Testosterone replacement therapy (TRT) is typically the first line of treatment for low testosterone. Low testosterone (known informally as low T and medically as hypogonadism) is a condition that occurs when the body doesn’t produce enough of the testosterone hormone or has a decreased ability to make sperm (or both). In adults, this disorder can result in embarrassing and inconvenient issues, including:
- Decreased body hair production
- Decreased muscle mass
- Erectile dysfunction (ED)
- Growth of breast tissue (gynecomastia)
- Infertility
- Loss of bone mass (osteoporosis)
Up until recently, TRT has come under fire for increasing the risk of cardiovascular (CV) events, such as stroke or heart attack, due to the complexities in how testosterone interacts with the CV system. In fact, in 2015, the Food and Drug Administration (FDA) began requiring companies that manufacture approved TRTs to include labels explaining the coronary risks of the therapy.
So, what changed?
A few studies have come out in the past couple of years indicating that TRT may not be as dangerous for the CV system as previously thought. Some research is now suggesting that low testosterone levels in older adults are the culprit for increased CV risk and that TRT may actually reduce that risk.
In a study recently published in JAMA Internal Medicine, 44,335 male patients diagnosed with androgen deficiency (a low level of sex hormones, including testosterone) between January 1, 1999 and December 31, 2010 were evaluated. Of them, 8,808 were treated with TRT and 35,527 were not. After following the men for an average of 3.4 years, researchers discovered:
- Among the men who never received TRT, 10.2 percent had a heart attack or stroke during the study period
- Among the men who did receive TRT, 8.2 percent had a heart attack or stroke during the study period
In another study conducted by a research team at the Intermountain Medical Center Heart Institute, elderly males with low testosterone and preexisting coronary artery disease (CAD) who received TRT had a reduced risk of having a CV event.
The research team studied 755 male patients between the ages of 58 and 78—all of whom had severe CAD. They were split into three groups, receiving varied doses of testosterone administered either by injection or gel.
The study revealed that:
- After one year, 64 patients who did not have TRT suffered serious CV events, while only 12 who were taking moderate doses of testosterone and nine who were taking high doses did
- After three years, 125 patients who did not have TRT suffered major adverse CV events, while only 38 moderate-dose and 22 high-dose patients did
What’s the bottom line?
Though more research needs to be done to change the minds of the many (including the FDA), current findings continue to make TRT a less disconcerting treatment option for men living with the effects of low testosterone.
Meet the Testosterone Specialists
At Partners In Urology, we have a great deal of expertise in using TRT and other treatment modalities to effectively treat low testosterone. With over 25 years of experience, we put our patients needs first, treating them with care and dignity.
For more information or to schedule an appointment, contact us today.
