Testosterone Replacement Therapy (TRT) and the Heart

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Testosterone Replacement Therapy (TRT) and the Heart

The MisconceptionTestosterone Replacement Therapy (TRT) Heart

Historically, a major concern about testosterone replacement therapy was that it was potentially harmful to the heart. Testosterone has traditionally been regarded as a hormone that is harmful to the heart.    

Why the Misconception?

This misconception stems from the belief that testosterone causes heart disease. Additionally, the high doses of testosterone used by bodybuilders can damage the heart, leading to a variety of diseases and often necessitating surgery   to correct one or more problems.


Based on certain research reviews, physiological doses (replacement doses) of testosterone do not equate to a higher risk of atheroscelorosis or coronary artery disease.1-3 Other reviews conclude that treating a healthy man with normal replacement doses of testosterone is as likely to reduce coronary artery disease, as it is to increase it.4-7 However, no high-quality, randomized controlled trials have been performed to definitely determine the effect of TRT on heart disease risk.


Concerns about cardiovascular side effects should not prevent you from considering testosterone replacement therapy. The decision to begin TRT should be made after thoughtful consideration and discussion with your physician. And, once you have begun TRT, your physician should closely monitor your cardiovascular health.

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2. Wu FC, von Eckardstein A. Androgens and coronary artery disease. Endocr Rev. Apr 2003; 24 (2): 183-217.
3. Rhoden EL, Morgentaler A. Risks of testosterone-replacement therapy and recommendations for monitoring. N Engl J Med. Jan 2004; 350 (5): 482-492.
4. Barrett-Connor EL. Testosterone and risk factors for cardiovascular disease in men. Diabete Metab. Jun 1995; 21 (3): 156-161.
5. Alexanderson H, Stenström CH, Lundberg I. Safety of a home exercise programme in patients with polymyositis and dermatomyositis: a pilot study. Rheumatology (Oxford). Jul 1999; 38 (7): 608-611.
6. English KM, Steeds R, Jones TH, Channer KS. Testosterone and coronary heart disease: is there a link? QJM. Dec 1997; 90 (12): 787-791.
7. D. C. Androgen therapy in the aging male: assessing the effect on heart disease. 1999; 2: 1-6.