Testosterone therapy and the risk of atrial fibrillation, venous thromboembolism and cardiovascular events in cis men with hypogonadism and trans men
Authors' conclusion
Testosterone treatment in cis men with hypogonadism was associated with a lower risk of myocardial infarction but a higher risk of atrial fibrillation and venous thromboembolism. Testosterone therapy in trans men was not associated with an increased risk of cardiovascular events when compared to untreated trans men or cis men.
Study context
- Population
- Cis men with hypogonadism and trans men, TriNetX Research networkmatched cohorts
- Exposure
- TRT vs no testosterone in cis men with hypogonadism and in trans men
- Cis men treated with testosteronen = 117,908
- Trans men treatedn = 6,251
- Trans men not treatedn = 6,251reference
- Trans men treatedn = 6,986
- Cis men not treatedn = 6,986reference
- Outcome
- Cardiovascular events, mortality and suicide attempts
- Follow-up
- 5 years
Methodological detailspropensity-score matched (1:1), TriNetX Research network
- Propensity-score matched (1:1)
- TriNetX Research network
Main finding
As reported in the abstract
Cardiovascular events in cis men with hypogonadism
Cis men TRT vs Cis men untreatedEstimate (95% CI)P value
Lower risk of MI
HR (MI) 0.94(0.89–0.99)
P = 0.01Higher risk
HR (AF) 1.27(1.22–1.32)
P < 0.0001Higher risk
HR (acute PE/DVT) 1.26(1.18–1.34)
P < 0.0001Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| Suicide attempts in trans menTrans men TRTvs Untreated trans menLower rate with TRT | 0.52 (0.35–0.78) | P = 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Suicide attempts in trans men
- No significant differences vs untreated cis men
Original publication
Testosterone therapy and the risk of atrial fibrillation, venous thromboembolism and cardiovascular events in cis men with hypogonadism and trans men. Eur J Endocrinol. Published 9 September 2025. doi:10.
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