The increase in prescription testosterone over the last decade has drawn attention to the potential risk of adverse cardiovascular events and the association of testosterone with prostate cancer. Literature has failed to demonstrate the associated cardiovascular risk with testosterone replacement therapy (TRT), with studies suggesting that it may be cardioprotective. The American Association of Clinical Endocrinologists and the American College of Endocrinology's position remains that no evidence suggests TRT is cardioprotective or cardio-destructive. The Food and Drug Administration’s findings were inconclusive but require testosterone manufacturers to label products with possible cardiovascular risk and mandated clinical trials for conclusive evidence. Additionally, the literature does not show a significant correlation of TRT causing prostate cancer, also suggesting that men successfully treated for prostate cancer can safely use TRT with close biochemical monitoring. There have been no published, placebo-controlled, double-blinded clinical studies to directly evaluate the relationship between testosterone replacement therapy (TRT) and cardiovascular risk or TRT and prostate cancer.
Harrington CW. An updated review on the risks of Testosterone Replacement Therapy. Lynchburg Journal of Medical Science. 2023; 5(1).
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