Science and research
At Apex, our team delivers evidence-based, personalized care for men by combining the latest scientific research with clinical expertise. Below we're sharing some of the research behind our treatments to ensure that you have all of the information you need to make the most informed decisions for your health.
Studies on Testosterone replacement therapy
A deeper look at the effects, benefits, and potential risks of Testosterone Replacement Therapy (TRT) for men with low testosterone levels.
Cardiovascular Safety of Testosterone-Replacement Therapy
New England Journal of Medicine 2023
Quick Hit: For men with low T on replacement, they were not at higher risk for major negative heart events.
In men with hypogonadism and preexisting or a high risk of cardiovascular disease, testosterone-replacement therapy was noninferior to placebo with respect to the incidence of major adverse cardiac events.
Cardiovascular safety of testosterone replacement therapy (TRAVERSE trial)
Trends in Urology and Men's Health 2024
Quick Hit: A number of new studiest suggest that some previous concerns about testosterone replacement are OVER estimated, and that the true benefits may be UNDER estimated.
The publication of several separate papers in relation to testosterone treatment and cardiovascular safety,effects on prostate and bone, anemia,depression, somatic symptoms and sexual function potentially leads to underestimation of the combined health benefits of treatment to achieve multiple modest improvements. TRAVERSEshould provide physicians with reassuring evidence to enable them to management with symptomatic testosterone deficiency with greater confidence.
Making Sense of the TRAVERSE Trials (The Androgen Society)
Androgren Society
Quick Hit: Testosterone replacement likely provides more benefit and less risk, than historically thought.
As this study was conducted at the request of the FDA, these positive findings should aid in the lifting of the cardiovascular “Summary of Product Characteristics” warning on testosterone products. Additionally, the lack of an association of a raised haematocrit with cardiovascular risk is reassuring. It does seem that every positive testosterone study comes with caveats, and in this case, it is the report of a small increase in fracture rate, atrial fibrillation, and acute kidney injury, where other studies have no such links. This raises the possibility that increased vitality and physical activity before therapeutic benefits might have been contributory (14). This might justify caution in frail patients in the early stages of treatment, and the need for appropriate advice. The publication of multiple papers potentially leads to an underestimation of the combined health benefits, as specialists might not refer to evidence beyond their subject area. TRAVERSE should provide physicians reassurance, enabling them to manage symptomatic testosterone deficiency without the seemingly inevitable conclusion that “more studies are required”.
Long-Term Cardiovascular Safety of Testosterone Therapy: A Review of the TRAVERSE Study
World Journal of Men's Health 2024
Quick Hit: Appropriate testosterone replacement does not show an increase in heart or prostate cancer related events, which is a NEW understanding of the lack of risks with replacement.
The primary cardiovascular safety end point was the first occurrence of any component of a composite of death from cardiovascular causes, non-fatal myocardial infarction, or non-fatal stroke, assessed in a time-to-event analysis. TRAVERSE found no increase in major adverse cardiac events or prostate-related events, including prostate cancer, effectively addressing the concerns raised by the United States Food and Drug Administration.
Prevention and Early Detection of Cardiovascular Diseases in Hypogonadal Patients
International Journal of Clinical Studies & Medical Case Reports 2024
Quick Hit: Sexual (erectile) dysfunction can be related to testosterone deficiency and may be a sign of cardiovascular disease.
This paper examines the interplay between testosterone deficiency, sexual dysfunction, and cardiovascular risk. It supports testosterone replacement as a preventive strategy against endothelial dysfunction and cardiometabolic syndrome. The findings impacted clinical practice by encouraging earlier screening of hypogonadism in men with CVD risk.
Impact of Symptoms of Late-Onset Hypogonadism as a Potential Driver of Presenteeism
American Journal of Men's Health 2025
Quick Hit: Low testosterone can not only affect health, but reduce work productivity.
