Sex steroid hormones regulate autophagy during myocardial infarction in rats, a research team from Australia shows. Moreover, ex vivo experiments reveal a novel mechanism of action for androgens during ischaemia–reperfusion through downregulation of the antiapoptotic protein Bcl-XL, a key controller of the crosstalk between autophagy and apoptosis. This action shifts the balance towards apoptosis, leading to aggravated cardiac damage in both male and female rats.