Stillpoint Integrative Men’s Health
Testosterone and Heart Disease: What the Science Really Shows
The Concern: Testosterone and Heart Disease
When men begin testosterone replacement therapy (TRT)—or as we often call it, testosterone optimization therapy (TOT)—one of the first concerns that arises is heart health.
You’ve probably heard commercials warning about cardiovascular risks or seen headlines linking testosterone therapy to heart attacks.
Let’s explore where this idea came from—and what the latest research actually shows.
Where the Controversy Began
In 2013 and 2014, two studies suggested that men starting testosterone therapy experienced a higher rate of cardiovascular events such as heart attacks and strokes.
The media quickly amplified these findings, and the FDA responded by issuing a cautionary warning about testosterone therapy.
However, both studies were later found to have serious design flaws:
- One study eventually published a correction, showing the opposite—that men receiving TRT had a 50% lower risk of cardiovascular disease.
- The other study did not include a proper control group, making its conclusions unreliable.
As a result, medical organizations began re-evaluating the evidence.
What Experts Say Today
Following these flawed reports, both the American Association of Clinical Endocrinology (AACE) and the American College of Endocrinology (ACE) reviewed the available data.
Their conclusion:
There is no conclusive evidence that testosterone therapy increases the risk of cardiovascular disease.
In other words, TRT is not proven to cause heart problems, and when prescribed responsibly, it may actually support overall cardiovascular health.
The Good News: Healthy Testosterone Supports a Healthy Heart
More recent studies show that men with optimal testosterone levels often have lower rates of heart disease and better cardiovascular outcomes.
Low testosterone, on the other hand, has been linked to increased inflammation, insulin resistance, and arterial plaque—all of which can raise heart risk.
Here are a few key studies:
- Ohlsson et al., 2011: Found that men with higher serum testosterone levels had a reduced risk of cardiovascular events over five years.
- Akishita et al., 2010: In a study of 171 men, those with low testosterone were more likely to experience cardiovascular events.
- Cheetham et al., 2017 (JAMA): Reviewed 8,808 men on TRT over 3.4 years and found lower rates of heart disease compared to untreated men.
Across multiple studies, the pattern is consistent—normalizing testosterone levels appears to protect heart health, not harm it.
Why It’s Complicated
Cardiovascular disease has many contributing factors: genetics, blood pressure, cholesterol, inflammation, and lifestyle.
Because of this complexity, it’s difficult for any single study to prove beyond doubt that testosterone directly affects heart outcomes.
Still, the growing body of evidence points to a neutral or even beneficial relationship between healthy testosterone levels and heart health.
The Clinical Perspective
At Stillpoint Integrative, we share the view of the AACE and ACE:
Testosterone therapy should be considered in men who are symptomatic and clinically low, and there is no compelling evidence that TRT increases cardiovascular risk.
Our approach emphasizes personalized care and careful monitoring. We assess baseline labs, cardiovascular health markers, and overall well-being throughout treatment to ensure both safety and optimal benefit.
The Bottom Line
Current evidence does not support the claim that testosterone therapy causes heart disease.
In fact, restoring testosterone to healthy levels may improve heart function, metabolism, and overall vitality when guided by an
experienced provider.
If you’re experiencing fatigue, low libido, or loss of motivation—and have concerns about TRT and heart health—schedule a consultation with Stillpoint Integrative.
We’ll help you make an informed, evidence-based decision about your care.
To understand how testosterone therapy fits safely within a holistic men’s health approach, visit our Testosterone Optimization Therapy overview page.
Frequently Asked Questions About Testosterone and Heart Health
Does testosterone therapy increase the risk of heart disease?
No. The majority of modern research shows that testosterone replacement therapy (TRT) does not increase the risk of cardiovascular events. In fact, several large studies have found that men with optimized testosterone levels have a lower risk of heart disease compared to those with untreated low testosterone.
Can testosterone therapy improve heart health?
Healthy testosterone levels support heart function by improving energy metabolism, reducing inflammation, and helping maintain lean muscle mass. Some studies suggest TRT may improve blood vessel flexibility and reduce cardiovascular risk factors when used under medical supervision.
Is TRT safe if I already have heart disease?
Men with stable cardiovascular disease can often receive testosterone therapy safely, provided they are closely monitored. At Stillpoint Integrative Psychiatry & Wellness, we evaluate each patient’s individual cardiovascular profile before beginning TRT and track ongoing labs and vitals to ensure safety.
What heart-related labs or markers are monitored during TRT?
We routinely monitor hematocrit, lipid profile, blood pressure, and inflammation markers, along with hormone levels, to ensure your cardiovascular system stays balanced and healthy throughout treatment.