Erythrocytosis following testosterone therapy

CLINICAL PRACTICE GUIDELINE
 | 
2018
Ohlander SJ
Varghese B
Pastuszak AW
Sex Med Rev. 2018 Jan;6(1):77-85.
Summary

INTRODUCTION: A rapid increase in awareness of androgen deficiency has led to substantial increases in prescribing of testosterone therapy (TTh), with benefits of improvements in mood, libido, bone density, muscle mass, body composition, energy, and cognition. However, TTh can be limited by its side effects, particularly erythrocytosis. This review examines the literature on testosterone-induced erythrocytosis and polycythemia.

AIM: To review the available literature on testosterone-induced erythrocytosis, discuss possible mechanisms for pathophysiology, determine the significance of formulation, and elucidate potential thromboembolic risk.

METHODS: A literature review was performed using PubMed for articles addressing TTh, erythrocytosis, and polycythemia.

MAIN OUTCOME MEASURES: Mechanism, pharmacologic contribution, and risk of testosterone-induced erythrocytosis.

RESULTS: For men undergoing TTh, the risk of developing erythrocytosis compared with controls is well established, with short-acting injectable formulations having the highest associated incidence. Potential mechanisms explaining the relation between TTh and erythrocytosis include the role of hepcidin, iron sequestration and turnover, erythropoietin production, bone marrow stimulation, and genetic factors.

High blood viscosity increases the risk for potential vascular complications involving the coronary, cerebrovascular, and peripheral vascular circulations, although there is limited evidence supporting a relation between TTh and vascular complications.

CONCLUSION: Short-acting injectable testosterone is associated with greater risk of erythrocytosis compared with other formulations. The mechanism of the pathophysiology and its role on thromboembolic events remain unclear, although some data support an increased risk of cardiovascular events resulting from testosterone-induced erythrocytosis.

Keywords
erythrocytosis
polycythemia
blood clots
thromboembolism
Comments

Related studies: https://www.ncbi.nlm.nih.gov/pubmed/26205547

Risk of Venous Thromboembolism in Men Receiving Testosterone Therapy. Baillargeon J, Urban RJ, Morgentaler A, Glueck CJ, Baillargeon G, Sharma G, Kuo YF. Mayo Clin Proc. 2015 Aug;90(8):1038-45.

https://www.ncbi.nlm.nih.gov/pubmed/28495861

Testosterone treatment and cardiovascular and venous thromboembolism risk: what is 'new'? Corona G, Dicuio M, Rastrelli G, Maseroli E, Lotti F, Sforza A, Maggi M. J Investig Med. 2017 Aug;65(6):964-973

  • PP-NEB-ALL-0347-1

Copyright © 2019,
Bayer AG

This website is intended to provide information to an international audience outside the USA and UK.

Page last modified Tue, 20/08/2019

Bayer logo