Testosterone Deficiency & Cardiovascular Disease in Men
Testosterone deficiency and cardiovascular disease in men may be linked. In the United States, heart disease is the top cause of death in men. Heart disease accounts for 1 in 4 deaths for men. However, for men who do have a testosterone deficiency, testosterone therapy may be one safe and effective method of protecting against cardiovascular issues.
Testosterone deficiency in male patients lead to many unpleasant side effects. But physicians across the nation are seeing a correlation between testosterone deficiency and increase risk of serious disease or even death. As studies evolve on the topic of low testosterone and mortality rates, physicians are seeking ways to help their patients achieve more positive outcomes and live longer. Physician hormone replacement therapy (HRT) training helps physicians understand how to dose their male patients to meet their unique needs.
Causes of Testosterone Deficiency
There are many causes of testosterone deficiency in men. As men grow older, testosterone production natural declines. Other causes of decrease in testosterone production include issues such as testicular failure, trauma, and chronic illness.
In a recent study, it was concluded that there is no evidence that testosterone therapy is not related to an increased risk in cardiovascular problems. But there is ample evidence that testosterone therapy does not increase risk.
Many studies support testosterone replacement therapy as a cardiovascular benefit. This is noteworthy because low levels of testosterone are associated with increased risk of cardiovascular disease and death. Men who receive testosterone replacement therapy with a higher concentration see greater improvement in cardiac risk and mortality rates.
Testosterone replacement therapy has additional benefits such as improvement in myocardial ischemia, exercise capacity, and glucose levels.
Testosterone’s Effects on the Male Cardiovascular System
Testosterone has a significant effect on a male’s cardiovascular system. As men age, typically after age 40, testosterone levels will begin to decrease. This decrease is linked to an increase in mortality and cardiovascular risks.
Low testosterone levels put men at a greater risk of developing type 2 diabetes, coronary artery disease (CAD), and metabolic syndrome. Reduced testosterone levels further complicate the prognosis for men with congestive heart failure (CHF) and can lead to higher mortality rates.
Testosterone replacement therapy can improve many of the cardiovascular diseases that older men face. Testosterone therapy is also linked to reduced mortality in men who were previously testosterone deficient.
Testosterone Deficiency and Coronary Artery Disease
Testosterone deficiency may be associated with more severe cases of coronary artery disease (CAD).
A review conducted in 2013 provided supporting evidence that men with lower serum testosterone levels are more likely to develop coronary artery disease. This study also evaluated the severity of CAD in association with testosterone levels in the blood. These studies found that coronary artery disease was more severe in men who reported with lower testosterone levels.
While the sample size on these studies were small, they show promising correlation between higher serum testosterone levels and decreased severity of CAD.
Testosterone Deficiency and Congestive Heart Failure
Testosterone deficiency is found in many cases of congestive heart failure.
As congestive heart failure continues to be studies, there is evidence to suggest it is more than just failure of the heart. Congestive heart failure may involve other pathways such as the endocrine and muscular systems. In a study of 208 men with congestive heart failure, low serum testosterone levels were found in all classes. These reduced testosterone levels are also associated with more serious patient outcomes and increased risk of death.
Testosterone Deficiency and Metabolic Syndrome
Testosterone deficiency has been shown to be linked to metabolic syndrome (MetS). In an observation study, it was found that there is a relationship between total testosterone, free testosterone, sex hormone binding globulin (SHBG) and metabolic syndrome.
The relationship varied across different aspects of MetS but were stronger for abdominal obesity, high triglycerides, and high blood sugar.
Many studies have established that men with type 2 diabetes have lower levels of testosterone compared to men without diabetes. Studies also indicate that men are most testosterone deficient are also at increased risk of metabolic syndrome and type 2 diabetes.
2023 Research Studies on Low Testosterone & Cardiovascular Disease
There were several new research studies conducted in 2023 investigating the relationship between testosterone deficiency and cardiovascular disease (CVD) in men.
In 2023 a Cleveland Clinic-Led Trial entitled Testosterone Replacement Therapy and Incident Cardiovascular Events in Men was published in the New England Journal of Medicine1. This large-scale, randomized, double-blind, placebo-controlled trial assessed over 5,000 men with low testosterone and pre-existing or high-risk CVD. They found that testosterone replacement therapy did not increase the risk of major adverse cardiovascular events compared to placebo. This study provided important reassurance regarding the cardiovascular safety of testosterone replacement therapy in this population.
Also in 2023, the Danish Registry Study published in the JAMA Network Open2 analyzed data from over 120,000 men with type 2 diabetes. They found that lower testosterone levels were associated with an increased risk of myocardial infarction (heart attack), highlighting the potential link between testosterone deficiency and heart health in this population.
Additionally, a 2023 review of various clinical trials and observational studies published in the Sexual Medicine Review summarized the evidence on the relationship between testosterone deficiency and CVD. The authors concluded that there is compelling evidence for a detrimental effect of low testosterone on vascular health and increased risk of CVD in men with hypogonadism.
While these are just a few examples of recent studies on testosterone and CVD – and research in this area is ongoing – it is increasingly evident that low testosterone levels in men present a significant risk factor for the development of cardiovascular disease.
As a SottoPelle Method HRT trained physician you will be better able to assess your patients’ individual CVD risk factors and evaluate the potential benefits of testosterone replacement therapy – based on each patient’s specific circumstances to ensure they receive the appropriate care.
Physician Training for Treating Testosterone Deficiency
Treating testosterone deficiency may not solve or prevent every disease. However, studies support the evidence that testosterone replacement can help to reduce risks of metabolic syndrome, congestive heart failure, and diabetes.
The SottoPelle® Method places an emphasis on treating patients and their individual needs. SottoPelle® Certified Providers are taught how to individually customize dosages for their patients.
Bio-identical hormones, such as pellets used in the SottoPelle® Method, replicate the structure of hormones naturally created by the body. Bio-identical hormones are more effective than pills, patches, or creams. They are also safer for patients, without side effects caused by synthetic hormone replacement therapy methods.
Physician Testosterone Therapy Training: 323.986.5100 (press 1)
Sources:
- Testosterone Replacement Therapy and Incident Cardiovascular Events in Men with Hypogonadism and Preexisting or High-Risk Cardiovascular Disease: A Randomized, Double-Blind, Placebo-Controlled Trial; The New England Journal of Medicine (NEJM). (2023) https://www.nejm.org/doi/full/10.1056/NEJMoa2215025
- Association Between Serum Testosterone Level and Long-Term Risk of Myocardial Infarction in Men With Type 2 Diabetes Mellitus: A Danish Nationwide Registry Study; JAMA Network (2023).
- Major cardiovascular disease risk in men with testosterone deficiency (hypogonadism): appraisal of short, medium and long-term testosterone therapy – a narrative review; Sexual Medicine Review (2023). https://academic.oup.com/smr/article-abstract/11/4/384/7243023: https://academic.oup.com/smr/article-abstract/11/4/384/7243023
