When blood flow to the heart is blocked, it can cause chest pain (also called angina) or a heart attack (also called myocardial infarction). This narrowing blocks blood flow to and from your heart and other organs. Having high blood cholesterol can lead to a buildup called "plaque" on the walls of your arteries (a type of blood vessel). But you can take steps to lower your risk for high cholesterol by changing things you can control.
It plays a central role in energy levels, sexual health, muscle and bone strength, red blood cell production, and overall sense of well-being. For these men, the effects of testosterone on cholesterol are especially important. Another reason this topic matters is because heart disease is the number one cause of death worldwide. The type of testosterone treatment, the dose, the length of therapy, and the health of the patient before starting all seem to influence the outcome.
Of the commonly assessed lipid parameters, high triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) are important CVD risk factors in older women2–4, and may confer greater risk than elevated total cholesterol and low-density lipoprotein cholesterol (LDL-C). These studies have also shown that there is an inverted relationship between the total cholesterol plasma triglycerides and testosterone levels. Some studies have found that testosterone replacement therapy may cause slight shifts in cholesterol levels. Testosterone can influence cholesterol levels, but the effects vary widely depending on the person’s overall health and if they’re taking medication to help normalize testosterone levels.
Whether you’re managing high cholesterol, navigating symptoms of low testosterone, or simply trying to better understand your health, the connection between these two substances matters. More research is necessary on the effects of taking testosterone supplements on cholesterol. These can help manage your cholesterol, blood pressure, and other manageable risk factors. Doctors usually give testosterone therapy for one of two reasons.
This mixed evidence means doctors cannot say with certainty that TRT universally raises LDL, but they remain cautious—especially for men with preexisting heart risks. Some clinical trials show that LDL levels increase slightly in men receiving testosterone, while others find little to no change. These plaques can limit blood flow or break apart, leading to heart attack or stroke.