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This article is general information only and is not medical advice.
A new study has found a striking link between testosterone therapy in postmenopausal women and serious heart problems — but its authors and outside experts are urging caution about what it actually proves. The research, presented at The Menopause Society's 2026 annual meeting in San Diego, compared more than 6,300 postmenopausal women and found first-time cardiovascular events far more often among those receiving testosterone.
What the study found
According to reports from Fox News and Clinical Advisor, the retrospective study, led by Dr Xuezhi Daniel Jiang of Drexel University College of Medicine, used data from the TriNetX US Collaborative Network. It compared postmenopausal women aged 45 and older who started testosterone therapy with women who had no testosterone exposure. After propensity-score matching, 3,164 women remained in each group, and women with a history of cardiovascular disease were excluded.
Over a mean follow-up of about three years, 3.8% of women receiving testosterone experienced a first-time cardiovascular event, compared with 0.5% of women who did not receive the treatment — about 38 events per 1,000 women versus five per 1,000. The hazard ratio was 8.08, meaning the rate was about eight times higher in the testosterone group. The events counted included coronary artery disease, cerebrovascular disease such as stroke, and heart failure. The link held when women on testosterone plus menopausal hormone therapy were compared with women on hormone therapy alone.
Association is not causation
The most important sentence in this story is the caveat. The study was observational and retrospective: researchers looked at outcomes among women who were already receiving testosterone rather than assigning treatment in a controlled trial. That design can show a link, but it cannot prove testosterone caused the events. Unmeasured differences between the groups — why some women were prescribed testosterone in the first place — could explain part of the gap, and the researchers acknowledged the limitations.
Context also matters. Testosterone therapy is often prescribed off-label to treat low sexual desire, which affects an estimated 10% to 15% of postmenopausal women, and long-term safety data in women have been limited. A 2024 study in The Journal of Sexual Medicine found no statistically significant increase in major cardiovascular events among testosterone users aged 56 and older, though its population, outcomes and follow-up differed. The new findings are, in the words of one expert quoted in reports, "an important safety signal that deserves further investigation, not definitive evidence of causation."
What this means for patients
For women currently on testosterone therapy, the study is a reason to talk to a clinician — not a reason to stop treatment abruptly on the basis of a headline. For clinicians, it is a reminder that off-label prescribing without long-term safety data carries real uncertainty, and that cardiovascular risk needs to be part of the conversation before therapy starts. Prospective trials, which follow patients forward under controlled conditions, will be needed to settle whether testosterone itself raises risk, and by how much.
Until then, the honest summary is narrower than the headline: in a large health-records study, postmenopausal women on testosterone had substantially higher rates of first-time heart and stroke events than matched women who were not. That signal is strong enough to warrant attention — and preliminary enough that it should not, on its own, decide anyone's treatment.