Testosterone use among men has increased significantly in recent years. Much of this increase is in response to doctors recommendations for treatment of symptomatic low testosterone levels, advertising of testosterone replacement therapy and the belief that low testosterone may increase the risk of developing cardiovascular disease (heart attack and stroke). Most recent studies that followed a population over time suggested that deficiencies in male hormones such as testosterone and dihydrotestosterone may increase the risk of cardiovascular disease. Because low testosterone is a potentially reversible condition, it makes some sense that hormone replacement would be a good idea to prevent cardiovascular disease. Additionally, higher testosterone levels among men in these observational studies was associated with a healthier cardiovascular risk profile, such as less diabetes, lower blood pressure, lower LDL cholesterol (bad cholesterol) and higher HDL cholesterol (good cholesterol). However, reality may tell a different story. We had long believed that hormone replacement therapy in women would protect against heart attacks and strokes. Estrogens help lower cholesterol and have other beneficial effects. However, it was not until a major study involving about 27,000 women chosen at random to receive hormone replacement therapy or a sugar pill that we learned that there was … Continue reading
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