Is testosterone therapy good

   The difference in sex hormone concentrations between men and women has been linked to sex differences in the risk of cardiovascular disease. Endogenous estrogen are believed to have a protective impact on the vasculature in premenopausal women, delaying the start of cardiovascular disease (ie, the so-called female advantage). On the other hand, pre-menopausal women (such those with polycystic ovarian syndrome)1 and post-menopausal women2 have been linked to higher cardiovascular risk due to a more androgenic (so-called male-like) sex hormone pattern. Therefore, it has been hypothesized that some of men's elevated age-adjusted cardiovascular event rates relative to women may be due to higher testosterone concentrations in their bodies. The big question: Is testosterone good or bad for the heart health of men?Men's bioavailable testosterone levels gradually decrease as they age at a rate of roughly 2% every year. 3 The term "andropause" or "male menopause" has been used to describe this age-related reduction. Low endogenous testosterone levels have been linked in epidemiologic studies to increased cardiovascular risk in males. 4 Numerous negative cardiometabolic effects, including inflammation, insulin resistance, dyslipidemia, and atherosclerosis, have been linked to low testosterone levels. 

    The usage of testosterone replacement Furthermore, gen this issue of The Lancet Healthy Longevity, Jemma Hudson and colleagues10 performed a meta-analysis of 35 placebo-controlled trials of testosterone replacement therapy that included 5601 men with low baseline testosterone concentrations (12 nmol/L [350 ng/dL]), and 17 of these trials had individual patient-level data available. Their goal was to provide insight into this clinical conundrum. The average treatment time was 9 months and 5 days. Reassuringly, there was no substantially higher risk of cardiovascular events during this brief follow-up between the testosterone replacement therapy group and the placebo groups (odds ratio 107 [95% CI 081-142]; p=062). Furthermore, no specific subgroup was shown to have a markedly elevated risk of cardiovascular events after receiving testosterone replacement treatment. Participants in the trials were 65 years old on average (SD 11), indetically pre% of the participants had previously experienced a myocardial infarction. However, there was no proof of a treatment-by-baseline cardiovascular status or age interaction.

     The authors deserve praise for doing the greatest individual-level study of testosterone studies to date. The association between testosterone replacement therapy and several subtypes of cardiovascular disease and non-cardiovascular outcomes, as well as alterations in a number of physiological markers, was examined by the authors (ie, glycaemia, blood pressure, haematocrit, and lipids). Although the authors claim that testosterone replacement therapy significantly lowers triglycerides, high-density lipoprotein cholesterol, and total cholesterol, it should be noted that these changes were relatively minor—for instance, there was only a 3% difference in low-density lipoprotein cholesterol concentrations.dicted greater testosterone concentrations are linked to an increased risk of heart failure in men, according to Mendelian randomisation studies.  Due to potential elevated cardiovascular risks, the US Food and Drug AdministraMeta-analyses are only as good as the underlying data that are accessible, despite the fact that their analysis is comforting for safety. Unfortunately, due to the follow-up period being too little, the data are still insufficient to draw conclusions on the results. There was minimal evidence to support cardiovascular safety beyond a 12-month period, but the duration of the trials ranged from 3 months to 3 years, and the results were unaffected by integrating follow-up time in the models. Longer follow-up will be required in future trials.

The TRAVERSE trial is an ongoing testosterone replacement treatment cardiovascular outcome study (NCT03518034). 5246 males between the ages of 45 and 80 who had low serum testosterone levels (300 ng/dL), at least one sign or symptom of hypogonadism, and either had a known cardiovascular risk were participated in this study issued a warning in 2014 advising against using testosterone replacement treatment for aging-related low testosterone; it was instead advised to save this sort of medication for symptomatic hypogonadism. Many hypogonadically affected men who could benefit from testosterone replacement treatment may unintentionally be discouraged from seeking it out since the findings are still ambiguous.reatment has been shown to alleviate erectile dysfunction, increase desire, and improve mood, energy levels, and physical strength. However, when testosterone replacement medication is administered to older men, a number of observational and clinical trial studies5, 6, 7 (but not all8) have revealed a potential elevated cardiovascular risk. Furthermore,  randomization research has shown that genetics predicted higher.

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