Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass.
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Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in treating heart failure, angina, and myocardial ischemia. A large, prospective, long-term study of T replacement, with a primary endpoint of a composite of adverse cardiovascular events including myocardial infarction, stroke, and/or cardiovascular death, is needed. The Food and Drug Administration recently put additional restrictions on T replacement therapy labeling and called for additional studies to determine its cardiac safety.
Journal of the American College of Cardiology. 2016 Feb 09 [Epub]
Robert A Kloner, Culley Carson, Adrian Dobs, Stephen Kopecky, Emile R Mohler
Huntington Medical Research Institutes, Pasadena, California; Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine at University of Southern California, Los Angeles, California. Department of Urology, University of North Carolina, Chapel Hill, North Carolina. , Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland. , Division of Cardiology, Mayo Clinic, Rochester, Minnesota. , Section of Vascular Medicine, Division of Cardiovascular Disease, Perelman School of Medicine at the University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania.