{"id":10977,"date":"2026-09-23T20:00:00","date_gmt":"2026-09-23T13:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=10977"},"modified":"2026-10-31T07:33:26","modified_gmt":"2026-10-31T00:33:26","slug":"testosterone-therapy-heart-safety-traverse","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/th\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/","title":{"rendered":"\u0e2e\u0e2d\u0e23\u0e4c\u0e42\u0e21\u0e19\u0e40\u0e17\u0e2a\u0e42\u0e17\u0e2a\u0e40\u0e15\u0e2d\u0e42\u0e23\u0e19\u0e41\u0e25\u0e30\u0e2b\u0e31\u0e27\u0e43\u0e08: \u0e2a\u0e34\u0e48\u0e07\u0e17\u0e35\u0e48\u0e01\u0e32\u0e23\u0e17\u0e14\u0e25\u0e2d\u0e07 TRAVERSE \u0e17\u0e35\u0e48\u0e21\u0e35\u0e0a\u0e37\u0e48\u0e2d\u0e40\u0e2a\u0e35\u0e22\u0e07\u0e44\u0e14\u0e49\u0e2a\u0e23\u0e38\u0e1b\u0e1c\u0e25"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 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data-permalink=\"https:\/\/drsoaraweeurology.com\/th\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/testosterone-heart-traverse-infographic\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?fit=800%2C600&amp;ssl=1\" data-orig-size=\"800,600\" data-comments-opened=\"0\" data-image-meta=\"{&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"testosterone-heart-traverse-infographic\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;TRAVERSE showed testosterone did not increase major cardiac events \u2014 safe is not the same as protective.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Infographic on the TRAVERSE trial: testosterone did not increase heart attacks or strokes, is not heart-protective, and raised red cell counts and fractures.\" class=\"wp-image-12313\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/10\/testosterone-heart-traverse-infographic.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">TRAVERSE showed testosterone did not increase major cardiac events \u2014 safe is not the same as protective.<\/figcaption><\/figure>\n\n<p class=\"wp-block-paragraph\">For nearly a decade, one question hung over every conversation about testosterone therapy: <strong>does it damage the heart?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In 2015, on the strength of a few observational studies and one trial that was stopped early, the United States Food and Drug Administration required a cardiovascular warning on testosterone products. That warning did what warnings do. Doctors hesitated to prescribe. Men who genuinely needed treatment went without it. And a legitimate medical therapy acquired a reputation for danger that the evidence never really supported.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then, in 2023, the results of the largest and most rigorous trial ever conducted on this question were published \u2014 and on the main question the answer was clear.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This article explains what that trial found, why the distinction between <em>safe<\/em> and <em>protective<\/em> matters enormously, and \u2014 the part that is most often got wrong, including in an earlier version of this page \u2014 which of its adverse findings were statistically significant and which were not.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Before Anything Else: Symptoms That Need Same-Day Care<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">If you are taking testosterone, go to an emergency department the same day for chest pain or tightness, breathlessness at a level of exertion that never used to trouble you, pain or swelling in one calf, sharp chest pain that is worse on breathing in, a racing or irregular heartbeat, or any stroke symptom \u2014 face drooping, arm weakness, difficulty speaking \u2014 even if it settles within minutes. In Thailand, call <strong>1669<\/strong>. The rest of this page explains why those particular symptoms are the ones listed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Why Anyone Suspected a Heart Connection<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The suspicion did not come from nowhere. Men with cardiovascular disease reliably tend to have lower testosterone levels than healthy men of the same age and build. Low testosterone has been linked to narrowed arteries, thicker artery walls, poorer function of the blood vessel lining, and higher markers of inflammation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Very large population studies have refined this considerably. What emerged is not a simple straight line but a <strong>threshold effect<\/strong>: men whose testosterone sits in the ordinary low-normal range do not appear to face meaningfully higher risk, while men whose levels are <em>genuinely and substantially low<\/em> show higher rates of death from all causes and from cardiovascular disease specifically. It is severe deficiency that carries prognostic weight \u2014 not being slightly below average.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Here is the trap in all of this, and it is worth naming plainly: <strong>an association does not tell you which way the arrow points.<\/strong> Serious chronic illness suppresses testosterone production. So a man with heart disease may have low testosterone <em>because<\/em> he is unwell, rather than being unwell because his testosterone is low. Observational data alone cannot separate those two stories. Only a randomised trial can.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">TRAVERSE: The Trial That Answered the Question<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The TRAVERSE trial, published in the <em>New England Journal of Medicine<\/em> in 2023, was designed specifically to settle the safety question \u2014 and it was designed to be a hard test.