Conclusions Oral TRT produces significant CV risk .
Differences in the degree to which serum DHT is elevated may underlie the varying CV risk by TRT administration route , as elevated serum dihydrotestosterone has been shown to be associated with CV risk in observational studies
Background Potential cardiovascular ( CV ) risks of testosterone replacement therapy ( TRT ) are currently a topic of intense interest .
However , no studies have addressed CV risk as a function of the route of administration of TRT .
Cognitive changes associated with supplementation of testosterone or dihydrotestosterone in mildly hypogonadal men: a preliminary report.
This study prospect ively examined changes in cognition in hypogonadal men given testosterone ( T ) or older hypogonadal men given dihydrotestosterone ( DHT ) gel .  A battery of cognitive tests assessing verbal and spatial memory , language , and attention was administered at baseline ( prior to medication ) and again at days 90 and 180 of treatment for men receiving T gel and at baseline and days 30 and 90 of treatment for men receiving DHT gel . For men receiving T gel , circulating total T and estradiol ( E(2 ) ) were significantly raised compared with baseline , and a significant improvement in verbal memory was observed . For men receiving DHT gel , serum DHT levels increased and T levels decreased significantly compared with baseline , and a significant improvement in spatial memory was observed . The results suggest that beneficial changes in cognition can occur in hypogonadal men using T replacement levels and DHT treatment , and these changes in cognition can be reliably measured during a relative steady-state dose level . Further , our results suggest that aromatization of T to E(2 ) may regulate verbal memory in men , whereas nonaromatizable and rogens may regulate spatial memory
Conclusions Oral TRT produces significant CV risk .
Differences in the degree to which serum DHT is elevated may underlie the varying CV risk by TRT administration route , as elevated serum dihydrotestosterone has been shown to be associated with CV risk in observational studies
Background Potential cardiovascular ( CV ) risks of testosterone replacement therapy ( TRT ) are currently a topic of intense interest .
However , no studies have addressed CV risk as a function of the route of administration of TRT .