Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:
The second theory is similar and is known as "evolutionary neuroandrogenic (ENA) theory of male aggression".   Testosterone and other androgens have evolved to masculinize a brain in order to be competitive even to the point of risking harm to the person and others. By doing so, individuals with masculinized brains as a result of pre-natal and adult life testosterone and androgens enhance their resource acquiring abilities in order to survive, attract and copulate with mates as much as possible.  The masculinization of the brain is not just mediated by testosterone levels at the adult stage, but also testosterone exposure in the womb as a fetus. Higher pre-natal testosterone indicated by a low digit ratio as well as adult testosterone levels increased risk of fouls or aggression among male players in a soccer game.  Studies have also found higher pre-natal testosterone or lower digit ratio to be correlated with higher aggression in males.     
Because the relationship between long-term androgen use and gynecological health is not yet fully understood, and because many trans men often experience embarrassment and/or access issues over obtaining ongoing gynecological care, some may feel it is appropriate to pursue such surgeries as a preventative measure. Always discuss the latest medical research and the pros and cons of these procedures with your doctor. For more information on hysterectomy, oophorectomy, PCOS, endometrial cancer, and ovarian cancer see the hysterectomy and oophorectomy page on this web site.