Testosterone therapy has long been questioned for its potential impact on heart health, leaving many men unsure whether treatment is safe. New large-scale studies and expert reviews now suggest that medically supervised testosterone therapy is not associated with an increased risk of heart attack or stroke, reshaping how clinicians evaluate TRT today. *
For years, men considering testosterone replacement therapy (TRT) have faced conflicting messages: low testosterone is linked to fatigue, muscle loss, metabolic dysfunction, and reduced quality of life but testosterone therapy increases heart attack and stroke risk. Men considering Testosterone Replacement Therapy (TRT) have long received conflicting messages. On one hand, concerns persist that testosterone therapy increases the risk of heart attack and stroke. On the other hand, low testosterone is undeniably linked to negative health outcomes such as fatigue, muscle loss, metabolic dysfunction, and a reduced quality of life.
These mixed signals have caused understandable hesitation. However, more recent, higher-quality research is helping clarify what earlier studies could not.*
Old Assumptions vs. What New Research Shows
Early concerns about TRT and cardiovascular risk were largely driven by observational studies and headline-level interpretations that did not always account for baseline health, dosing, or medical supervision.
More recent evidence tells a different story.
A large meta-analysis of interventional studies found that testosterone therapy was not associated with an increased risk of cardiovascular events, including heart attack or stroke, when appropriately prescribed and monitored.*
One of the most influential modern studies is the Traverse trial, a large, randomized trial specifically designed to assess cardiovascular safety in men receiving testosterone therapy. Results demonstrated that testosterone therapy was non-inferior to placebo for major adverse cardiovascular events when used under medical supervision.*
In other words, it was found that men receiving medically supervised testosterone therapy did not experience more heart attacks or strokes than men who were not receiving testosterone. When therapy was prescribed appropriately and monitored by a provider, cardiovascular risk was comparable – not higher – than placebo.*
These findings are supported by expert consensus statements and international endocrinology panels, which now emphasize that cardiovascular risk appears neutral when TRT is prescribed according to clinical guidelines.*
What This Means for Men Considering TRT
The evolving evidence reframes how testosterone therapy should be evaluated.
Fear Based on Outdated Data
Many men have avoided hormone evaluation because of earlier studies that were limited in design or misinterpreted in the media. Newer randomized trials and meta-analyses provide a more balanced and clinically relevant perspective.*
Risk Depends on Medical Oversight
Testosterone therapy is not risk-free but neither is untreated testosterone deficiency. Cardiovascular safety depends heavily on proper patient selection, dosing, and ongoing monitoring.*
Metabolic Health Matters
Low testosterone has been associated with:
- Increased fat mass
- Reduced lean muscle
- Insulin resistance
- Adverse lipid profiles
Clinical reviews and meta-analyses show that testosterone therapy may help support improvements in body composition and metabolic markers in medically qualified men.*
How Revibe Approaches Testosterone Therapy
At Revibe Men’s Health, testosterone therapy is never treated as a shortcut or cosmetic solution.
Our approach includes:
- Comprehensive lab testing to confirm testosterone deficiency
- Cardiovascular and metabolic risk assessment before treatment
- Individualized dosing protocols, not one-size-fits-all plans
- Ongoing monitoring of hormone levels, symptoms, and key health markers
- Integration with nutrition, movement, and metabolic support when appropriate
This approach aligns with current clinical guidance and the strongest available evidence on TRT safety.
What to Do Next
If you’ve avoided testosterone therapy because of concerns about heart risk, current evidence suggests the conversation is worth revisiting — with a qualified provider.
The first step is simple:
Have your testosterone levels evaluated and review your overall health profile.
An informed discussion can help determine whether TRT is appropriate for your goals and medical history – and how to proceed safely if it is.
Sources
Corona, G., et al. (2018). Testosterone and cardiovascular risk: Meta-analysis of interventional studies. The Journal of Sexual Medicine.
https://pubmed.ncbi.nlm.nih.gov/29803351/
Goodman, N., et al. (2015). American Association of Clinical Endocrinologists and American College of Endocrinology position statement on the association of testosterone therapy and cardiovascular risk. Endocrine Practice.
https://pubmed.ncbi.nlm.nih.gov/26355962/
Hackett, G. (2019). Metabolic effects of testosterone therapy in men with type 2 diabetes and metabolic syndrome: A review. World Journal of Men’s Health.
https://pubmed.ncbi.nlm.nih.gov/30803918/
Isidori, A. M., et al. (2005). Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: A meta-analysis. Clinical Endocrinology.
https://pubmed.ncbi.nlm.nih.gov/16117815/
Lincoff, A. M., et al. (2023). Cardiovascular safety of testosterone-replacement therapy. The New England Journal of Medicine.
https://pubmed.ncbi.nlm.nih.gov/37326322/
Zitzmann, M., et al. (2026). Cardiovascular safety of testosterone therapy—Insights from the TRAVERSE trial and beyond: A position statement of the European Expert Panel for Testosterone Research. Andrology.
https://pubmed.ncbi.nlm.nih.gov/40372318/
*This content is for educational purposes only and is not intended as medical advice. Testosterone therapy may not be appropriate for everyone. Treatment decisions should be made in consultation with a qualified healthcare provider based on individual health history and lab results