186-Testosterone Replacement Headlines: Can They Be Trusted?

Last month, Dr. Andrew Kates—a cardiologist at Washington University—published an article on the editorial page of the St. Louis Post-Dispatch in which he expressed his opinion regarding testosterone replacement. He addressed this subject because it has been the object of a lot of negativity in the media recently. For example, JAMA—the Journal of the American Medical Association—recently published a report entitled Testosterone Therapy and Risk of Cardiovascular Disease in Men, claiming that testosterone replacement could lead to heart attacks and cardiac events. Dr. Kates’s article was in response to this JAMA article, as well as to the news headlines in general.

In his article, Dr. Kates says that there is both evidence that encourages the replacement of testosterone and evidence that discourages it. He recommends that patients take their time in making the decision of whether or not to undergo testosterone replacement therapy. All in all, I believe that to be an appropriate approach. But, what we want to discuss is the role that headlines play in patients’ medical decisions and reasoning. The headline of JAMA’s report suggests that taking testosterone replacements might cause you to have a heart attack. However, current research and scientific thought is contrary to that opinion. Harvard professor Dr. Abraham Morgenthaler—a leading expert on testosterone in men and the author of Testosterone for Life—recently gave a speech at the AMMG Conference in Orlando, FL regarding this very issue. In his speech, Dr Morgenthaler challenged the research behind the aforementioned article in JAMA. Specifically, he challenged the selection criteria for the population that was studied; all elderly male veterans that already had heart conditions and/or histories of strokes. He challenged the study because ten percent of those included in the study of men and cardio risks turned out to be women. He challenged the interpretation of the data on statistical methodology, and, finally, he asked that the article be taken down.