Chronic heart failure (CHF) primarily affects the cardiovascular system. In addition, there is strong evidence that CHF is a complex metabolic disorder. Metabolic abnormalities include insulin resistance and lack of anabolic hormone activity. To date there have been few interventional trials targeting insulin sensitivity. A recent study suggests a link between testosterone therapy and improvements in insulin sensitivity, measured using the homeostatic model assessment (HOMA-IR). We discuss this study in detail. Further studies are needed to substantiate this link and to generally explore the value of testosterone therapy in CHF patients.