"Despite the continued controversy surrounding the use of testosterone in men who have testosterone deficiency hypogonadism a new study has found that longterm use of testosterone therapy not only improves vigor and vitality but may reduce the risk of death due to cardiovascular CV disease. These findings appear online in the Journal of Cardiovascular Pharmacology and Therapeutics. Testosterone T is the primary male sex hormone. In men T plays a key role in the development of male reproductive tissues as well as promoting secondary sexual characteristics such as increased muscle and bone mass and growth of body hair. In addition T is essential for overall health and wellbeing and for the prevention of osteoporosis. Insufficient levels of circulating T in men contributes to frailty and bone loss. In the absence of large prospective placebocontrolled clinical trials of longer duration substantial evidence regarding the safety and risk of testosterone therapy TTh with regard to cardiovascular outcomes can only be gleaned from observational studies. To date there are limited studies comparing the effects of longterm TTh in hypogonadal men who were treated or remained untreated with T.  Researchers at Boston University Schools of Medicine BUSM and Public Health BUSPH along with researchers in Germany established a registry to assess longterm effectiveness and safety of T in men. For this study they sought to compare its effects on a host of parameters obesity cholesterol levels diabetes liver function considered to contribute to cardiovascular disease. The researchers followed a group of men for eight years who had been on TTh and compared them with another group of men who remained untreated for the same time period. They found there were only two deaths in the TTh group and neither was related to CV events. In the nontreated control group there were  deaths  of which were related to CV events. Furthermore there were  nonfatal myocardial infarctions and  nonfatal strokes in the control group but none in the Ttreated group.  According to the researchers longterm TTh in men with hypogonadism appears to be an effective approach to achieve sustained improvements in cardiometabolic function and reduces the risk of CV events. The low CV events observed in the Tgroup compared to the untreated control group strongly suggest that TTh is protective. We believe that the protective effect of T on the CV system provides clinicians with the opportunity to utilize this approach for secondary prevention for hypogonadal men with a history of CV events explained corresponding author Abdulmaged M. Traish PhD professor of biochemistry and urology at BUSM.  Conflict of interest disclosure statement  Contributing authors Dr. Farid Saad is a full time employee of Bayer Pharma.  Dr. Ahmad Haider has received partial compensation for data entry from Bayer Pharma.  Dr. Gheorghe Doros has received payment for statistical analysis from Bayer Pharma."