While many men will have a reduced level of male sex hormone testosterone as they get older, new research claims using testosterone replacement therapy (TRT) could actually increase the risk of strokes and heart attacks – especially during the first two years of use.
TRT can be administered by skin gel creams or injections to treat issues caused by low testosterone such as androgen deficiency, which in turn can lead to an array of symptoms including reduced sexual desire, hot flushes, body hair loss, reduced muscle mass and strength, breast development and reduced bone mass. Testosterone is an important hormone when it comes to bone and muscle development, production of sperm, prostate function and libido.
For the latest study, which was published in the American Journal of Medicine, researchers analysed a large database of electronic medical records of patients enrolled in primary care practices in the United Kingdom. They formed a cohort of 15,401 men, all over the age of 45, who had low testosterone levels.
It was found men who used TRT had a 21 per cent greater risk of cardiovascular events when compared with nonusers. In fact, TRT users saw an additional 128 events when compared to non-users but the increased risk declined after two years of using the treatment.
“Our findings show that the use of TRT was associated with an increased risk of stroke, transient ischaemic attacks, or cardiac arrest during the first two years of use,” researcher Christel Renoux said in a statement. “There is limited evidence on the long-term clinical benefits of TRT to effectively treat the modestly declining levels of endogenous testosterone levels of ageing but healthy men.”
Researchers recommended clinicians proceed with caution when considering prescribing TRT and discuss the benefits and risks with patients.
The study specifically aimed to study men with low testosterone levels due to ageing and not as a result of secondary causes.
According to researchers, rates of hypogonadism (which is where the sex glands produce little or no sex hormones) have remained stable, but prescriptions for TRT have increased over the past two decades. It’s being increasingly prescribed to treat nonspecific symptoms of ageing including fatigue or a modest decline in sexual functioning.
Researchers added that further large, observational studies need to be conducted to reaffirm the latest results.
“Until such time, the potential cardiovascular risk of TRT should be weighed against the perceived and expected benefits among ageing men, a perspective that aligns with warnings issued by health agencies,” Renoux added.
It’s always important to talk to a health professional about whether TRT is best for you and if the benefits will outweigh the risks.
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