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It randomised <strong>5,246 men aged 45 to 80<\/strong> who had confirmed low testosterone on repeat morning testing with genuine symptoms, <em>and<\/em> who either already had cardiovascular disease or carried multiple risk factors for it. In other words, it deliberately selected the men most likely to be harmed if testosterone were harmful. Half received testosterone gel with doses adjusted to reach normal levels; half received an identical placebo gel. Neither the men nor their doctors knew which. Mean treatment lasted around 22 months and men were followed for a mean of 33 months.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The main question was straightforward: would more men on testosterone suffer a heart attack, a stroke, or death from cardiovascular causes?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>They did not.<\/strong> Testosterone met the criterion for non-inferiority to placebo on that combined endpoint, and the rates in the two groups were essentially identical. This is the finding that matters most, and it is genuinely reassuring.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To appreciate how decisive it was, consider the scale: TRAVERSE alone recorded more cardiovascular events than every previous randomised testosterone trial in history put together. This was not another small study adding noise to a debate.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One caveat worth stating on the population: TRAVERSE studied men with an average testosterone well below the normal range and with real symptoms, treated to a normal level under supervision. It says nothing about men with normal testosterone taking it anyway, and nothing about supraphysiological doses.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The Distinction That Matters Most<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Now for the part that gets misrepresented constantly, particularly by clinics and supplement sellers with something to gain.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>TRAVERSE showed that testosterone therapy did not increase major cardiac events. It did not show that testosterone therapy protects the heart.<\/strong> Those are entirely different claims, and the trial was built to answer only the first one.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A safety trial asks: <em>does this treatment cause harm?<\/em> A superiority trial asks: <em>does this treatment deliver benefit?<\/em> They are designed differently and answer different questions. TRAVERSE was the former. Finding no increase in the feared harm is not the same as finding a benefit, and nobody should present it as such.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If someone tells you testosterone will protect your heart, they are going beyond what the evidence supports. If someone tells you it will wreck your heart, they are working from a warning that has since been overturned. The accurate position sits between them \u2014 and it is genuinely useful, because it means a man with real testosterone deficiency and real symptoms can be treated without living in fear of his heart.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The Adverse Findings \u2014 and Which Ones Reached Significance<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>This section has been substantially corrected.<\/strong> An earlier version of this page listed pulmonary embolism, atrial fibrillation and fractures together under the heading of risks that are real, described the pulmonary embolism signal as real, and built a treatment recommendation on it. That was wrong in both directions at once, and the distinction matters enough to set out properly.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Statistically significant: thickened blood<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Erythrocytosis was the clearest adverse effect in the trial<\/strong>, and it was absent from the earlier version of this page altogether. Testosterone raises the red cell count, and it did so in TRAVERSE far more often than placebo \u2014 a difference of a wholly different order from the other signals discussed below.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is not an abstract laboratory finding. It is the single commonest reason a dose is reduced, a preparation is changed, or treatment is paused, and it is why <strong>haematocrit is checked before starting and regularly afterwards for as long as you remain on treatment<\/strong>. A man managing his own testosterone without monitoring is neglecting the one adverse effect that the largest trial in the field demonstrated convincingly.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Statistically significant: fractures<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version called this simply unexpected and unexplained. It deserves stronger language than that. The TRAVERSE fracture subtrial found a <strong>statistically significant increase of roughly 43% in clinical fractures<\/strong> on testosterone \u2014 around 3.5% of men versus 2.5% on placebo, with the curves separating within the first few months of treatment. Ribs, wrist and ankle were the commonest sites.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is genuinely counterintuitive, because testosterone improves bone density on a scan, and the mechanism is not settled. But bone density and broken bones turned out not to be the same endpoint. The practical conclusion is firm: <strong>testosterone should not be prescribed to protect bone<\/strong>, and a man with osteoporosis needs treatment aimed at bone specifically.