Testosterone therapy and heart safety: what women should know

A new report on testosterone therapy is adding to a long-running debate about how safe the hormone is for women, especially when it is used for symptoms tied to menopause or sexual health. The latest findings, presented at the 2026 annual meeting of the Menopause Society and reported by AARP, suggest a possible link between testosterone use and higher rates of cardiovascular events in women, but the evidence is not definitive. This is an area where the details matter: what was studied, how the data were collected, and how well the findings apply to everyday care can all affect the interpretation.

Testosterone is not approved by the U.S. Food and Drug Administration for use in women, and many prescriptions are written off label. That makes safety questions especially important, because people using the therapy may not be getting it under a labeled indication with well-established long-term risk data. The newest report does not prove that testosterone causes heart attacks, strokes, or heart failure in women, but it does reinforce the need for caution and for more rigorous research.

What the new report says

According to the AARP report, the study presented at the Menopause Society meeting found an association between testosterone therapy and increased cardiovascular risk in postmenopausal women. The reported outcomes included heart attack, stroke, heart failure, and other cardiovascular events. AARP also noted that testosterone prescriptions for women have grown in recent years, which helps explain why safety concerns are getting more attention now.

Because the findings were presented as conference research, they should be treated as preliminary unless and until the full study is published and independently reviewed. Conference abstracts can be informative, but they often provide fewer details than a full paper about the patient population, dosing, treatment duration, and statistical adjustments.

Why it matters

Heart disease risk changes across the life course, and menopause is one point when risk may begin to rise. That does not mean testosterone is harmful in every case, but it does mean any hormone used for symptoms should be considered in the context of a person’s overall cardiovascular profile. If a treatment is being used off label and the safety evidence is still evolving, clinicians generally need to weigh symptom relief against uncertainty.

The FDA has also emphasized that testosterone products are intended for specific approved uses and that cardiovascular safety concerns have been part of the regulatory conversation for years. While much of the FDA’s public discussion has focused on men treated for low testosterone, it underscores a broader point: the cardiovascular effects of testosterone are an active area of research, not a settled issue.

What the evidence actually shows

The current evidence is mixed. Some studies have raised concern about cardiovascular outcomes, while others have not found an increased risk. A recent PubMed-indexed claims database analysis reported no association between testosterone therapy in females and increased cardiovascular or breast cancer risk, showing that not all observational data point in the same direction. Other published studies and reviews have also described uncertainty rather than a clear answer.

That inconsistency matters because different studies can examine different populations, testosterone formulations, doses, and treatment durations. Some include women with specific health conditions; others are limited by claims data, follow-up time, or incomplete information about whether medication was actually taken as prescribed. As a result, even a signal of increased risk should be interpreted cautiously unless the full methods and results are available.

What remains uncertain

At this point, several important questions remain unanswered. Researchers still need to clarify whether risk depends on the form of testosterone used, the dose, how long it is taken, and whether the person has underlying heart disease or other risk factors. It is also not yet clear whether any observed association is related to testosterone itself, to other medications taken at the same time, or to the health conditions that led to treatment in the first place.

Another uncertainty is how well conference findings will hold up after peer review. Early reports can be useful for identifying possible safety issues, but they are not the same as a completed clinical trial or a fully published long-term study.

What to discuss with a clinician

For anyone currently using or considering testosterone therapy, the most practical next step is a careful conversation with a clinician about why the treatment is being used, what benefit is expected, and what is known about safety. It is reasonable to ask whether the therapy is FDA-approved for the intended use, whether there are alternatives with better evidence, and whether any personal factors could increase cardiovascular risk.

It can also help to ask how treatment response will be measured and how long therapy should continue if benefits are modest or unclear. Because testosterone is not approved for women in the U.S., the threshold for continuing treatment should usually include a clear, measurable reason to stay on it.

If someone develops chest pain, shortness of breath, one-sided weakness, sudden trouble speaking, or other possible emergency symptoms, they should seek urgent medical care right away. Those symptoms need prompt evaluation regardless of whether hormone therapy is involved.

The bottom line

New research is renewing concern about the cardiovascular safety of testosterone therapy in women, but the story is still developing. The strongest conclusion right now is not that testosterone definitively causes heart problems in women, but that the risk picture is unsettled enough to justify caution, closer study, and individualized medical discussion.