Testosterone therapy: What older men should know about heart health risks

For years, doctors have argued about whether older men with low testosterone should use replacement therapy. Many past studies were small or gave mixed results. But in 2023, a major study called TRAVERSE changed the conversation. This research was the first big, well-designed trial to test if testosterone treatments affect heart health in a clear way. Low testosterone happens when the body makes too little of the hormone. Many men over 65 have this issue. Symptoms like fatigue, low mood, and reduced muscle strength often lead to therapy. Yet questions remained about heart risks—until TRAVERSE. The study compared men using testosterone gels or injections to those given placebos. After careful tracking, it found no major extra heart risks from the treatment. Still, some smaller problems like skin irritation popped up more in the therapy group.

Does this mean testosterone therapy is completely safe? Not exactly. The study only looked at short-term effects over a few years. Long-term heart health could still be a concern. Also, the men in the study were mostly healthy at the start. Those with serious heart conditions weren’t included, so risks for sicker patients remain unclear. Doctors now have stronger data to guide their advice. But every patient is different. Side effects like blood clots or sleep apnea can still happen. Weight gain, acne, and mood swings are also possible. Patients should weigh these against the benefits: better energy, stronger muscles, and improved mood. Always discuss options with a doctor before starting or stopping treatment. Older men considering testosterone therapy should ask: What are my biggest health concerns right now? How will this treatment improve—or complicate—my life? The TRAVERSE study answered some questions but left others open. More research will help doctors fine-tune their recommendations.

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