Testosterone is not a preventive medicine
Advertising increasingly claims that testosterone prevents heart disease, lowers cholesterol or treats diabetes. In reality, TRT is not a general treatment to prevent heart disease or diabetes. It treats hormone deficiency, requires a clinical indication and needs safety monitoring.[1]
At the same time, the long-standing fear that testosterone causes heart attacks and strokes has received a clearer answer from large studies in recent years.
Why the distinction matters
It is important to separate treating deficiency from claims of preventing heart disease or diabetes.[1] Believing testosterone prevents disease can lead people to neglect treatments that do have evidence: blood pressure and cholesterol medicines, glucose control and stopping smoking.
Men with chronic conditions such as diabetes or obesity often also have low testosterone. Good care looks at both together, without letting one replace the other.
A low result does not always need treatment
Estimates of deficiency vary with age, illness and diagnostic criteria.[1] Low results are more common in men with obesity or diabetes, but some improve as weight falls and the condition is better controlled.
What the TRAVERSE trial showed
TRAVERSE, published in the New England Journal of Medicine in 2023, studied 5,246 men aged 45–80 with low testosterone and either cardiovascular disease or high risk. They were randomised to testosterone gel or placebo gel and followed for about 33 months on average.[3]
- Major cardiovascular events (cardiovascular death, heart attack, stroke) were no different from placebo: 7.0% versus 7.3%.[3]
- Some events were slightly more frequent with testosterone: atrial fibrillation, acute kidney injury and pulmonary embolism.[3]
Testosterone also changes body composition and some blood measures, such as raising red cells, but changes in blood markers do not prove that disease is prevented.[1],[2]
What is assessed in people with chronic disease
Deficiency is confirmed first. The doctor then assesses cardiovascular disease, blood pressure, any history of blood clots, haematocrit and other conditions.[1],[2] Men with a recent heart attack or stroke, uncontrolled heart failure or previous clots need especially careful consideration.
Latest safety information and proper care
The US Food and Drug Administration (FDA) updated testosterone safety information and labelling in 2025, removing the boxed warning about cardiovascular risk while adding a warning about increased blood pressure, and further labelling changes were requested in 2026.[2] Blood pressure and haematocrit monitoring therefore remain essential.
The core of chronic disease care remains standard treatment of cholesterol, glucose and blood pressure, physical activity and stopping smoking. TRT does not replace this care.[1],[2]
Importantly, TRAVERSE studied only men with genuine deficiency on standard doses. It does not establish that testosterone prevents heart disease, nor that higher-than-natural doses, such as those used for muscle building, are safe.[1],[3]
How we care for you at Dr. Kris Clinic
As family physicians, we look after hormone problems and chronic conditions together. Anyone interested in TRT has their cardiovascular risk, blood pressure, glucose and cholesterol assessed, and if a chronic condition is present we help improve its care too, rather than offering hormones instead.
If testosterone treatment is chosen, we monitor blood pressure and haematocrit regularly and explain the latest research honestly, in English or Thai.
Frequently asked questions
Does testosterone increase the risk of heart attack?
TRAVERSE found no increase in major cardiovascular events in men with genuine deficiency, but slightly more atrial fibrillation and pulmonary embolism.
Can testosterone treat diabetes?
No. Diabetes control still depends on standard treatment, diet and exercise.
Is testosterone safe as an anti-ageing treatment?
It is not recommended for men who are not deficient. Safety findings apply only to diagnosed men on appropriate doses.
I have heart disease. Can I use TRT?
Some men can, after careful assessment. A recent heart attack or stroke, or uncontrolled heart failure, needs particular caution.
TRAVERSE is reassuring about cardiovascular safety in men with genuine deficiency, but it does not show that testosterone prevents heart disease, or that higher-than-natural doses are safe.[1],[3] Standard chronic disease care remains the most important step.
Talk to a doctor about this
Confidential care in Surat Thani, the mainland gateway to Koh Samui, Koh Phangan and Koh Tao. Tue–Fri 17:00–20:00 · Sat–Sun 10:00–15:00 (UTC+7)
Book a visit LINE @dr.krisclinic WhatsAppYour appointment is confirmed once the booking system or the clinic confirms it.
Dr. Krida Uakridathikarn (Dr. Kris)
Board-certified family physician with certificate training in clinical sexology and sexual medicine. He works at Suratthani Hospital and provides sexual health, hormone and LGBTQ+ inclusive care at Dr. Kris Clinic. Profile and CV
References
- EAU Guidelines 2026: Male Hypogonadism
- FDA: Testosterone Information; June 2026 labelling update
- Lincoff et al. TRAVERSE. N Engl J Med. 2023. doi:10.1056/NEJMoa2215025
Keep reading
Main guide: Men's sexual health
Low Testosterone: Symptoms and How It Is Properly Diagnosed
Tests Before Starting Testosterone Therapy (TRT)
Testosterone Injections or Gel: How They Differ and How to ChooseThis article is general education, not personal medical advice or a promise of results. Diagnosis and treatment require assessment by a doctor. Content reflects the cited sources as of the update date.