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Numerically higher, but not statistically significant<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Atrial fibrillation, pulmonary embolism and acute kidney injury<\/strong> each occurred somewhat more often in the testosterone group than in the placebo group. None of these differences reached statistical significance in the trial.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That phrasing is deliberate, and the earlier version of this page did not use it. Saying a signal was real, when the trial could not distinguish it from chance, converts an uncertainty into a fact. It is the same error, in the opposite direction, as brushing off the fracture finding.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What follows from that? Not dismissal. These are serious events, the numbers moved the same way, and a trial of this size not reaching significance is not proof of no effect. It is reasonable to raise a previous blood clot, a clotting disorder or a known arrhythmia before starting, and to weigh it in the decision. It is also reasonable to know the emergency symptoms at the top of this page. What is <em>not<\/em> reasonable is to describe these as established harms of testosterone, or to refuse treatment to a man who needs it on the strength of them.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Where Testosterone Does and Does Not Help the Cardiovascular System<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Diabetes prevention \u2014 a claim this page previously overstated<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version of this article called testosterone\u2019s effect on diabetes prevention the most striking finding in the entire field, and led with it. That was too strong, and it has been rewritten.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The encouraging study is the Australian T4DM trial: men with abdominal obesity and impaired glucose tolerance, <em>all<\/em> of them enrolled in a structured lifestyle programme, were less likely to develop type 2 diabetes over two years if they also received testosterone.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The problem is what happened when the question was asked again in a larger trial without that lifestyle programme attached. <strong>The prespecified TRAVERSE diabetes substudy found no significant difference in progression from prediabetes to diabetes<\/strong>, and no difference in glucose or HbA1c. The American Diabetes Association does not recommend testosterone for diabetes prevention.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The honest reading is that testosterone is <strong>not a treatment for diabetes and not a substitute for weight loss<\/strong>. If there is an effect at all, it appears alongside real lifestyle change rather than instead of it. That is also the position taken in <a href=\"https:\/\/drsoaraweeurology.com\/2026\/04\/28\/low-testosterone-2024-guide\/\">low testosterone: what the evidence actually supports<\/a> and in <a href=\"https:\/\/drsoaraweeurology.com\/2026\/05\/26\/obesity-low-testosterone-weight-loss-mendelian-randomization\/\">why your doctor recommends the gym before the pharmacy<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Body composition and metabolic markers<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Testosterone therapy reliably increases muscle mass and reduces fat, including the visceral fat around the organs that is most strongly tied to cardiovascular risk. Pooled trials in men with diabetes or metabolic syndrome show improvements in blood sugar control, insulin sensitivity and cholesterol profile. These are modest changes rather than transformations, but they move in the right direction \u2014 and none of them has been shown to translate into fewer heart attacks.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Blood vessels and chest pain<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Testosterone acts directly on blood vessels as a dilator, relaxing the muscle in vessel walls and improving blood flow, including through the coronary arteries.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The most intriguing demonstration comes from a small randomised study in men with stable angina, now twenty-five years old, in which men given testosterone could exercise noticeably longer before their hearts showed signs of strain. The men who improved most were those whose testosterone had been lowest to begin with \u2014 the pattern you would expect if you are correcting a genuine deficiency rather than adding surplus hormone. It is a mechanistic finding from a small trial, and it has not translated into any demonstrated reduction in cardiac events.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Inflammation<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Testosterone reduces several inflammatory signalling molecules and increases an anti-inflammatory one. Laboratory work has also shown it helps immune cells clear cholesterol \u2014 a mechanism directly relevant to how arteries fur up. Whether this translates into fewer heart attacks over decades has never been tested, and it would take a very long trial to find out.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Who Actually Benefits<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The men who gain from testosterone therapy are those with <strong>genuinely low levels confirmed on more than one properly taken morning blood test, together with real symptoms<\/strong> \u2014 low libido, erectile difficulty, persistent fatigue, low mood, loss of muscle. The lower the starting level, the clearer the benefit tends to be.