EDITORIAL

Cardiovascular effects of testosterone: implications of the "male menopause"?

K S Channer¹, T H Jones²

¹ Royal Hallamshire Hospital, Sheffield, UK
² Barnsley District General Hospital, Barnsley, and Academic Unit of Endocrinology, Division of Genomic Medicine, University of Sheffield, Sheffield, UK

Correspondence to:
Correspondence to:
Dr KS Channer, Royal Hallamshire Hospital, Sheffield S10 3HU, UK;
kevin.channer@sth.nhs.uk

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A relatively low blood concentration of testosterone in the older man may have adverse effects on atherosclerosis, and explain the higher incidence of coronary heart disease in the male

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Keywords: coronary artery disease; testosterone; "male menopause"

Abbreviations: CAD, coronary artery disease; HRT; hormone replacement therapy; SHBG, sex hormone binding globulin

The first 150 words of the full text of this article appear below.

Death from coronary artery disease (CAD) varies by a factor of five in different populations in the world.¹ However, despite these wide differences the ratio of male to female affected individuals remains reasonably constant at more than three to one,¹ and is not explained by differences in the risk factor profile between the sexes.² The lower incidence of CAD in females is particularly prominent in pre-menopausal women, and increases after the menopause.³ This observation spawned the idea that female sex hormones may be protective and that hormone replacement therapy (HRT) may be beneficial. Observational non-randomised epidemiological studies tended to confirm this,⁴ although case controlled studies were less conclusive.⁵ In two published randomised controlled trials,^6,7 combined oestrogen and progestogen HRT was shown to have no benefit and indeed appeared to have deleterious effects. The influence of sex hormones in the pathophysiology of CAD in men has been relatively ignored. Early studies . . . [Full text of this article]

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