Exercise Beats Testosterone for Blood Vessel Health in Men

Getting regular physical activity[1] is important to maintaining healthy blood vessels in middle-aged and older men, while a testosterone treatment wasn’t found to be helpful, according to the results of a new study published in the journal Hypertension[2].

The report looked at how different interventions affected the health of the endothelium — the lining of blood vessels — in study participants, who were 80 men between the ages of 50 and 70. Participants all had a waist circumference of at least 95 centimeters (37.4 inches) and a low-normal testosterone level (6 to 14 nmol/L). Each was randomly assigned to one of two interventions in two different areas. First, each participant was assigned to use either a testosterone cream or a placebo[3] (inactive substance), which they applied to their skin as directed. Second, each participant was assigned to take part in either a supervised exercise program, or no program. Both interventions lasted 12 weeks.

To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, sign up for our free newsletter[4]!

Exercise better for blood vessel health

Not surprisingly, taking testosterone was found to raise those participants’ blood testosterone levels, with 62% seeing their levels increase to higher than 14 nmol/L. Using a placebo cream had no effect on testosterone levels. But taking testosterone had no beneficial effect on measures of endothelial health, such as flow-mediated dilation (how much the endothelium expands to accommodate blood flow). In fact, taking testosterone appeared to have a slightly negative effect on this measurement. Members of the placebo-plus-exercise group saw an average increase in flow-mediated dilation of 1.0%, while those in the testosterone-plus-exercise group saw an increase of only 0.5%. Members of the placebo-without-exercise group saw a slight increase of 0.2%, while members of the testosterone-without-exercise group actually saw a decrease of 0.7%.

“In middle-to-older-aged men with central adiposity and low/normal testosterone levels, we observed no evidence that testosterone added to the beneficial impact of exercise on vascular function and health,” the researchers concluded. This is a significant finding because both older age and lower testosterone levels are linked to worse endothelial function in men — and it suggests that endothelial dysfunction may not be a direct result of lower testosterone levels.


Testosterone replacement therapy has become increasingly popular over time, with the rate of prescriptions growing by a factor of 12 in recent decades, according to a press release[5] on the study from the American Heart Association. This has taken place despite a lack of changes in clinical recommendations that would warrant such an increase in prescriptions.

“The global increase in testosterone use has been very large, particularly among middle-aged and older men who might see it as a restorative hormone to increase energy and vitality,” said study author Daniel J. Green, PhD, a professor at the University of Western Australia, in the press release. “However, previous studies are mixed as to whether replacement testosterone is beneficial or not, or whether it provides additional benefit over and above the effects of an exercise program.”

Based on the result of this study, Green says, “An exercise program with some support and supervision can help to improve the function and health of your arteries” if you’re a middle-aged or older man with some excess body weight who isn’t very physically active. “Testosterone therapy may have some benefits, for example in increasing muscle mass in the legs, however, we didn’t find any benefits in terms of artery function, which is a determinant of future cardiovascular risk.”

“Be Heart Smart: Know Your Numbers,”[6] “Does Diabetes Hurt Your Heart?”[7] “Fight Off Heart Disease With These Five Heart-Healthy Foods”[8] and “Lower Your Risk of Heart Disease.”[9]

  1. physical activity: https://dsm.diabetesselfmanagement.com/nutrition-exercise/exercise/picking-the-right-activity-to-meet-your-fitness-goals/
  2. Hypertension: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16411
  3. placebo: https://dsm.diabetesselfmanagement.com/diabetes-resources/definitions/placebo/
  4. sign up for our free newsletter: https://dsm.diabetesselfmanagement.com/newsletter/
  5. press release: https://newsroom.heart.org/news/structured-exercise-program-not-testosterone-therapy-improved-mens-artery-health?preview=485e
  6. “Be Heart Smart: Know Your Numbers,”: https://dsm.diabetesselfmanagement.com/education/be-heart-smart-know-your-numbers/
  7. “Does Diabetes Hurt Your Heart?”: https://dsm.diabetesselfmanagement.com/education/does-diabetes-hurt-your-heart/
  8. “Fight Off Heart Disease With These Five Heart-Healthy Foods”: https://dsm.diabetesselfmanagement.com/blog/fight-off-heart-disease-five-heart-healthy-foods/
  9. “Lower Your Risk of Heart Disease.”: https://dsm.diabetesselfmanagement.com/managing-diabetes/complications-prevention/lower-risk-heart-disease/

Source URL: https://dsm.diabetesselfmanagement.com/news-research/2021/03/03/exercise-beats-testosterone-for-blood-vessel-health-in-men/

Disclaimer Statements: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.