Study links testosterone use without documented deficiency to higher heart risk

Men using testosterone without documented evidence of hormone deficiency had higher rates of serious cardiovascular problems than users treated for confirmed deficiency in an observational study. The findings show an association between prescribing context and later outcomes, not proof that the hormone itself caused the difference.

Researchers examined electronic health records from 123 healthcare organisations. Nearly 359,000 men aged 30 to 75 were identified as testosterone users, and roughly a third had no recorded evidence of hypogonadism, the medical term for insufficient testosterone production.

After comparing groups with similar recorded characteristics, researchers found that users without documented deficiency had about a 50% higher risk of major cardiovascular problems over follow-up of up to ten years. Their risk of death from any cause was also higher. These comparisons were between two groups taking testosterone, not between users and people taking none.

Important uncertainties remain. Medical records may not capture every diagnosis, lifestyle factor or reason for treatment. Unmeasured differences between the groups could influence the results, and the study cannot establish cause and effect.

The report supports a full clinical assessment before starting testosterone rather than using it simply for general energy or ageing concerns. Decisions about beginning, continuing or changing treatment should be made with a clinician who can assess the indication, cardiovascular risks and monitoring needs.