Fears of a link between testosterone replacement therapy and cardiovascular risk may be misplaced, according to a review in Mayo Clinic Proceedings.

The review of the literature led by Abraham Morgentaler, MD, of Director of Men’s Health Boston and a urologist at Beth Israel Deaconess Medical Center said there was no good evidence that testosterone therapy increases cardiovascular risk.

“That’s not to say it’s perfectly safe. But we cannot find evidence and the headlines that jumped out on recent retrospective studies appear to be too strong,” said Mortgentaler.

The research team identified only four published scientific journal articles since 1940 that suggest increased cardiovascular risks with testosterone prescriptions. According to the authors two of the research papers had “serious methodological limitations”.

There were many studies that found low testosterone levels were linked to an increased mortality risk.

The testosterone story “has been turned upside-down,” says Morgentaler, “by trumpeting studies providing remarkably weak evidence of risk, and ignoring a substantial literature with reassuring or beneficial results.”

Morgentaler and his colleagues write “public health may be harmed not only by inadequate appreciation of an actual risk but also by the failure to offer beneficial treatment for a medical condition because of false claims of risk concerns.”

Mortgantaler has served on scientific advisory boards of several pharmaceutical companies, including ones that manufacture and market testosterone replacement therapy.