From a relatively young age, men are more prone to develop atherosclerosis, or hardening of the arteries, than women. Kaiser Permanente in Oakland, California, reports that men tend to develop coronary heart disease a decade earlier than women, although by age 70 -- after women have lost the protective benefits of estrogen -- the risk for coronary heart disease is equal in both sexes. This has led to conjecture that testosterone, a male hormone, plays a role in the genesis of atherosclerosis. However, testosterone's participation in this process is far from clear.
Hormone Receptors
Healthy men and women produce both estrogen and testosterone in their tissues. According to the April 2003 issue of "Endocrine Reviews," your arteries contain receptors that respond to estrogen and testosterone, as well as the metabolic machinery to convert testosterone to estrogen. These receptors help to regulate the diameter of your arteries and play a role in the processes that initiate the development of atherosclerotic plaques. Your gender, the amount of testosterone in your bloodstream and a variety of unknown factors dictate how your arteries respond to receptor activation.
Paradox
Women with polycystic ovary syndrome, or PCOS, have higher circulating levels of testosterone than women whose ovaries are normal, and PCOS-afflicted women have a higher incidence of coronary heart disease, according to "Endocrine Reviews." In contrast, men who suffer from hypogonadism -- a condition characterized by abnormally low testosterone levels -- tend to exhibit abdominal obesity, low HDL levels, high LDL, triglyceride and cholesterol levels, and insulin resistance, all of which contribute to a higher incidence of cardiovascular disease in these individuals. If PCOS patients are treated with medications to lower their testosterone levels, their risk for atherosclerosis decreases. If hypogonadal men are given testosterone to increase their levels, their risk for atherosclerosis also decreases, notes "The American Journal of Cardiology." This paradox cannot be easily explained on the basis of testosterone's effects alone.
Adolescent Observations
Among the many factors that increase your risk for atherosclerosis and coronary artery disease, a high LDL cholesterol level is one of the most prominent. More specifically, a higher level of small, dense LDL particles has been associated with a higher risk for heart disease. The April 2011 issue of "Journal of Korean Medical Science" demonstrated that the profound increases in serum testosterone levels seen in adolescent males are directly related to a sudden increase in the level of small, dense LDL particles. Hence, young men naturally develop an "atherogenic" profile as part of the testosterone spike associated with puberty.
Considerations
Testosterone produced in the bodies of healthy individuals has not been convincingly linked to a higher risk of atherosclerosis, according to the April 2003 issue of "Endocrine Reviews." In some disease states, such as PCOS, excessive testosterone may contribute to heart disease. Whether administration of "exogenous" testosterone causes health problems is unclear, because testosterone confers both beneficial and deleterious effects on lipid levels and arterial dynamics. Therapeutic use of testosterone does not appear to be associated with atherosclerosis and is even protective in some cases, such as male hypogonadism. However, since the long-term effects of testosterone administration in healthy individuals are poorly defined, the use of testosterone for non-therapeutic purposes should be discouraged.
References
- "The Permanente Journal"; Sex-Based Differences in Causes of Hospitalization for Coronary Heart Disease; A.L. Klatsky, M.A. Armstrong; Fall 2000
- "Endocrine Reviews"; Androgens and Coronary Artery Disease; F.C.W. Wu, A. von Eckardstein; April 2003
- "The American Journal of Cardiology"; Cardiovascular Issues in Hypogonadism and Testosterone Therapy; R. Shabsigh, et al.; December 2005
- "Korean Journal of Medical Science"; A Higher Burden of Small, Low-Density Lipoprotein Particles is Associated with Profound Changes in the Free Androgen Index in Male Adolescents; Y.J. Choi, et al.; April 2011
