Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels

American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: A Neuroendocrine Approach to Patients With Traumatic Brain Injury

“…In men, testosterone replacement can be administered as transdermal gels, patches, buccal or subcutaneous pellets, or intramuscular injections (37). As the cardiovascular safety of testosterone replacement in older men, particularly those with cardiovascular disease, has been called into question in recent observational studies, caution is advised before considering testosterone replacement in these groups until more definitive data from clinical trials become available (48,49). Women of premenopausal age who have central hypogonadism can receive estrogen and progestin replacement (if they have an intact uterus) or estrogen replacement only (after hysterectomy), if not contraindicated, based on careful gynecologic evaluation and follow-up.…”

Sexual function and ageing

“…[14] In men with established coronary artery disease using testosterone, the absolute risk of rehospitalisation, death, myocardial infarction and stroke showed an increase of 5.8% over 3 years. [15] While multiple medical risk factors are associated with erectile dysfunction (ED), age is the greatest risk factor. ED is found in 20 -40% of men aged 60 -69 years and increases to 50 -100% in men over 70.…”

Testosterone therapy and cardiovascular risk

“…More recent studies demonstrating that low testosterone in men is inversely associated with CV risk have led to suggestions that testosterone replacement may be beneficial (6). Safety concerns about testosterone came to the forefront after the recent publication of two observational studies suggesting associations of testosterone therapy with adverse CV outcomes (7,8). These studies were widely covered by the media, and cardiologists are likely to see patients with questions about testosterone and CV risk.…”