Risks of Different Testosterone Preparations: Too Much, Too Little, Just Right

There is a developing story that the increased use of testosterone therapy without a diagnosis of hypogonadism is associated with an elevated cardiovascular risk for some patients. In this issue of JAMA Internal Medicine, Layton and coauthors¹ deepen our knowledge with their analysis of 3 large databases (Truven MarketScan and Medicare cohorts from the United States and the Clinical Practice Research Datalink cohort from the United Kingdom) to ask whether they could detect a difference in cardiovascular or cerebrovascular events and mortality in patients newly prescribed testosterone therapy in the form of injectable testosterone compared with testosterone gels or patches.