The clinical question about which men should receive testosterone therapy is controversial, with data from short-term clinical trials suggesting benefits for improving sexual function, strength, and well-being. What is missing from the literature are data from randomized trials that include a sufficient number of men for an adequate amount of time to assess the long-term benefits and risks of testosterone therapy. There is no study involving men that is equivalent to the Women’s Health Initiative, nor is it likely that there will be a trial of equal scale. Because testosterone therapy is available and prescribed for an estimated 2.9% of US men aged 40 years or older,1 observational data from existing cohorts of men can contribute meaningfully to assessment of therapeutic risk.
Cappola AR. Testosterone Therapy and Risk of Cardiovascular Disease in Men. JAMA. 2013;310(17):1805-1806. doi:10.1001/jama.2013.280387