Testosterone replacement therapy in men diagnosed with pre-existing heart disease has been related to an increased risk of myocardial infarction.  Furthermore, recent research has linked testosterone replacement therapy to an increase in deaths and other cardiovascular occurrences in men whom document a history of coronary artery disease.  Further research is required to determine the full extent to which testosterone replacement therapy in aging men plays a role in the risk and/or advantage of cardiovascular occurrences. 
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If you’re a healthy guy in your 30s and 40s, your testosterone will be declining—but that doesn’t mean you actually need treatment. “If you go in and say, ‘Well, you know, in the past 10 years I’ve gotten more tired, I’m having trouble keeping weight off…’ that’s simply not enough—it’s a natural phenomenon!” Jacques Baillargeon, ., an epidemiologist at the University of Texas Medical Branch at Galveston, told Men’s Fitness. However, if you’re a man north of 50, and you’re having difficulty getting it up, you’re feeling depressed, and you’re generally unhappy, you should seek out TRT.