RCT2023 · NEJM · Lincoff AM et al.
TRAVERSE: testosterone replacement doesn't raise cardiovascular risk
Who, how long
5,246 hypogonadal (testosterone < 300 ng/dl, symptomatic) men aged 45–80 at high CV risk, 2.8 years
What they found
Transdermal testosterone gel didn't increase major cardiovascular events (7.0% vs 7.3%) — closing the debate opened by the 2014 FDA warning. Sexual function, mood and anaemia improved; fractures, surprisingly, increased.
⚠ Caveat
Applies only to confirmed deficiency with symptoms; atrial fibrillation, pulmonary embolism and acute kidney injury were more common on treatment. It does NOT answer for healthy men with normal testosterone.
Related in the knowledge base
Last reviewed: 6 September 2026
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