Testosterone replacement therapy or TRT has become an increasingly popular treatment for men dealing with symptoms of low testosterone, also known as hypogonadism.
However, some concerns have been raised over the potential link between TRT and high blood pressure.
For men considering TRT, it’s important to understand how it may impact your cardiovascular health and what the latest research shows about heart risks associated with this treatment.
The Link Between Testosterone and Blood Pressure
The relationship between testosterone levels and blood pressure is complex. Some studies have found that TRT may actually lower blood pressure in men, while other research indicates it could raise blood pressure and lower “good” HDL cholesterol.
Testosterone supplements in large amounts could spike arterial blood pressure, leading to an enlarged left heart ventricle. However, when taken as prescribed under medical supervision, TRT is unlikely to significantly increase blood pressure for most men, though there is a small risk.
The evidence points to an inverse association between low testosterone and high blood pressure, especially in older men where declining testosterone is linked to age.
So for some, TRT may help normalize blood pressure. However, it’s critical to consider how any treatment may affect your heart health and blood pressure. TRT is no exception.
Latest Research on TRT and Heart Risks: Some Good News
One of the biggest concerns about TRT and cardiovascular health has been the potential increased risk of heart attack or stroke. However, the results of an important clinical trial in 2018 helped alleviate some of these fears.
The TRAVERSE trial studied over 5,000 men with low testosterone and heart disease risk factors. After almost two years of treatment, researchers found no significant difference in rates of cardiovascular events like heart attack, stroke, or death from heart disease between men receiving TRT versus a placebo.
This robust study provides some reassurance for men with underlying heart disease who’ve been prescribed TRT but were unsure of the safety.
However, TRT should still only be used under medical supervision to prevent abuse for performance enhancement. TRT does carry risks like worsening prostate cancer or reduced sperm count, so doctors need to carefully weigh the benefits and potential side effects for each patient.
While the TRAVERSE trial’s findings are encouraging, more research is needed to fully understand the cardiovascular impact of long-term TRT and ensure its safe use for those with heart disease.
But the study suggests, at least in the short term, TRT does not appear to increase the risk of serious cardiovascular problems for most men.
Talk to your doctor about your heart health, medical history, and risk factors to determine if TRT may be an option, especially if you have underlying heart disease.
Close monitoring and follow-up are important, but this latest research provides some reassurance that TRT itself does not directly cause or worsen high blood pressure or other heart issues for the majority of men.
Lifestyle, age, and genetics are much more significant contributors to heart risks and high blood pressure over the long run.
Is There a Link Between Testosterone Therapy and Cardiovascular Function?
The relationship between testosterone levels and heart health is complex. While low testosterone has been associated with cardiac risks, there is little evidence it directly causes heart disease.
However, if testosterone therapy could benefit men with heart disease, it may indicate testosterone is safe for cardiovascular function. Only a few small studies to date have explored this link, with mixed results.
Blood vessels and heart muscle cells have receptors for testosterone. Men on androgen deprivation therapy tend to have stiff arteries. In men with atherosclerosis and normal testosterone, short-term testosterone treatment improved blood flow and vessel responsiveness.
If testosterone helps widen blood vessels, it may improve angina in men with coronary artery disease. A 2000 study of 46 men with stable angina and low testosterone tried 12 weeks of a testosterone patch or placebo. The testosterone group showed slightly better exercise tolerance, gaining an average 26 seconds.
A similar 2004 study compared testosterone or placebo injections in 10 men with angina and low testosterone. After 1 month, the testosterone group had a 74-second gain in exercise time with no change in cholesterol.
Another 2004 trial gave 20 men with heart failure testosterone or placebo injections. After 12 weeks, testosterone increased treadmill walking distance 33% and reduced symptoms.
A 2008 study gave 22 men with coronary artery disease and low testosterone either oral testosterone or placebo. Testosterone mildly improved blood flow to healthy heart muscle by widening arteries but not partially blocked ones. It also strengthened heart muscle contractions but did not reduce angina pain and lowered HDL cholesterol.
While limited research suggests short-term testosterone may provide some benefits for heart and blood vessel function, the evidence is not conclusive.
Larger, long-term studies are still needed to fully understand the cardiovascular impacts of testosterone therapy and whether benefits outweigh potential risks like reduced HDL cholesterol or worsening atherosclerosis.
For men with heart disease, testosterone should only be used under close monitoring by your doctor. But for some, it could play a role in improving quality of life and cardiac health when properly prescribed based on your unique medical situation.
Benefits and Side Effects of TRT
When used properly under medical guidance, testosterone replacement therapy can effectively relieve symptoms associated with low testosterone like fatigue, reduced sex drive, mood changes, hair loss, and hot flashes.
However, TRT is not scientifically proven to boost libido, mood, or energy in men with normal testosterone levels.
The long-term effects of TRT are still not fully understood and it should not be used without an established medical need. Testosterone supplements in large amounts could have negative consequences like accelerating prostate cancer growth or decreasing sperm production.
Because testosterone is a male sex hormone, the benefits of TRT for men with low levels can be substantial when properly diagnosed and monitored. Improved mood, sex drive, strength, and metabolism are commonly reported.
However, misuse or abuse of testosterone supplements for performance or muscle enhancement can be dangerous and may have lasting negative health impacts.
TRT can be costly, ranging from several hundred to over a thousand dollars per year depending on the delivery method. Insurance coverage varies, so you need to weigh the benefits of treatment with the financial costs. The risks also depend on your age, medical conditions, and health habits.
For men with hypogonadism, the benefits of TRT when properly prescribed and monitored likely outweigh the risks for most. However, you must be vigilant about regular blood testing and doctor visits to check for potential side effects or health issues as with any long-term therapy.
Be open and honest with your doctor about symptoms, health changes, and any concerns you may have. Together you can determine if TRT is suitable and safe based on your unique situation.
Considerations for TRT
Several factors should be considered when evaluating testosterone replacement therapy as an option. The costs of treatment and potential long-term effects are two of the most important to keep in mind.
The cost of TRT depends on factors like the delivery method (gels, patches, injections), dosage, and duration of treatment. Insurance coverage varies, and treatment may cost several hundred to over a thousand dollars per year.
For some, the expense could be a barrier, while for others the benefits outweigh the costs. It’s a personal decision based on your means and how significantly low testosterone impacts your life.
TRT Long Term Effects
In terms of long-term effects, there are still uncertainties since TRT has only been used for several decades. Some research links TRT to increased risks of prostate cancer, reduced sperm count, and blood clots from high red blood cell levels.
The risks seem to be greater for older men, especially over 65. However, the evidence is not conclusive and when properly monitored risks appear to be small. But as with any long-term therapy, side effects may emerge over time.
The safety of TRT depends on your personal health status and medical history. Discuss any concerns you may have with your doctor regarding your heart health, blood pressure, cholesterol levels, blood cell counts, prostate health, fertility, etc.
Close monitoring through follow-up blood work and exams can help reduce risks. Lifestyle changes may also be recommended to optimize your health and the effects of treatment.
TRT may not be for everyone. Careful consideration of the costs, benefits, risks, and your personal situation is needed before starting treatment.
But for men with low testosterone due to aging or an underlying condition, TRT could significantly improve quality of life when properly prescribed and monitored under medical guidance. An honest and open relationship with your doctor is key to safe and effective treatment.
Contact Physicians Rejuvenation Centers today if you want to know more about TRT, our experts will be happy to assist you.