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Testosterone treatment and higher blood clot risk (2016-12-14)

A striking increase in prescribing of testosterone occurred over the first decade of this century, with a 10-fold increase in testosterone prescriptions per capita in the United States (excluding compounding pharmacies).

The 40-fold increase in Canada, which includes internet pharmacies providing additional testosterone sales, suggests that this may be an underestimate.

Yet pathological hypogonadism, defined as recognised pathological disorders of the male reproductive system, remains the sole unequivocal indication for testosterone treatment.

In a recent study researchers examined data on 19,215 patients with blood clots (comprising deep venous thrombosis and pulmonary embolism) and more than 900,000 similar men without a history of clots collected from 2001 to 2013 in the U.K. to determine the risk of venous thromboembolism associated with use of testosterone treatment in men, 909,530 age matched controls from source population including more than 2.22 million men.

In the first six months after starting testosterone, men have a 63 percent higher risk of clots in the legs and lungs than they did before beginning treatment, the study found: the risk peaked within six months and declined thereafter.

Testosterone levels decline gradually over time, leading to symptoms such as decreased libido, sexual dysfunction, decreased bone mineral density, mood disorders, reduced muscle mass and fatigue.
Most of these symptoms can also come from other causes such as diabetes, high blood pressure, heart disease and thyroid disorders.

Millions of men worldwide have taken testosterone to address these symptoms.

Some previous studies suggest a possible relationship between low testosterone and hardening of the arteries, heart disease, and blood clots, said Dr. Joao Zambon, a researcher at Wake Forest University in Winston-Salem, North Carolina who wasn't involved in the study.

For more information
Testosterone treatment and risk of venous thromboembolism: population based case-control study