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Current expert reviews describe the realistic gains as improved libido and sexual function, better erections, correction of anaemia, and modest improvements in mood, energy and physical function. That is a worthwhile list. It is not a promise of rejuvenation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Men whose testosterone is normal will not get these benefits, because there is nothing to correct \u2014 but they will still carry the risks. This is the central problem with clinics that prescribe testosterone on the basis of vague tiredness without proper testing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One area still uncertain is heart failure. Testosterone deficiency is common in men with heart failure and tracks with severity, and some small studies showed improved exercise capacity. Pooled analyses have been less convincing. Current advice is to avoid testosterone in severe heart failure and in the months immediately following a heart attack.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One cost of treatment sits outside the cardiovascular question entirely and must be raised before the first dose rather than after it: <strong>testosterone given from outside suppresses sperm production, frequently to zero.<\/strong> If you may want children, say so \u2014 clomiphene citrate, hCG or an aromatase inhibitor can raise testosterone while preserving fertility.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two related questions come up so often in clinic that I have written about them separately: whether testosterone is dangerous for the prostate \u2014 <a href=\"https:\/\/drsoaraweeurology.com\/2026\/05\/19\/testosterone-prostate-cancer-saturation-model\/\">the evidence there has shifted just as dramatically<\/a> \u2014 and whether erectile dysfunction medications themselves affect the heart, which I <a href=\"https:\/\/drsoaraweeurology.com\/2026\/09\/16\/pde5-inhibitors-heart-protection-evidence\/\">reviewed last week<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The Bottom Line<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The decade-long fear that testosterone therapy causes heart attacks and strokes has been tested properly and did not survive. In men with genuine testosterone deficiency \u2014 including men who already have heart disease \u2014 treatment did not increase major cardiac events in the largest trial ever conducted.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That is meaningful. It means a man with real deficiency and real symptoms can be treated on the merits, rather than being refused out of a fear that turned out to be unfounded.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But safe is not the same as protective, and the trial also found things that get quietly dropped from the summary: a significant rise in red cell count that requires lifelong monitoring, and a significant rise in fractures. I would rather be clear about all of it than let a patient believe a hormone is doing work that it is not. Testosterone is not a heart medication. It helps indirectly \u2014 through muscle, fat, blood sugar and blood vessels \u2014 and most convincingly when it sits alongside the things that genuinely protect hearts: managing blood pressure, cholesterol and blood sugar, not smoking, moving regularly, and sleeping properly.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Used properly, in the right man, with the right monitoring, testosterone therapy is a legitimate and valuable treatment. See how <a href=\"https:\/\/drsoaraweeurology.com\/services\/testosterone-replacement-therapy\/\">testosterone replacement therapy<\/a> is structured in practice, including the testing and monitoring that should accompany it, and how it relates to <a href=\"https:\/\/drsoaraweeurology.com\/services\/erectile-dysfunction-bangkok\/\">erectile dysfunction treatment<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have symptoms of low testosterone \u2014 reduced libido, erectile difficulty, persistent fatigue, or loss of muscle \u2014 please have it assessed properly with appropriate blood tests rather than self-treating. Dr. Soarawee Weerasopone offers specialist consultations in men\u2019s health and testosterone therapy at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok Hospital Headquarters<\/a>, and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. A video consultation is useful for reviewing symptoms, previous results and your clotting and cardiac history before deciding what to test; testosterone therapy itself is started and monitored in person, because it depends on blood tests. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital rather than through this website.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Testosterone and Heart Health<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Does testosterone therapy cause heart attacks?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. The TRAVERSE trial randomised 5,246 men aged 45 to 80 with confirmed low testosterone who either already had cardiovascular disease or carried multiple risk factors. Over a mean follow-up of 33 months, rates of heart attack, stroke and cardiovascular death were essentially identical between testosterone and placebo, meeting the criterion for non-inferiority. This trial recorded more cardiovascular events than all previous randomised testosterone trials combined.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Does testosterone therapy protect the heart?