Is Testosterone Replacement Good or Bad?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
Posted on

The news flash many folks saw recently was that testosterone replacement caused a 35% increase risk of heart attack. Given results of this and another recent study, the FDA has stepped in to investigate. If you are a man on testosterone replacement do you need to worry?

The FDA is currently evaluating the risk of stroke, heart attack, and death in male patients taking FDA-approved testosterone products. The FDA stepped in because of two studies that suggested an increased risk of cardiovascular events among male patients prescribed testosterone therapy. While it has certainly not been firmly concluded that approved testosterone treatment increases the risk of stroke, heart attack, or death you need to know you are using testosterone replacement for the right reasons and you need to be aware of these risks.

Testosterone therapy is heavily marketed to the consumer (you). Despite folks hearing that it is the fountain of youth it has risks, as we’ve seen, and is not to be used by everyone. In men with symptoms (low libido, anemia, etc) with low (< 200) testosterone levels you may talk to your doctor about whether the benefits for you outweigh the risks. If you are older and have a known history of heart disease it’s looking strongly like the risks outweigh the benefits.

Even if you do have low-T and your doctor has decided on replacement, he/she has to closely monitor your dose and response to testosterone. We are guessing that part of the reason for the higher rates of heart attack and stroke seen is that testosterone may contribute to clot formation by raising the hemoglobin (red blood cell count) among other things.

It is not the fountain of youth but it can improve symptoms in men with low-T. Buyer beware.

Dr O.

Drugs featured in this story

Filed under