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Cardiovascular and cancer safety of testosterone in women

Davis, Susan R

Current Opinion in Endocrinology, Diabetes and Obesity: June 2011 - Volume 18 - Issue 3 - p 198–203
doi: 10.1097/MED.0b013e328344f449
Androgens: Edited by David Handelsman

Purpose of review To examine the recent data pertaining to the relationships between testosterone and cardiovascular disease (CVD) and cancer in women.

Recent findings Despite the entrenched belief that higher blood levels of testosterone increase the risk of CVD in women, data from recent observational studies mostly show an inverse relationship between testosterone and CVD risk. One pilot study suggests favorable effects of nonoral testosterone treatment of women with established congestive cardiac failure which merits further evaluation. The relationship between endogenous testosterone production and breast cancer risk remains contentious, with recent studies indicating either no relationship, or a possible increase in risk when estrone and estradiol are not taken into account. No randomized controlled trial of testosterone therapy has been sufficiently large or of sufficient duration to establish whether such treatment may influence breast cancer occurrence. There does not appear to be an association between testosterone and endometrial cancer, or other malignancies on review of published studies.

Summary Testosterone is inversely associated with increased CVD risk in women, whereas low sex hormone binding globulin increases CVD risk. The relationship between testosterone and breast cancer remains unclear, although a clear signal of risk has not emerged from studies of women treated with testosterone therapy over the past decade.

Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

Correspondence to Susan R. Davis, MBBS, FRACP, PhD, Women's Health Research Program, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC 3004, Australia Tel: +61 3 9903 0827; fax: +61 3 9903 0828; e-mail: susan.davis@monash.edu

© 2011 Lippincott Williams & Wilkins, Inc.