Editing Male Reproductive Physiology (section)

== Cardiovascular disease and testosterone==

*Androgen deprivation therapy increases cardiovascular risk by affecting various risk factors: increased body weight, decreased insulin sensitivity, altered lipid profile, and increased fat mass
*'''Coronary artery disease'''
**'''The degree of testosterone deficiency has been reported as having an inverse relationship to the severity of CAD'''
**'''Exogenous testosterone therapy in men with testosterone deficiency improves myocardial ischemia, exercise capacity, and CV risk factors'''.
**'''Current guidelines do not recommend offering testosterone deficiency screening to patients with heart disease, nor do they recommend supplementing testosterone therapy to improve outcome'''
*'''Cerebral vascular disease''' 
**'''Testosterone deficiency has also been implicated in the development of cerebral vascular disease'''
*'''Proposed mechanisms of testosterone’s action on the cardiovascular system (3):'''
*#'''Protective effect on endothelial function'''
*#'''Anti-anginal, anti-inflammatory, anti-ischemia effects'''
*#'''Testosterone levels correlate negatively with fibrinogen'''

=== <span style="color:#ff00ff">TEAAM (Testosterone's Effects on Atherosclerosis Progression in Aging Men) (JAMA 2015) ===
*'''Population: 156 men age ≥ 60 years or older with low or low-normal testosterone levels'''
*'''Randomized to 7.5g of 1% testosterone gel packets daily vs. placebo for 3 years'''
*'''Coprimary outcomes:'''
** '''Common carotid artery intima-media thickness'''
** '''Coronary artery calcium'''
*Secondary outcomes: sexual function and health-related quality of life
*'''Results:'''
**'''No significant difference in common carotid artery intima-media thickness, coronary artery calcium, sexual desire, erectile function, overall sexual function scores, partner intimacy, and health-related quality of life.'''
**'''Hematocrit and prostate-specific antigen levels increased more in testosterone group.'''
* [https://pubmed.ncbi.nlm.nih.gov/26262795/ Effects of Testosterone Administration for 3 Years on Subclinical Atherosclerosis Progression in Older Men With Low or Low-Normal Testosterone Levels: A Randomized Clinical Trial]. JAMA. 2015 Aug 11;314(6):570-81. doi: 10.1001/jama.2015.8881.