Testosterone Therapy and Heart Risk in Women: What the Evidence Means

Reports linking treatment for low sexual desire in women with higher rates of heart attack and stroke have raised questions about testosterone therapy and cardiovascular safety. The headline matters, but it does not identify the exact treatment, dose, formulation, study design, or absolute risk. It also does not prove that treatment caused the reported events.

A Fox News report described an association between treatment for low sexual desire and higher rates of heart attack and stroke Source 1. An AARP summary specifically identified testosterone therapy and increased heart risks in older women Source 3.

The available summaries do not provide the study’s full methods, sample size, follow-up period, participant characteristics, comparison group, treatment formulation, dose, route, or statistical results. Women should not stop prescribed treatment without consulting the prescribing clinician.

What Treatment Is Being Discussed?

Low sexual desire can have many causes, including:

• Menopause and other hormonal changes
• Vaginal dryness or pain
• Stress, anxiety, depression, or relationship concerns
• Poor sleep and fatigue
• Chronic illness, diabetes, or obesity
• Thyroid disorders
• Prescription medications
• Cancer treatment or other major medical events
• Caregiving demands

An evaluation should determine whether the primary problem involves desire, arousal, pain, orgasm, mood, medication effects, or another health condition. Treatment should address the underlying cause rather than assume that every case reflects a hormone deficiency.

Testosterone therapy

Clinicians may consider testosterone for selected postmenopausal women with persistent, distressing low sexual desire after a clinical assessment. Testosterone is not appropriate for everyone with low libido, and a testosterone blood level alone does not establish the cause.

Potential cardiovascular effects may vary with the formulation, route, dose, duration, age, menopausal status, medications, and existing health conditions. The supplied reports do not provide enough information to determine which product or dose was studied.

What the Reported Association Means

The central claim is that women who received treatment for low sexual desire had higher rates of cardiovascular events, including heart attack and stroke, than a comparison group. The correct terms are “associated with” or “linked to.” These describe a relationship in observed data; they do not establish causation.

Women who receive treatment may differ from those who do not. Relevant confounding factors include age, blood pressure, cholesterol, diabetes, obesity, smoking, existing cardiovascular disease, other medications, access to preventive care, baseline health, and frequency of medical visits.

Observational studies can identify patterns but generally cannot establish cause and effect as reliably as well-designed randomized clinical trials. Absolute risk is also important. An increase from 1 event per 1,000 women to 2 events per 1,000 women is a 100% relative increase but only a 1-in-1,000 absolute difference.

Readers should look for the study size, participant age, treatment product, dose, route, follow-up duration, comparison group, confirmed outcomes, statistical adjustments, and absolute event rates.

How Testosterone Could Affect Cardiovascular Health

Depending on the product and dose, testosterone may affect blood pressure, cholesterol, blood clotting, blood sugar, fluid retention, body composition, and red blood cell production. These possible mechanisms do not explain the reported study unless the researchers demonstrated them. They show why treatment requires medical supervision and periodic reassessment.

Before starting or continuing therapy, a clinician may review:

• Blood pressure
• Cholesterol and blood sugar
• Smoking history and weight
• Personal and family cardiovascular history
• Current medications
• History of blood clots
• Liver and other relevant health conditions

High cholesterol, hypertension, diabetes, smoking, obesity, physical inactivity, age, family history, and existing cardiovascular disease can all contribute to heart attack and stroke risk. The CDC lists multiple cholesterol risk factors and prevention measures Source 5.

Symptoms Requiring Emergency Care

Possible heart attack symptoms include chest pressure or discomfort, shortness of breath, pain in the arm, back, neck, jaw, or upper abdomen, unusual fatigue, nausea, dizziness, sweating, and weakness. Symptoms can vary, and a possible heart attack requires immediate medical evaluation.

Stroke warning signs include facial drooping, weakness or numbness on one side, trouble speaking or understanding speech, sudden vision changes, loss of balance, or a sudden severe headache. Call emergency services immediately. Do not drive yourself or wait for symptoms to disappear.

Research and care gaps can contribute to under-recognized cardiovascular symptoms and incomplete risk assessment in women. The Conversation discusses these sex and gender gaps Source 7.

What to Discuss With a Clinician

Ask about:

• The likely cause of low sexual desire
• Whether testosterone or another treatment is appropriate
• Expected benefits and alternatives
• Personal cardiovascular risks
• The proposed formulation, dose, and duration
• Baseline testing and monitoring
• When treatment should be reassessed
• Nonhormonal options

Monitoring may include blood pressure, cholesterol, blood sugar, liver function, hormone levels when clinically appropriate, symptoms, and side effects. Possible treatment-related concerns include acne, unwanted hair growth, scalp hair thinning, voice changes, mood changes, and menstrual changes in women who still menstruate.

Do not abruptly stop or change prescribed treatment based only on a news report. Contact the prescribing clinician to review the evidence, treatment purpose, dose, duration, and monitoring plan. A second opinion may help when the benefits or risks remain unclear.

Reducing Cardiovascular Risk

Heart attack and stroke prevention includes:

• Eating a balanced diet lower in saturated and trans fats
• Exercising according to individual ability
• Avoiding tobacco
• Managing weight, diabetes, and blood pressure
• Completing recommended cholesterol screening
• Taking prescribed cardiovascular medicines as directed
• Limiting alcohol when advised
• Prioritizing adequate sleep

Sexual health care should also address vaginal pain or dryness, medication effects, depression or anxiety, poor sleep, relationship concerns, thyroid problems, metabolic conditions, and menopause-related changes.

Conclusion

The reported link between treatment for low sexual desire and higher rates of heart attack and stroke warrants careful clinical discussion, not automatic discontinuation. The available summaries do not establish which treatment was studied, whether the finding was causal, or whether it applies to every woman or every testosterone product.

The decision to start or continue therapy should balance expected sexual health benefits with individual cardiovascular risk, treatment formulation, dose, duration, and monitoring requirements.

FAQ

Does testosterone therapy cause heart attacks or strokes in women?

The supplied reports describe an association, not definitive proof that testosterone caused the events. Risk may depend on age, dose, formulation, duration, and existing cardiovascular factors.

Is testosterone approved for low sexual desire in women?

Approval and guidance vary by country and formulation. Clinicians may consider it for selected postmenopausal women with persistent, distressing low sexual desire. Use only under medical supervision.

Should women stop testosterone after hearing about the study?

No. Contact the prescribing clinician before stopping or changing treatment. Seek emergency care for possible heart attack or stroke symptoms.

What increases cardiovascular risk in women?

Major factors include high blood pressure, high cholesterol, diabetes, smoking, obesity, inactivity, older age, family history, and existing cardiovascular disease.

How can women address low libido while reducing cardiovascular risk?

Complete recommended screening, exercise, eat a heart-healthy diet, avoid tobacco, manage chronic conditions, and evaluate nonhormonal causes and treatments alongside any hormone therapy.