Study: Testosterone Treatment Doesn’t Increase Older Men's Clot Risk

New research finds that elderly men with hypogonadism who undergo testosterone treatment face no greater risk of a thrombotic event than those who are not treated with testosterone.  

A team led by Ranjith Ramasamy MD, a clinical associate in urology at the Baylor College of Medicine studied a group of 217 hypogonadal men older than 65, retrospectively reviewing participants’ medical records. Among these men, 153 received testosterone therapy. Fifty-three were treated with injections, while 47 were treated with gel and 53 were treated with pellets placed intramuscularly beneath the skin. The other 64 men taking part in the study did not receive testosterone therapy. Median follow-up for the treated group was 3.8 years, versus 3.5 years for the untreated group. The median age was 74 to 75 in both groups.
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The authors observed that there were fewer deaths in the treated group (1), compared to 6 in the untreated group. There were also more myocardial infarctions in the treated group (1 versus 0). While noting that the differences were not significant, the authors also found there were more cerebrovascular accidents in the treated group (2 versus 1), and more pulmonary embolisms (1 versus 0). In addition, scores on the Charlson Comorbidity Index were similar, but testosterone levels were higher in the treated group in comparison to the untreated group (475 versus 236 ng/dL; P < .001), according to the authors.

The retrospective study is “limited by sample size,” says Ramasamy, but “overcomes several limitations in the large epidemiological studies.”

For example, “the study included an age and comorbidity matched control group of hypogonadal men not treated with testosterone,” he says. “All men had at least 2 testosterone levels checked, follow-up was over 3 years, thrombotic events were verified through patient calls, and mortality was verified using national death index.”

The findings were originally presented at the American Urological Association 2015 Annual Meeting, held May 15-19 in New Orleans.

—Mark McGraw