Testosterone Therapy and Cardiovascular Risks for Postmenopausal Women: Study Insights

Recent research indicates that postmenopausal women undergoing testosterone therapy might experience an elevated risk of cardiovascular issues such as heart attacks and strokes. This study, unveiled during The Menopause Society’s 2026 annual meeting in San Diego, analyzed over 6,000 postmenopausal women aged 45 and above, comparing those on testosterone therapy to counterparts who were not receiving such treatment. Notably, women with pre-existing cardiovascular disease were excluded from the study.

Findings revealed that 3.8% of women on testosterone therapy had a first-time cardiovascular event compared to 0.5% of women who did not receive the therapy. These events encompassed heart attacks, strokes, heart failure, and other cardiovascular complications, as reported by The Menopause Society.

Testosterone, a hormone produced by the ovaries and adrenal glands, influences sexual desire, muscle and bone health, mood, and cognitive functions, according to the Cleveland Clinic. The disparity in cardiovascular events between the two groups warrants careful consideration, emphasized Anna Cabeca, a board-certified OB-GYN and menopause expert based in Dallas, who was not involved in the study.

The difference between 3.8% and 0.5% is certainly significant enough to warrant attention, but we need to be careful about what these numbers actually tell us,” said Cabeca.

For women evaluating testosterone therapy, medical professionals should assess the patient’s broader health profile, including heart history, blood pressure, cholesterol, metabolic health, medications, and family history. While testosterone can enhance sexual desire and satisfaction in appropriately selected postmenopausal women, potential benefits should be weighed against possible risks, Cabeca advised.

In scenarios deemed appropriate for testosterone use, Cabeca recommends precise dosing, regular monitoring, and continuous evaluation of patient symptoms and laboratory results. It is important to note that the research was observational; therefore, it observed outcomes among women already on testosterone rather than assigning treatments in a controlled trial. This design indicates an association between testosterone use and cardiovascular events but does not establish causation.

There may be differences among women receiving testosterone therapy compared to those who are not, such as in age, blood pressure, diabetes, cholesterol levels, or other health factors, which may influence heart risk, Cabeca noted. She emphasized the importance of considering this potential safety signal for further investigation.