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">This has not been shown, and the distinction matters. TRAVERSE was designed as a safety trial asking whether testosterone causes harm, not a superiority trial asking whether it delivers cardiovascular benefit. Finding no increase in the feared harm is not evidence of protection. Testosterone does improve several cardiovascular risk factors indirectly, including body composition, blood sugar control and blood vessel function, but no trial has shown it prevents heart attacks or cardiovascular deaths.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Which adverse findings in TRAVERSE were statistically significant?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Two. <strong>Erythrocytosis<\/strong> \u2014 a rise in red cell count \u2014 was by far the clearest, occurring several times more often on testosterone than on placebo, and it is why haematocrit is monitored for as long as treatment continues. <strong>Clinical fractures<\/strong> also rose significantly, by roughly 43%, in the fracture subtrial. Atrial fibrillation, pulmonary embolism and acute kidney injury were each numerically higher on testosterone but <strong>did not reach statistical significance<\/strong>. An earlier version of this page presented those three as established risks and did not mention erythrocytosis at all; both errors have been corrected.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Should a previous blood clot stop me having testosterone?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not automatically. The pulmonary embolism signal in TRAVERSE was numerically higher but not statistically significant, so it does not support a blanket prohibition. It is still worth raising a previous clot, a known clotting disorder or an arrhythmia before starting, so it can be weighed in the decision \u2014 and worth knowing the emergency symptoms: breathlessness, pain or swelling in one calf, or sharp chest pain worse on breathing in mean same-day assessment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can testosterone help prevent type 2 diabetes?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not on current evidence. The Australian T4DM trial found a benefit, but every participant in it was also enrolled in a structured lifestyle programme. The prespecified TRAVERSE diabetes substudy, without that programme, found no significant difference in progression from prediabetes to diabetes and no difference in glucose or HbA1c, and the American Diabetes Association does not recommend testosterone for diabetes prevention. Testosterone is not a treatment for diabetes and not a substitute for weight loss.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Who should actually receive testosterone therapy?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Men with genuinely low testosterone confirmed on more than one properly taken morning blood test, combined with real symptoms such as reduced libido, erectile difficulty, persistent fatigue, low mood or loss of muscle mass. Benefits are clearest in men whose levels are substantially low rather than borderline. Men with normal testosterone will not gain these benefits because there is nothing to correct, yet they still carry the risks. Anyone who may want children should raise fertility first, since testosterone suppresses sperm production.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can I discuss testosterone therapy by video consultation?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients, and is arranged in advance by email to the Urology department at bhquro@bdms.co.th. A video consultation is useful for reviewing symptoms, previous results and clotting and cardiac history before deciding what to test. Testosterone therapy itself is started and monitored in person, because it depends on blood tests. Samitivej Sriracha Hospital is in-person only.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">References<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular safety of testosterone-replacement therapy. <em>N Engl J Med.<\/em> 2023;389(2):107\u2013117. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37326322\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Snyder PJ, Bauer DC, Ellenberg SS, et al. Testosterone treatment and fractures in men with hypogonadism. <em>N Engl J Med.<\/em> 2024;390(3):203\u2013211. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38231623\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Bhasin S, Lincoff AM, Nissen SE, et al. Effect of testosterone on progression from prediabetes to diabetes in men with hypogonadism: a substudy of the TRAVERSE randomized clinical trial. <em>JAMA Intern Med.<\/em> 2024;184(4):353\u2013362. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38315466\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Bhasin S, Snyder PJ. Testosterone treatment in middle-aged and older men with hypogonadism. <em>N Engl J Med.<\/em> 2025;393(6):581\u2013591. <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMra2404637\" target=\"_blank\" rel=\"noreferrer noopener\">NEJM<\/a><\/li>\n\n\n<li>Morgentaler A, Dhindsa S, Dobs AS, et al. Androgen Society position paper on cardiovascular risk with testosterone therapy. <em>Mayo Clin Proc.<\/em> 2024;99(11):1785\u20131801. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39436329\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Wittert G, Bracken K, Robledo KP, et al. Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM): a randomised, double-blind, placebo-controlled, 2-year, phase 3b trial. <em>Lancet Diabetes Endocrinol.<\/em> 2021;9(1):32\u201345. