Heart Disease and Testosterone

A recent study has found that postmenopausal women with higher testosterone levels may be at a greater risk for developing heart disease.   The study will be published in an upcoming issue of the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).   The study results are an important step in doctors’ efforts to better understand the role of hormones in women’s health.

The study involved 344 women between the ages of 65 and 98.  The women with the highest testosterone levels—those in the top 25 percent among the participants—were three times as like to have coronary heart disease, as compared to study participants with lower levels of testosterone.  This same group of women with elevated testosterone was also at greater risk for a group of metabolic risk factors called the metabolic syndrome.

For many years prior to the completion of this study, doctors knew that heightened levels of testosterone were associated with heart disease in men, but thought to be almost completely irrelevant in women.  With time, doctors began to accept that postmenopausal women with polycystic ovary syndrome, a condition where androgens are elevated, were at a greater risk for health problems.  Now, with the results of this study, the clinical relevance of testosterone in women will be better incorporated into the diagnosis and preventative care of women at risk for heart disease.

Researchers believe that further studies will have to be conducted to better understand the connection between heightened testosterone and these health conditions.  One theory is that insulin resistance might be the link.  Study authors found a high level of insulin resistance among the group of women with heightened testosterone.  Insulin resistance is a condition in which the body does not use insulin efficiently.  It is itself a risk factor for the metabolic syndrome and for cardiovascular disease.   Further studies are required to determine what the relationship between heightened testosterone, insulin resistance, and heart disease might be.  Which comes first…what leads to what? These and other such questions will be among the questions posed in follow-up studies.