From the Guidelines
High testosterone levels are not typically associated with increased cholesterol levels, particularly when testosterone replacement therapy is used within the physiologic range. The relationship between testosterone and cholesterol is complex, and the body uses cholesterol to produce testosterone naturally. However, when testosterone levels become elevated beyond normal physiological ranges, it can potentially impact lipid profiles. According to a study published in the New England Journal of Medicine 1, most studies show no change in lipid alterations with physiologic replacement doses of testosterone. Another study 1 found that testosterone-replacement therapy within the physiologic range is not associated with worsening of the lipid profile.
Some key points to consider:
- Testosterone replacement therapy may have minimal effects on lipid profiles when used within the physiologic range 1.
- Supraphysiologic doses of androgens, particularly oral nonaromatizable androgenic steroids, may lower high-density lipoprotein (HDL) levels 1.
- Lifestyle factors like diet, exercise, and maintaining a healthy weight remain important for managing cholesterol levels even when testosterone levels are being addressed.
- Men on testosterone therapy should have their cholesterol levels monitored regularly, typically every 3-6 months during treatment.
It's essential to note that the effects of testosterone on cholesterol levels can vary depending on the dosage and mode of administration. Regular monitoring of cholesterol levels and lifestyle modifications can help mitigate any potential negative effects of high testosterone levels on cholesterol. Overall, the current evidence suggests that high testosterone levels, when achieved through physiologic replacement therapy, are not typically associated with increased cholesterol levels 1.
From the Research
Testosterone and Cholesterol Relationship
- The relationship between testosterone and cholesterol is complex, and research has yielded mixed results 2, 3.
- Some studies suggest that higher testosterone levels are associated with higher HDL-cholesterol and lower triglyceride concentrations in older women 4.
- In men, the relationship between testosterone and HDL-cholesterol is positive, but this association may not be causal 3.
- Testosterone therapy has not been shown to mitigate cardiovascular disease risk, and may even increase it in certain groups of men 2.
Effects of Testosterone on Lipids
- Testosterone has been shown to have varying effects on lipids, including increasing HDL-cholesterol and decreasing triglycerides in older women 4.
- In men, testosterone has been associated with increased HDL-cholesterol, but this relationship is influenced by factors such as obesity and age 3.
- The use of statins to lower LDL-cholesterol has been shown to decrease testosterone levels and contribute to erectile dysfunction in hypercholesterolemic male patients 5.
Cardiovascular Disease Risk
- The relationship between testosterone and cardiovascular disease risk is not fully understood, but research suggests that testosterone therapy may increase cardiovascular disease risk in certain groups of men 2.
- Higher testosterone levels have been associated with a less atherogenic profile in older women, but this relationship is complex and influenced by multiple factors 4.
- Further research is needed to fully understand the relationship between testosterone, cholesterol, and cardiovascular disease risk 2, 6.