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33338415\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Yeap BB, Marriott RJ, Dwivedi G, et al. Associations of testosterone and related hormones with all-cause and cardiovascular mortality and incident cardiovascular disease in men: individual participant data meta-analyses. <em>Ann Intern Med.<\/em> 2024;177(6):768\u2013781. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38739921\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Kloner RA, Carson C, Dobs A, Kopecky S, Mohler ER. Testosterone and cardiovascular disease. <em>J Am Coll Cardiol.<\/em> 2016;67(5):545\u2013557. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26846952\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>English KM, Steeds RP, Jones TH, Diver MJ, Channer KS. Low-dose transdermal testosterone therapy improves angina threshold in men with chronic stable angina: a randomized, double-blind, placebo-controlled study. <em>Circulation.<\/em> 2000;102(16):1906\u20131911. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11034937\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. <em>J Clin Endocrinol Metab.<\/em> 2018;103(5):1715\u20131744. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29562364\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n\n\n<li>Lee H, Hwang EC, Oh CK, et al. Testosterone replacement in men with sexual dysfunction. <em>Cochrane Database Syst Rev.<\/em> 2024;1:CD013071. <a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD013071.pub2\/full\" target=\"_blank\" rel=\"noreferrer noopener\">Cochrane Library<\/a><\/li>\n\n\n<li>Di Lodovico E, Facondo P, Delbarba A, et al. Testosterone, hypogonadism, and heart failure. <em>Circ Heart Fail.<\/em> 2022;15(7):e008755. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35392658\" target=\"_blank\" rel=\"noreferrer noopener\">PubMed<\/a><\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Medically written &amp; reviewed by:<\/strong> Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist, Bangkok Hospital Headquarters.<br>Andrology Fellowship and Robotic Surgery &amp; Minimally Invasive Urology Fellowship, Chang Gung Memorial Hospital (Taiwan) \u00b7 Endourology Observership, Juntendo University Hospital (Japan) \u00b7 Research Scholar &amp; Clinical Observer, Scott Department of Urology, Baylor College of Medicine (USA)<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/\",\n      \"name\": \"Testosterone and the Heart: What the Landmark TRAVERSE Trial Settled\",\n      \"description\": \"What the TRAVERSE trial showed about the cardiovascular safety of testosterone therapy, why safe is not the same as protective, which adverse findings reached statistical significance (erythrocytosis and fractures) and which did not (atrial fibrillation, pulmonary embolism, acute kidney injury).\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2026-09-23\",\n      \"dateModified\": \"2026-08-29\",\n      \"lastReviewed\": \"2026-08-29\",\n      \"specialty\": \"https:\/\/schema.org\/Urologic\",\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/#trt\" },\n      \"citation\": [\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"Cardiovascular safety of testosterone-replacement therapy\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"The New England Journal of Medicine\" }, \"datePublished\": \"2023\", \"identifier\": \"10.1056\/NEJMoa2215025\" },\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"Testosterone treatment and fractures in men with hypogonadism\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"The New England Journal of Medicine\" }, \"datePublished\": \"2024\", \"identifier\": \"10.1056\/NEJMoa2308836\" },\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"Effect of testosterone on progression from prediabetes to diabetes in men with hypogonadism\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"JAMA Internal Medicine\" }, \"datePublished\": \"2024\", \"identifier\": \"10.1001\/jamainternmed.2023.7862\" }\n      ],\n      \"disambiguatingDescription\": \"CORRECTION NOTICE: an earlier version of this page grouped pulmonary embolism, atrial fibrillation and fractures together as risks that are real, described the pulmonary embolism signal as real, and derived a recommendation to avoid treatment in some men from it. In TRAVERSE, atrial fibrillation, pulmonary embolism and acute kidney injury were numerically higher on testosterone but did NOT reach statistical significance. The two findings that did reach significance were erythrocytosis, which the earlier version omitted entirely, and clinical fractures, which rose by approximately 43% in the fracture subtrial and which the earlier version described merely as unexpected and unexplained. The diabetes-prevention claim, previously called the most striking finding in the field, has been rewritten: the prespecified TRAVERSE diabetes substudy found no significant difference in progression from prediabetes to diabetes, and the American Diabetes Association does not recommend testosterone for that purpose.\"\n    },\n    {\n      \"@type\": \"MedicalTherapy\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/#trt\",\n      \"name\": \"Testosterone replacement therapy\",\n      \"description\": \"Replacement of testosterone in men with biochemically confirmed deficiency and corresponding symptoms. In the TRAVERSE trial of 5,246 men aged 45 to 80 with cardiovascular disease or risk factors, testosterone was non-inferior to placebo for major adverse cardiovascular events over a mean 33-month follow-up. It has not been shown to protect the heart and is not indicated for that purpose, and it is not a treatment for diabetes or for fracture prevention.