Does TRT Affect Blood Pressure?

As the levels of testosterone decline, most people resort to TRT as an alternative. While TRT offers numerous benefits, one of the concerns that people often have is whether long-term use of TRT affects blood pressure. TRT increases hematocrit, which increases blood volume and consequently induce hypertension. Read more to learn about the connection between TRT and the Cardiovascular system

Testosterone is a steroid hormone produced mainly in testicles (1). The levels of testosterone peak as you hit adolescence. And with age, normal levels of testosterone decline in the body.

In men, testosterone regulates the development of secondary sexual characteristics such as body hair, deepening of the voice, muscle mass, and bone density. Being a sex hormone, it also plays an important role in libido. 

However, low levels of testosterone can have adverse effects on different aspects of health, thus, testosterone therapy is much needed. 

As studies have shown proven benefits, testosterone therapy is widely used by athletes and bodybuilders to increase lean muscle mass. 

TRT helps restore healthy testosterone levels as exogenous testosterone can be induced into the body through injections, pellets, and gels. Keeping aside the vast benefits, men on long-term TRT are likely to develop cardiovascular diseases. 

TRT and Cardiovascular System: Connection

There is limited evidence regarding TRT being the actual cause of cardiovascular diseases in men. Although a few studies suggest that men using TRT are at high risk of stroke or cardiac arrest as higher levels of testosterone lowers HDL (good cholesterol) and elevates the levels of LDL (bad cholesterol) (2).  

Although low testosterone is associated with obesity, diabetes, and atherosclerosis (build-up of plaque made up of fat, cholesterol, calcium, and other substances in the arterial wall), all of which can contribute to CVD, stroke, and myocardial infarction. 

Besides, testosterone can also thicken the blood, reduce HDL and raise blood pressure. Perhaps one of the biggest concerns that people usually have is whether TRT affects blood pressure, and the theoretical answer to this is yes! 

Does TRT Affect Blood Pressure? 

Testosterone replacement therapy offers great benefits, but long-term use or testosterone abuse will have severe consequences. 

TRT causes an increase in hematocrit, causing your blood to thicken. As the blood cells increase, so does the blood volume resulting in increased arterial resistance and eventually high blood pressure (3). 

Moreover, Testosterone metabolism produces estradiol, a predominant form of estrogen. Now when testosterone is converted to estrogen, estrogen retains sodium. So with the increase in the body’s sodium content, fluid retention also increases, resulting in increased blood volume and hence high blood pressure. 

People using TRT must keep a check on their blood pressure readings. High blood pressure is a serious medical issue that must be dealt with straight away. 

Other Symptoms of Low Testosterone 

Testosterone helps develop secondary male characteristics. Low levels of testosterone affect men both emotionally and physically. 

Testosterone is a sex hormone that is responsible for libido. It is an important concern in men as they age because, with low testosterone levels, they experience less sexual drive, fewer erections, and infertility (4). 

As mentioned earlier, testosterone helps reduce body fat and increase muscle mass and endurance. With its levels decreasing, muscle strength also reduces, making it difficult for men to maintain their desired body shape. 

With so much going on inside a men’s body due to low testosterone levels, they tend to experience depression, mood swings, and low self-confidence.

Can Low Testosterone Affect Blood Pressure? 

With the research still going on whether low testosterone affects blood pressure, a few studies suggest that low testosterone is associated with diabetes and obesity, both of which exhibit a potential cardiovascular risk. 

Therefore, one may say that both low and high levels of testosterone affect blood pressure. 

How to Lower Blood Pressure Caused By Testosterone? 

Blood pressure can be controlled by making some lifestyle changes. This includes changes in eating habits, and routine can help a lot. 

Glutathione, an antioxidant, has proven to be effective in lowering blood pressure (5). 

Intake of medications to keep blood pressure under normal range is one of the options. But if you are looking for a drug-free approach to keeping your blood pressure under control, then exercise should be your go-to approach! 

Exercise is very beneficial for overall health, especially for people with high blood pressure. Studies suggest exercise improves the health of your heart and blood vessels, thereby improving the raised BP. 

You may take the stairs when coming back from work. Go jogging in your free time or run on a treadmill. 

Incorporating fiber into your diet can also help lower blood pressure and reduce cholesterol levels. Therefore, a meal rich in fruits, vegetables, whole grains, beans, and lentils would be beneficial. 

Including these healthy habits will help you lower your blood pressure while being on TRT and improve your cardiovascular and metabolic health. 

1)https://www.ncbi.nlm.nih.gov/books/NBK526128/
2)ttps://pubmed.ncbi.nlm.nih.gov/33317996/#:~:text=Background%3A%20Treatment%20of%20%22adult%2D,increased%20CV%20risk%20and%20mortality.
3)https://pubmed.ncbi.nlm.nih.gov/28709177/
4)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391003/#:~:text=Hypogonadism%20causes%20a%20wide%20range,mass%20and%20strength%5B5%5D.
5)https://pubmed.ncbi.nlm.nih.gov/27511994/

Kartik Kumar Rathi

Kartik is a Doctor in training currently in his second year of medical school with the ultimate goal of becoming a successful cardiologist, he currently contributes to health blogs, research papers and also founded a social health startup to help educate others.

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