Meditech Pharma

Men with low testosterone are at greater risk of dying prematurely from heart disease and other causes, researchers warn.

They found almost twice as many men with low levels of the male hormone died, compared to those with normal levels.

And their research suggests that many men at risk of heart disease would benefit from testosterone replacement therapy such as patches, injections and gels.

The experts tracked the progress of almost 1,000 men with coronary heart disease for around seven years.

Low testosterone affected one in four and was an independent risk factor for early death.

Professor Kevin Channer, of Sheffield’s Royal Hallamshire Hospital department of cardiology, said the finding refutes fears that testosterone might actually cause heart problems.

Although high doses of testosterone in anabolic steroids used by bodybuilders are known to damage health, the latest study suggests deficiency can be just as harmful. Professor Channer said: ‘There is ongoing debate over the risk-benefit ratio of testosterone replacement in patients who are deficient, and there is still concern among doctors it might increase the risk of vascular disease.

‘Short-term studies show improvements in cardiovascular health, even in men with lower than average testosterone levels – and men feel much better when they are taking it.’

Testosterone is a key male hormone responsible for sex drive, sperm production and muscle tone but its production declines gradually in middle age.

Some doctors dismiss the fashion of men taking it to ward off ageing and increase their sex drive. But there has been a huge increase in demand for treatment as more than a million men in the UK have some kind of problem with erectile dysfunction.

Patches, injections, skin gels, creams and oral capsules are all used to treat testosterone deficiency, many by private clinics offering a male menopause service. Testosterone products are wrongly regarded as ‘sex aids’ although they can boost libido and improve a man’s response to drugs such as Viagra.

In the latest study, 930 men with coronary heart disease who were referred to a specialist heart centre between 2000 and 2002 had their testosterone levels checked and health monitored for seven years.

Those most at risk had abnormally low levels – known as hypogonadism – rather than the natural reduction which occurs with ageing.

During the monitoring period almost twice as many men with low testosterone – one in five – died as did those with normal levels – one in eight – says a report in the medical journal Heart.

Men at high risk of diabetes and heart disease may stand to gain most from testosterone replacement, said Professor Channer.

‘Physiological testosterone replacement is an inexpensive and well-tolerated therapy but does require careful monitoring.’

But there are risks to replacement therapy including prostate cancer, claims Dr Ronald Ma of the Chinese University of Hong Kong in an accompanying editorial.

A recent trial of 800 men over 50 at the University of California San Diego showed having low testosterone raises the risk of death from heart disease.