TRT and Stroke: No Connection Found, But More Research Called For

While there have been studies of the role TRT may play in terms of cardiovascular disease, there have been few focusing specifically on TRT and stroke. Testosterone Replacement Therapy and the Risk of Stroke in Men: A Systematic Review, “Maturitas, The European Menopause Journal.” December 2017 (available online August 2017), undertook a systematic study of existing research on the limited question of stroke and TRT.

  • Among seven cohort studies of hypogonadal men, one study reported that TRT was associated with a significant decreasein the risk of ischemic stroke (hazard ratio (HR) 0.64; 95% confidence interval (CI) 0.52–0.80).
  • Another reported a similar decreasein risk (HR 0.64; 95% CI 0.43–0.96) among treated men who achieved normalized levels of testosterone.
  • The remaining observational studies did not report measures of association to estimate the independent risk of stroke associated with TRT. Among eight RCTs, a low frequency of stroke events (<5) was observed across both testosterone and control groups, thus precluding any definitive conclusions.

As has been seen in other studies and reports on the relationship between TRT and generalized, cardiovascular disease, the authors of this article called for more “robust” prospective studies to further clarify the role TRT may play in the specific issue of stroke.