Is Testosterone and Hormone Therapy Safe for My Heart?

Estrogen and Testosterone are the two primary hormones that have a variety of effects in the body. Estrogen is mainly produced by the ovaries where as testosterone is primary produced by the testes. 

Important functions of these hormones: 

  1. Sexual function
  2. Bone structure
  3. Sleep cycles
  4. Brain health
  5. Body mass

Many people now are aware that as we age, these hormones experience a natural decline which leads to “aging symptoms” to pop up. These can include hot flashes, low libido, and constant fatigue. When these declines are measured using blood tests, your physician or nurse practitioner may prescribe pills, creams, or pellets that contain these hormones. 

However, one question lingers in the minds of many patients and that is...Are these hormone medications safe for my heart? 

Estrogen and testosterone therapy is not without controversy, especially when including estrogen and female patients. For many years, it was very common to prescribe estrogen to women who were looking for relief from hot flashes, vaginal dryness, and other aging related symptoms.However, the Women’s Health Initiative found that the most commonly prescribed hormone, PROGESTIN, which is a synthetic form of the naturally occurring progesterone, was linked to various health outcomes including heart attack and stroke.

If patients are considering estrogen and progesterone therapies, then it is important to use medications that are biologically identical to the hormones found in our bodies. Furthermore, it is important to combine this therapy with a lifestyle update of increasing exercise and maintaining a balanced diet. Finally, it is imperative that you meet regularly with your doctor or prescribing health professional to assess any risks moving forward with this therapy. 

Testosterone therapy

Testosterone levels in men start to decline as young as 20 years old. This decline is more gradual when compared to the female hormones decline. Male patients typically lose 2% of their testosterone levels every year after the age of 20. The symptoms of low testosterone gradually show up and these include decreased beard hair, body hair, loss of muscle mass, low libido, weight gain, and fatigue. 

Similar to estrogen therapy, testosterone can be a hot topic amongst physicians and prescribing health professionals. Several studies have looked at testosterone and heart health. What these studies found was an increase in blood clots and hypertension. However, the men that this study included already had a history of blood clots and hypertension. Therefore, the increased risk cannot be 100% attributed to testosterone treatments. The prevalence of both of these studies’ outcomes gives rise to the back and forth between physicians who advocate for TRT and those who do not.

What is our recommendation? The first step to boost your testosterone is to look at what you can control today. This means an increase in exercise and a well balanced diet low in refined sugars and carbohydrates. Research has shown that these two changes can go a long way in boosting testosterone. However, if your fatigue and low testosterone levels still persist, it may be time to test your levels. Research has shown a clear benefit to libido and other age related symptoms. Although potential risks do exist, the improvement in quality of life can make it valuable to many male patients.

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