This study correlates symptoms of late-onset hypogonadism (LOH) with workplace underperformance, or presenteeism. The research highlights fatigue and sleep disturbances as major symptoms affecting job efficacy. These results have impacted the field by framing TRT as an intervention not only for health but also for productivity.
Social Media and Men’s Health: Separating Science from Speculation in Andrology
Basic and Clinical Andrology 2025
Quick Hit: The online world of men's health is full of misinformation, so patients need to be mindful when seeking care.
This article explores the proliferation of misinformation about testosterone and ED treatments on social platforms. It underscores the risk of self-prescription and the need for clinician-guided care. It encouraged healthcare systems to increase online presence and educational outreach.
Studies on Erectile Dysfunction Intervention
Exploring the causes, potential risks, and treatment options for men suffering from Erectile Dysfunction (ED), including its impact on overall health and wellness.
Erectile Dysfunction: An Update
International Journal of Clinical Reports and Studies 2024
Quick Hit: Erectile dysfunction can be a signal for a number of health concerns in men.
A comprehensive update on ED covering psychogenic, hormonal, and vascular causes. The article stresses lifestyle modification and personalized therapy. It re-emphasized ED as a sentinel marker of systemic health.
studies on weight loss
Exploring the causes, potential risks, and treatment options for men struggling to lose weight, including the impact on overall health and wellness.
Preliminary Assessment of GLP-1 Receptor agonists on Testosterone levels, erectile
function, and metabolic outcomes in men with obesity or type 2 diabetes
The Journal of Urology 2025
Quick Hit: Medications in the GLP-1 RA class (like Ozempic) may lead to increases in testosterone levels and improved erectile function.
GLP-1 RA therapy is associated with significant increases in T among men with obesity or T2DM. The lack of a significant association between weight loss and T change suggests that the underlying mechanisms may be independent of weight loss. While preliminary data showed improvements in erectile function, additional data will be necessary to determine whether these trends will achieve clinical or statistical significance. Given emerging data on sarcopenia and GLP-1 RAs, future studies should investigate the potential role of combined GLP-1 and testosterone therapies to optimize outcomes in body composition, metabolic control, and sexual health.
The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity
Annals of Internal Medicine 2025
Quick Hit: For men with obesity and knee arthritis, tirzepatide offers the best balance of weight loss, pain relief, and overall value compared to other options.
Tirzepatide offers men with obesity and knee arthritis a powerful way to lose weight, ease joint pain, and stay active, often working better and costing less overall than semaglutide. While exercise, healthy eating, and surgery remain important options—with surgery providing the most long-term benefits for those who qualify—tirzepatide delivers the best balance of weight loss, pain relief, and overall health improvement for most men who are not pursuing surgery.
studies on Men's health - general assessments
Exploring men's overall health and wellness, including key factors for longevity, metabolic strength, and vitality.
Prioritizing Men’s Health: Key Elements for Longevity and Wellness
Men's Health 2025
Quick Hit: A more comprehensive assessment of men’s health related concerns improves health.
Sexual health concerns, including erectile dysfunction and low testosterone, require thorough evaluations and appropriate treatments. By implementing these strategies, medical professionals can significantly improve the health outcomes and quality of life for male patients.
Metabolic Syndrome and Cardiovascular Disease Volume II: The ED Connection
Frontiers in Endocrinology 2025
Quick Hit: Erectile dysfunction should be screened for more regularly as it can be a sign of heart or hormone concerns.
This article identifies erectile dysfunction as a clinical manifestation of metabolic syndrome. It supports integrated treatment models involving endocrinology and cardiology. It impacted practice by pushing for routine ED screening in metabolic patients.
Quick Hit: Testosterone has been underappreciated and underutilized as a tool to help improve men's health and avoid chronic illness.
Among middle-aged and older men with hypogonadism, testosterone treatment did not result in a lower incidence of clinical fracture than placebo. The fracture incidence was numerically higher among men who received testosterone than among those who received a placebo.