TRT, your heart, and your prostate

The two questions men ask most before starting therapy, answered with current evidence rather than old assumptions — plus what monitoring actually protects against.

The prostate question

For years men were warned that testosterone causes prostate cancer. Current evidence doesn't support that claim. What's true is that testosterone can stimulate existing prostate tissue, so PSA and prostate health are monitored throughout therapy — routine territory for a urologist, and one reason this care belongs with a specialist.

The heart question

Cardiovascular safety has been studied intensively, and recent large trials have been reassuring when therapy is properly managed. The known cardiovascular risk isn't testosterone itself so much as an uncontrolled rise in red blood cell count, which thickens the blood — and that is exactly what routine bloodwork catches early.

What monitoring actually does

This is the entire case for doing TRT with a physician. Regular labs catch a rising red blood cell count, track PSA, and keep estrogen in range — before any of it becomes a problem. It's the difference between supervised therapy and a mail-order vial. See our full safety and monitoring guide.

The bottom line

For appropriate, monitored candidates, TRT is safe. Nearly every serious risk traces back to therapy without oversight — which is the one thing AndroMD never skips.

DS
David Shusterman, MD
Board-certified urologist · New York City
Medically reviewed content · Last updated May 2026

Frequently asked questions

Current evidence does not show that it does. Because testosterone can stimulate existing prostate tissue, PSA and prostate health are monitored throughout.
When properly managed and monitored, recent large trials have been reassuring. The main risk — an uncontrolled red blood cell count — is exactly what monitoring catches.
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