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Updated: May 7, 2026
Combining Behavioral Endocrinology and Experimental Economics: Testosterone and Social Decision Making
Published on: March 2, 2011
Beneficial and adverse effects of testosterone on the cardiovascular system in men
Johannes B Ruige1, D Margriet Ouwens, Jean-Marc Kaufman
1MD, PhD, Department of Endocrinology, Ghent University Hospital, De Pintelann 185, B9000 Gent, Belgium. jean.kaufman@ugent.be.
Insights
Low testosterone levels are linked to cardiovascular issues. Testosterone therapy in aging men shows no proven cardiovascular benefits or harms, requiring more research for a cautious approach.
Area of Science:
- Cardiovascular Science
- Endocrinology
- Men's Health
Background:
- Testosterone (T) therapy is common in aging males.
- Understanding the T-cardiovascular system relationship is crucial.
Purpose of the Study:
- To review the relationship between androgens and cardiovascular disease.
- To evaluate the cardiovascular effects of testosterone therapy.
Main Methods:
- Conducted a comprehensive PubMed search (1970-2013).
- Included terms: androgens, cardiovascular disease, T, mortality, myocardial infarction, blood pressure, endothelial function, dyslipidemia, thrombosis, ventricular function, arrhythmia.
- Screened original articles, systematic reviews, meta-analyses, and citations.
Main Results:
- Low endogenous T is associated with increased cardiovascular risk factors (hypertension, dyslipidemia, atherosclerosis, etc.) and impaired ventricular function.
- A modest link exists between low T and cardiovascular disease/mortality.
- Testosterone therapy has not demonstrated cardiovascular benefits or specific adverse effects.
Conclusions:
- A significant knowledge gap exists regarding T and cardiovascular disease.
- A cautious approach to T therapy in aging men is recommended.
- Further adequately powered clinical trials are needed to clarify risks and benefits.
Context:
The widespread use of T therapy, particularly in aging males, necessitates knowledge of the relationship between T and the cardiovascular system.
Evidence Acquisition:
The review is based on a 1970 to 2013 PubMed search with terms related to androgens in combination with cardiovascular disease, including T, dihydrotestosterone, trial, mortality, cardiovascular disease, myocardial infarction, blood pressure, endothelial function, dyslipidemia, thrombosis, ventricular function, and arrhythmia. Original articles, systematic reviews and meta-analyses, and relevant citations were screened.
Evidence Synthesis:
Low T has been linked to increased blood pressure, dyslipidemia, atherosclerosis, arrhythmia, thrombosis, endothelial dysfunction, as well as to impaired left ventricular function. On the one hand, a modest association is suggested between low endogenous T and incident cardiovascular disease or cardiovascular mortality, implying unrecognized beneficial T effects, residual confounding, or a relationship with health status. On the other hand, treatments with T to restore "normal concentrations" have so far not been proven to be beneficial with respect to cardiovascular disease; neither have they definitely shown specific adverse cardiovascular effects. The cardiovascular risk-benefit profile of T therapy remains largely evasive in view of a lack of well-designed and adequately powered randomized clinical trials.
Conclusions:
The important knowledge gap as to the exact relationship between T and cardiovascular disease would support a cautious, restrained approach to T therapy in aging men, pending clarification of benefits and risks by adequately powered clinical trials of sufficient duration.
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