Your Questions Answered: Does Testosterone Help or Hurt the Heart? The American Heart Association stated that almost one in three adult men have some type of cardiovascular disease. It is no secret that heart disease in men appears much earlier in life than it does in women. Low testosterone appears to play a role.

Aging induces many changes in hormone levels that have wide ranging effects. Low testosterone is associated with:

  • Increased fat mass
  • Decreased muscle mass
  • High cholesterol
  • Insulin resistance
  • A decline in metabolism
  • Decreased heart function
  • High blood pressure
  • Thickened heart muscle (hypertrophy which is not good)

Therefore, heart failure goes hand in hand with insulin resistance, diabetes and lower muscle mass called sarcopenia. Could testosterone turn things around and does testosterone increase or decrease the risk of cardiovascular disease?

Heart icon wrapped with a doctors stethoscope

A review article analyzed many studies and found little evidence that testosterone causes cardiovascular harm. However, testosterone exhibits some protection for the heart and blood vessels.


  • Reduces inflammatory cytokines – this inflammation damages the heart and blood vessels
  • Reduces vascular cell adhesion molecules that would lead to thickening and hardening of the arteries
  • Dilates blood vessels and makes them better able to contract and relax thereby enhancing blood flow
  • Reduces the factors that cause blood clots
  • Reduces LDL cholesterol that forms plaques
  • Improves insulin sensitivity
  • Reduces fat mass in the internal organs known to increase the risk of heart disease
  • Reduces the ischemia (lack of blood flow and damage to tissues) in men with coronary heart disease

In elderly patients with congestive heart failure, testosterone replacement therapy improves exercise capacity. Furthermore, muscle strength, and glucose metabolism in men with moderately severe Congestive Heart Failure (CHF)

The Mayo Clinic sorted through the main clinical publications over the past 10 years related to testosterone levels, testosterone administration and their impact on the cardiovascular system. The studies showing harm that prompted the FDA to warn about the increased risk of cardiovascular disease when using testosterone therapy, were later found to be critically flawed. Experts, including the American Association of Clinical Endocrinologists and an expert panel regarding testosterone deficiency and its treatment, reported that some of the FDA statements regarding testosterone therapy were lacking scientific evidence.

Overall, they found testosterone:

  • Prevents heart disease
  • Improves exercise-induced myocardial ischemia
  • Dilates the coronary arteries
  • Decreases insulin resistance
  • Testosterone levels are beneficial for the male cardiovascular system
  • Low testosterone concentration is linked to unfavorable metabolic profile and increased cardiovascular risk.

Their conclusion:

  • Normal physiologic levels of testosterone are beneficial to the male cardiovascular (CV) system. Although, testosterone deficiency is associated with an unfavorable metabolic profile and increased CV disease events.
  • The Food and Drug Administration, the American Association of Clinical Endocrinologists/American College of Endocrinology, and an international consensus panel all state that testosterone therapy is safe and reasonable in patients with symptomatic testosterone deficiency.
  • Testosterone treatment should be considered for symptomatic men with clinically confirmed hypogonadism; there is no compelling evidence that testosterone therapy either increases or decreases CV disease risk, and testosterone therapy for men with hypogonadism is effective, rational, and evidence based.

There are a multitude of factors that influence the risk of cardiovascular disease and testosterone production such as obesity, zinc and vitamin D deficiency, insulin resistance, exercise, and the interrelations with other hormones. If you have a high risk of heart disease and are suffering from the symptoms of low testosterone, consider consulting with a functional medicine doctor who can put together all the pieces of the puzzle so you can live healthier longer. Apply for a free no obligation consultation to determine if you are a good fit for our practice.