TESTOSTERONE REPLACEMENT THERAPY AND CARDIOVASCULAR EFFECTS

Abstract

Testosterone replacement therapy (TRT) is a therapy aimed at restoring a patient's previous testosterone levels after clinical and laboratory confirmation of hormone deficiency. It is used to maintain or improve the quality of life. Maintenance or gain of muscle mass, bone density, sexual function, and overall well-being are mostly observed during the process. The objective of this review was to synthesize the positive effects and potential adverse effects of testosterone replacement therapy on the cardiovascular system. In this work, after applying inclusion criteria (clinical trial, controlled clinical trial, and observational study) and exclusion criteria (articles outside the topic), a total of 28 scientific articles from the PubMed and Virtual Health Library (VHL) databases were included. Therefore, only clinical trials, controlled clinical trials, and observational studies were used. Testosterone replacement therapy (TRT) offers clear metabolic benefits, such as improved insulin sensitivity, reduced total cholesterol, significant reduction in body fat, and increased muscle mass factors directly associated with a decreased cardiovascular risk in hypogonadal patients. Contradictory results regarding MACE have not been conclusive. Even the two studies that linked TRT to MACE did not contraindicate the therapy, demonstrating its safety and, of course, its effectiveness. Therefore, TRT is a valid and effective option for patients with hypogonadism, especially when clinical symptoms and expected metabolic benefits are present. Even so, treatment should be conducted with extreme caution, with rigorous monitoring, frequent blood pressure checks, blood counts, and periodic cardiovascular evaluations, ensuring that the benefits outweigh the potential risks.