How does testosterone and TRT relate to the lipid profile? To answer that you need a little background.

There are two types of hormones, peptide hormones (with a protein backbone), and steroid hormones (with a cholesterol backbone).

The steroid hormones are derived from cholesterol, derived from lipids in the diet and produced by the liver.

Testosterone, estrogen, and progesterone are some examples of steroids, derived from cholesterol. Diets low in cholesterol have been proven to lower testosterone production. The supply of free cholesterol for the production of steroid hormones occurs regardless of how much cholesterol you eat through alternative pathways such as de novo synthesis, reverse cholesterol transport, and mobilization of stored cholesteryl esters.

But what happens when you add exogenous testosterone. I will pull some quotes from this article to save time, but ultimately, it seems that TRT is cardioprotective and at worst, lowers HDL, and at best reduces risk or heart disease. Most studies that have shown detrimental effects of lipid profiles with exogenous T use are from young men and athletes abusing AAS.

"A positive correlation exists between HDL-c and circulating T concentrations, as seen in multiple studies including the San Antonito Heart study [36], the Tromso study [37], the Turku Male Aging study [38], the Rancho Bernardo study [39], MRFIT [40] and a study from Ghent, Belgium [41]. Most of these studies have also demonstrated an inverse relationship between T levels and both plasma triglycerides [32–34,36] and total cholesterol [32,34]. Elevated levels of VLDL are associated with increased risk of atherosclerosis. The Rancho Bernardo study also showed an inverse relationship between circulating T levels and plasma VLDL [35]. Additionally, data from the MESA study demonstrated that T levels were positively associated with smaller or less atherogenic VLDL particles [42]. Ohlsson et al. showed that higher T concentrations were associated with a more favorable apoprotein profile, with a lower apoB/apoA-1 ratio [11]. These findings prompted a prospective look at the relationship between plasma T levels and dyslipidemia through longitudinal studies. In the Study of Health in Pomerania, Haring et al. [43] examined the relationship between T levels and lipids, both at baseline and prospectively over 5 years.

"meta-analyses of studies of TRT in hypogonadal men have generally demonstrated that exogenous T lowers HDL-c; however, this effect is commonly associated with a concomitant lowering of total cholesterol and LDL-c concentrations [46,47]. Nonetheless, this HDL-c lowering effect has raised concern regarding the cardiovascular safety of TRT. Notably, substantial decreases in HDL-c concentrations have mainly been demonstrated with supraphysiologic doses of androgens administered to young men [48] and the use of anabolic androgens among athletes [49]. The HDL-c lowering effect appears variable with age, dose, and route of T administration [43] and it is most striking with high-dose, oral therapy. In contrast, normalization of circulating T levels with transdermal TRT did not affect HDL-c levels in older, hypogonadal men [50]. Importantly too, HDL-c concentrations in isolation may not be a reliable marker of CVD risk, since no long-term clinical data have established a link between the lower HDL-c concentrations caused specifically by TRT and increased incidence of CVD. '

So that is a long answer to say that if you are truly hypogonadal, you are more likely to die of a heart attack than someone who was hypogonadal and is now treated with TRT. TRT has never definitively been shown to raise LDL cholesterol, and any detrimental effect on HDL levels seems to be outweighed by the fact that normalization of testosterone levels decreases inflammation, creates a more favorable apoB/apoA-1 ratio, and otherwise improves overall health outcomes.

Basically, there is never a reason to start a statin concurrently with TRT as TRT at worst lowers HDL. Statins work primarily by lowering LDL (20.5%, at worst it lowers it 40-50 points) and have a minimal change on raising HDL (on average <7.5%; at best raises it 2-3 points).