\",\n      \"indication\": {\n        \"@type\": \"MedicalIndication\",\n        \"name\": \"Male hypogonadism confirmed on repeat morning testosterone testing with characteristic symptoms\"\n      },\n      \"seriousAdverseOutcome\": [\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Erythrocytosis\",\n          \"description\": \"The clearest and most statistically robust adverse effect in TRAVERSE, occurring several times more often on testosterone than on placebo. Haematocrit is checked before starting and monitored for as long as treatment continues; it is the commonest reason for dose reduction, change of preparation or a pause.\"\n        },\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Clinical fracture\",\n          \"description\": \"Statistically significant increase of approximately 43% in the TRAVERSE fracture subtrial, with curves separating within the first months and ribs, wrist and ankle the commonest sites. Testosterone should not be prescribed to protect bone despite improving bone mineral density on imaging.\"\n        }\n      ],\n      \"adverseOutcome\": [\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Atrial fibrillation (not statistically significant)\",\n          \"description\": \"Numerically higher on testosterone in TRAVERSE but the difference did not reach statistical significance. Should not be described as an established harm.\"\n        },\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Pulmonary embolism (not statistically significant)\",\n          \"description\": \"Numerically higher on testosterone in TRAVERSE but the difference did not reach statistical significance. A previous clot or clotting disorder is worth raising before starting, but does not constitute a blanket contraindication on the strength of this signal.\"\n        },\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Acute kidney injury (not statistically significant)\",\n          \"description\": \"Numerically higher on testosterone in TRAVERSE but the difference did not reach statistical significance.\"\n        },\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Suppression of sperm production, frequently to azoospermia\",\n          \"description\": \"Outside the cardiovascular question but must be raised before the first dose. Clomiphene citrate, hCG or an aromatase inhibitor raise testosterone while preserving fertility.\"\n        }\n      ],\n      \"contraindication\": [\n        { \"@type\": \"MedicalContraindication\", \"name\": \"Severe heart failure\" },\n        { \"@type\": \"MedicalContraindication\", \"name\": \"Recent myocardial infarction\" },\n        { \"@type\": \"MedicalContraindication\", \"name\": \"Active fertility planning (relative)\" }\n      ],\n      \"followup\": \"Haematocrit before starting and regularly throughout treatment. Same-day emergency assessment for chest pain, breathlessness on reduced exertion, unilateral calf pain or swelling, pleuritic chest pain, palpitations, or stroke symptoms even if they resolve; the Thai emergency number is 1669.\"\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does testosterone therapy cause heart attacks?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. The TRAVERSE trial randomised 5,246 men aged 45 to 80 with confirmed low testosterone who either already had cardiovascular disease or carried multiple risk factors. Over a mean follow-up of 33 months, rates of heart attack, stroke and cardiovascular death were essentially identical between testosterone and placebo, meeting the criterion for non-inferiority. This trial recorded more cardiovascular events than all previous randomised testosterone trials combined.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does testosterone therapy protect the heart?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"This has not been shown, and the distinction matters. TRAVERSE was designed as a safety trial asking whether testosterone causes harm, not a superiority trial asking whether it delivers cardiovascular benefit. Finding no increase in the feared harm is not evidence of protection. Testosterone does improve several cardiovascular risk factors indirectly, but no trial has shown it prevents heart attacks or cardiovascular deaths.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Which adverse findings in TRAVERSE were statistically significant?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Two. Erythrocytosis, a rise in red cell count, was by far the clearest, occurring several times more often on testosterone than on placebo, and it is why haematocrit is monitored for as long as treatment continues. Clinical fractures also rose significantly, by roughly 43%, in the fracture subtrial. Atrial fibrillation, pulmonary embolism and acute kidney injury were each numerically higher on testosterone but did not reach statistical significance.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Should a previous blood clot stop me having testosterone?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not automatically. The pulmonary embolism signal in TRAVERSE was numerically higher but not statistically significant, so it does not support a blanket prohibition. It is still worth raising a previous clot, a known clotting disorder or an arrhythmia before starting so it can be weighed in the decision, and worth knowing the emergency symptoms: breathlessness, pain or swelling in one calf, or sharp chest pain worse on breathing in mean same-day assessment.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Can testosterone help prevent type 2 diabetes?