February 26, 2019
  • Pitts, Johnny
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Physician Assistant Program
  • Background: Testosterone therapy, also known as male hormone replacement therapy has commonly been prescribed for older men since the 1950’s. Low testosterone (low T) in men has been linked with elevated cardiovascular risk factors, cardiovascular events, and increased cardiovascular mortality. However, in 2014 the Food and Drug Administration (FDA) issued a warning regarding therapeutic testosterone use for age related hypogonadism or low T regarding increased cardiovascular related events and stroke. Although studied extensively, providers continue to disagree as to its safety and effectiveness especially considering this recent recommendation. Therefore, the purpose of this clinical review is to discuss diagnosis and treatment options for men with low T while evaluating systematic reviews analyzing cardiovascular risk. Unlike female menopause, male hypogonadism does not universally develop in men. Low T, also known as hypogonadism or andropause, is associated with a lower quality of life and is currently estimated to affect as many as 38-40% of men in their lifetime. To treat men for andropause, Testosterone therapy (TTh) is prescribed in several different forms such as intramuscular (IM) injections, topical creams, subcutaneous (SC) pellets, oral pills, and transdermal patches. With sales projected to reach 3.2 billion by 2022, TTh is marketed to older men to treat multiple symptoms including: 1) fatigue, 2) mood, 3) muscle mass, 4) strength, and 5) sexual dysfunction as well as prevention of worsening heart disease. But, in multiple reviews the conclusion is that there is little benefit that outweighs the risks associated with TTh. These risks include cardiovascular events such as myocardial infarction (MI) and stroke as well as prostatic hyperplasia, and cancer. With the widespread use of TTh, more definitive determinations need to be made regarding the potential dangers of TTh.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Chelminski, Paul
  • Smith, Kilee
  • Master of Health Science
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
Deposit record
  • 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e

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