Hormones and Peptides

Hormone decisions are among the most debated in longevity medicine, and large trials have settled some questions. In TRAVERSE, 5,246 men aged 45 to 80 with symptoms of low testosterone and existing or high cardiovascular risk were randomized to testosterone gel or placebo. Testosterone did not increase major cardiac events (7.0% versus 7.3%), but atrial fibrillation, acute kidney injury and pulmonary embolism were more common in the testosterone group.¹

For menopausal hormone therapy, the North American Menopause Society’s 2022 position statement finds the benefit-risk ratio favourable for women under 60 or within 10 years of menopause onset who have bothersome hot flashes or need to prevent bone loss, and less favourable when therapy starts later, because of higher absolute risks of heart disease, stroke, blood clots and dementia.² Newer drugs are changing the picture too: in SELECT, 17,604 adults with heart disease and overweight or obesity but no diabetes had 20% fewer cardiovascular deaths, heart attacks and strokes on weekly semaglutide than on placebo, although twice as many stopped treatment because of side effects (16.6% versus 8.2%).³

The articles below also review peptides such as BPC-157 and epitalon, where the human evidence is thin.