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not on current evidence. The Australian T4DM trial found a benefit, but every participant was also enrolled in a structured lifestyle programme. The prespecified TRAVERSE diabetes substudy, without that programme, found no significant difference in progression from prediabetes to diabetes and no difference in glucose or HbA1c, and the American Diabetes Association does not recommend testosterone for diabetes prevention. Testosterone is not a treatment for diabetes and not a substitute for weight loss.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Who should actually receive testosterone therapy?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Men with genuinely low testosterone confirmed on more than one properly taken morning blood test, combined with real symptoms such as reduced libido, erectile difficulty, persistent fatigue, low mood or loss of muscle mass. Benefits are clearest in men whose levels are substantially low rather than borderline. Men with normal testosterone will not gain these benefits because there is nothing to correct, yet they still carry the risks. Anyone who may want children should raise fertility first, since testosterone suppresses sperm production.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Can I discuss testosterone therapy by video consultation?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients, and is arranged in advance by email to the Urology department at bhquro@bdms.co.th. A video consultation is useful for reviewing symptoms, previous results and clotting and cardiac history before deciding what to test. Testosterone therapy itself is started and monitored in person, because it depends on blood tests. Samitivej Sriracha Hospital is in-person only.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for general education only and does not constitute medical advice, diagnosis or treatment for any individual. Testosterone therapy is not approved or recommended for cardiovascular protection, and should only be taken when prescribed by a qualified doctor following appropriate testing and with ongoing monitoring. No advice, diagnosis or prescription is given through personal messaging channels or social media, and Dr. Soarawee operates no public social media account. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0e21\u0e32\u0e19\u0e32\u0e19\u0e2b\u0e25\u0e32\u0e22\u0e1b\u0e35 \u0e1c\u0e39\u0e49\u0e0a\u0e32\u0e22\u0e08\u0e36\u0e07\u0e44\u0e14\u0e49\u0e23\u0e31\u0e1a\u0e01\u0e32\u0e23\u0e40\u0e15\u0e37\u0e2d\u0e19\u0e27\u0e48\u0e32\u0e01\u0e32\u0e23\u0e23\u0e31\u0e01\u0e29\u0e32\u0e14\u0e49\u0e27\u0e22\u0e2e\u0e2d\u0e23\u0e4c\u0e42\u0e21\u0e19\u0e40\u0e1e\u0e28\u0e0a\u0e32\u0e22\u0e2d\u0e32\u0e08\u0e17\u0e33\u0e43\u0e2b\u0e49\u0e2b\u0e31\u0e27\u0e43\u0e08\u0e02\u0e2d\u0e07\u0e1e\u0e27\u0e01\u0e40\u0e02\u0e32\u0e40\u0e2a\u0e35\u0e22\u0e2b\u0e32\u0e22 \u0e01\u0e32\u0e23\u0e17\u0e14\u0e25\u0e2d\u0e07\u0e17\u0e35\u0e48\u0e43\u0e2b\u0e0d\u0e48\u0e17\u0e35\u0e48\u0e2a\u0e38\u0e14\u0e17\u0e35\u0e48\u0e40\u0e04\u0e22\u0e14\u0e33\u0e40\u0e19\u0e34\u0e19\u0e01\u0e32\u0e23\u0e21\u0e32\u0e01\u0e47\u0e15\u0e2d\u0e1a\u0e04\u0e33\u0e16\u0e32\u0e21\u0e19\u0e35\u0e49 \u0e41\u0e15\u0e48\u0e1c\u0e25\u0e01\u0e32\u0e23\u0e28\u0e36\u0e01\u0e29\u0e32\u0e14\u0e31\u0e07\u0e01\u0e25\u0e48\u0e32\u0e27\u0e21\u0e31\u0e01\u0e16\u0e39\u0e01\u0e19\u0e33\u0e21\u0e32\u0e2d\u0e49\u0e32\u0e07\u0e16\u0e36\u0e07\u0e40\u0e1e\u0e35\u0e22\u0e07\u0e04\u0e23\u0e36\u0e48\u0e07\u0e40\u0e14\u0e35\u0e22\u0e27\u0e40\u0e17\u0e48\u0e32\u0e19\u0e31\u0e49\u0e19 TRAVERSE \u0e44\u0e14\u0e49\u0e2a\u0e23\u0e38\u0e1b\u0e1c\u0e25\u0e2d\u0e22\u0e48\u0e32\u0e07\u0e44\u0e23 \u0e44\u0e21\u0e48\u0e44\u0e14\u0e49\u0e2a\u0e23\u0e38\u0e1b\u0e2d\u0e22\u0e48\u0e32\u0e07\u0e44\u0e23 \u0e41\u0e25\u0e30\u0e2a\u0e31\u0e0d\u0e0d\u0e32\u0e13\u0e14\u0e49\u0e32\u0e19\u0e25\u0e1a\u0e43\u0e14\u0e1a\u0e49\u0e32\u0e07\u0e17\u0e35\u0e48\u0e2a\u0e33\u0e04\u0e31\u0e0d\u0e17\u0e32\u0e07\u0e2a\u0e16\u0e34\u0e15\u0e34\u0e41\u0e25\u0e30\u0e43\u0e14\u0e17\u0e35\u0e48\u0e44\u0e21\u0e48\u0e2a\u0e33\u0e04\u0e31\u0e0d.<\/p>","protected":false},"author":185281453,"featured_media":11586,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"The TRAVERSE trial settled whether testosterone therapy harms the heart. Dr. Soarawee, urologist at Bangkok Hospital, explains what it proved about cardiovascular safety, why safe does not mean protective, and the blood clot and fracture risks that remain.","jetpack_seo_html_title":"Testosterone and the Heart: The TRAVERSE Trial | Dr. Pom Bangkok","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1363],"tags":[],"class_list":["post-10977","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mens-health"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-2R3","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/08\/testosterone-traverse-trial-featured.jpg?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts\/10977","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/comments?post=10977"}],"version-history":[{"count":8,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts\/10977\/revisions"}],"predecessor-version":[{"id":12323,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/posts\/10977\/revisions\/12323"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/media\/11586"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/media?parent=10977"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/categories?post=10977"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/th\/wp-json\/wp\/v2\/tags?post=10977"}],"curies":[{"name":"\u0e14\u0e31\u0e1a\u0e40\u0e1a\u0e34\u0e25\u0e22\u0e39\u0e1e\u0e35","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}