Testosterone Heart Risk Warning for Older Women on Therapy

New research presented at The Menopause Society 2026 Annual Meeting in San Diego suggests the testosterone heart risk for postmenopausal women is larger than many prescribers assumed. Women who had been prescribed testosterone experienced cardiovascular events at a rate of three point eight percent, compared with zero point five percent among similar women who never used the hormone, HealthDay reported on October twentieth.

That gap sits at the center of the testosterone heart risk story. The analysis drew on records from a United States clinical data network run by TriNetX and covered more than six thousand propensity-matched menopausal women aged forty-five and older, about half of whom had been prescribed testosterone. None had recorded cardiovascular disease when the study period began, and researchers tracked them for an average of nearly three years. The testosterone heart risk question had lingered for years because long-term safety data on the hormone in women were thin, according to MedicalXpress.

What the researchers measured

The combined outcome included coronary artery disease, certain problems affecting blood vessels in the brain, and heart failure. The team adjusted for recorded differences including smoking, obesity, diabetes and high blood pressure, and the association held across several additional analyses. It also held when researchers compared women taking both testosterone and menopause hormone therapy against women on hormone therapy alone, according to MedicalXpress.

Lead researcher Dr. Xuezhi Daniel Jiang, a professor of obstetrics and gynecology at Drexel University College of Medicine in Philadelphia, said in a news release that the findings identify "a potentially important cardiovascular safety signal associated with testosterone therapy in postmenopausal women." "Although absolute event rates were low, the consistency of the association across multiple analyses warrants further prospective investigation," Jiang added. MedicalDaily described the gap as roughly eight times the event rate.

Why testosterone gets prescribed anyway

Testosterone is not routinely recommended for aging women, and no testosterone product is approved for women in the United States. Doctors prescribe it off label in very low doses of male formulations, usually as a cream or gel, mainly for women experiencing a persistent and distressing loss of sexual desire. The condition, known as hypoactive sexual desire disorder, affects an estimated ten to fifteen percent of postmenopausal women. According to our earlier reporting, federal regulators have been watching this space as well: the FDA convened a workshop reviewing testosterone therapy for women, a sign that questions about testosterone heart risk were already on the table before this study landed.

The evidence for treating other complaints is thin. There is insufficient evidence that testosterone helps with fatigue, memory problems, weight changes or loss of bone density, according to MedicalXpress. What is documented is that off label prescriptions have more than doubled over the past decade, AARP reported. Higher doses carry known side effects such as acne, increased facial hair, scalp hair thinning and a deepening of the voice.

What to do with a conference abstract

A conference presentation is not a finished study, and this one is observational. Matching medical records cannot fully remove the differences between people who receive a prescription and people who do not, and the reasons for treatment, hormone dose and other unmeasured factors may explain part of the gap. Writing on her Substack, physician and author Dr. Jen Gunter noted that the findings were promoted in a press release ahead of the presentation and cautioned that an abstract offers a hypothesis rather than proof, pointing out that the same database previously produced an estrogen claim that influencers inflated beyond what its design could support.

That caution does not erase the testosterone heart risk signal, but it frames the right response. Talk with a prescriber before making any changes to medication, so dose, monitoring and heart risk factors can be reviewed together. Jiang himself described the result as a safety signal that needs prospective investigation rather than a verdict. According to our earlier reporting, sexual dysfunction after medical treatment is far more common than most people assume, and it deserves care that weighs both the symptom and the heart. For now, the testosterone heart risk finding is a prompt for that conversation, not a reason to panic.