TL;DR
Turn quiet afternoons into listening time
- Thousands of audiobooks, podcasts and originals
- Listen on your phone, tablet or Echo — also offline
- Cancel anytime
A large retrospective study reported higher rates of cardiovascular events among postmenopausal women who initiated testosterone therapy than among matched women who did not. The researchers and outside experts stressed that the association does not prove testosterone caused the events, and the study lacked details about treatment dose and formulation.
A retrospective study presented at the Menopause Society annual meeting found that postmenopausal women who started testosterone therapy had higher rates of cardiovascular events than matched women who did not receive it. The researchers said the results show an association, not proof that testosterone caused heart disease, and called for prospective studies to investigate the finding.
The study examined women aged 45 and older in the TriNetX electronic health record network. Researchers compared 3,164 women who initiated testosterone therapy with 3,164 matched women who were not exposed to the treatment. Women with prior cardiovascular disease and some other conditions that could complicate the analysis were excluded. Mean follow-up was 2.6 years.
Within five years, the study recorded cardiovascular events in 3.8% of the testosterone group and 0.5% of the comparison group. The composite outcome included coronary artery disease, cerebrovascular disease and heart failure. At 10 years, the reported proportions were 5.3% and 0.5%; in an analysis covering any time after treatment initiation, they were 6.2% and 1%.
For the five-year analysis, the researchers reported a hazard ratio of 8.08 (95% confidence interval 4.72-13.83). They also reported elevated hazard ratios in the 10-year and unrestricted analyses. A separate comparison of women using testosterone alongside menopausal hormone therapy with women using menopausal hormone therapy alone also found an association with higher cardiovascular risk. These statistical findings do not establish that testosterone was the cause.
Why Heart Safety Needs More Study
The findings matter because testosterone is sometimes prescribed to women after menopause, while long-term cardiovascular safety data remain limited. The study raises a safety question for patients and clinicians, but its design cannot determine whether testosterone itself accounts for the difference in event rates. The reported percentages are observations from this particular database and should not be read as an individual patient’s forecast.
The research also points to a gap between what small or short clinical trials can assess and the longer-term effects of treatment in broader groups. Larger, prospective studies could help clarify whether the association persists when researchers can track treatment details and cardiovascular outcomes more directly. Until then, the report is a signal for further investigation, not a definitive conclusion about treatment risk.
As an affiliate, we earn on qualifying purchases.
How Testosterone Is Used After Menopause
There are no FDA-approved testosterone products for women, according to the source report, although some clinicians prescribe low doses of products formulated for men off-label. Evidence that testosterone relieves menopausal symptoms is insufficient overall; some research suggests it may help women with low libido. Those questions about potential benefit are separate from the cardiovascular association reported in this study.
Previous clinical trials of testosterone therapy for menopause have often been small or short and were not designed to measure major cardiovascular events. Lead researcher Xuezhi (Daniel) Jiang, MD, PhD, of Drexel University College of Medicine and Reading Hospital, said his team used a large, multicenter health-record database to examine the issue. The study was retrospective, meaning researchers analyzed existing records rather than assigning treatment and following participants in a controlled trial.
“Our findings suggest that testosterone use is associated with a higher risk of cardiovascular events in postmenopausal women.”
— Xuezhi (Daniel) Jiang, MD, PhD, study lead, speaking to MedPage Today
postmenopausal hormone therapy supplements
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
Limits of the Health Record Data
The analysis cannot show whether testosterone caused the cardiovascular events. Its retrospective design leaves room for residual confounding—differences between groups that were not fully captured or controlled—as well as possible misclassification in health records. The researchers also reported few cardiovascular events overall and a mean follow-up of 2.6 years, shorter than the study’s 10-year and unrestricted outcome windows might suggest.
The database did not record the dose, formulation, route, delivery method or reason for testosterone treatment. That means the researchers could not determine which treatment patterns were associated with the results or assess them specifically for guideline-concordant physiologic-dose transdermal therapy. The findings should not automatically be generalized to all postmenopausal women using testosterone.
cardiovascular risk assessment kits
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
Prospective Research Is Needed
Jiang said the findings should be validated in prospective studies, which could follow participants forward and collect clearer information about treatment and health outcomes. Future research should also examine individual cardiovascular outcomes rather than relying only on the study’s combined measure of coronary artery disease, cerebrovascular disease and heart failure.
The source report does not describe a specific upcoming trial or timeline for further results. For now, the study adds an observational signal to a field with limited long-term safety evidence; it does not settle whether testosterone therapy increases cardiovascular risk.
menopause symptom relief supplements
As an affiliate, we earn on qualifying purchases.
As an affiliate, we earn on qualifying purchases.
Key Questions
Did the study prove testosterone causes heart disease?
No. It was a retrospective observational study, which found an association but cannot establish that testosterone caused the events.
How many women were included?
After matching, the analysis included 3,164 women who initiated testosterone and 3,164 unexposed comparison patients.
What cardiovascular outcomes did researchers count?
The primary composite outcome included coronary artery disease, cerebrovascular disease and heart failure.
Could the researchers identify the dose or type of testosterone?
No. The TriNetX data did not include the dose, formulation, route, delivery method or treatment indication.
What research is needed next?
The researchers called for prospective studies to validate the association, with better treatment information and analysis of individual cardiovascular outcomes.
Source: rss
Fall Picks
fall essentials
As an affiliate, we earn on qualifying purchases.
