From the Guidelines
Testosterone therapy may have a complex relationship with platelet count, and its impact can vary between individuals, but the most recent and highest quality study suggests that testosterone treatment is not associated with an increased risk for thromboembolic disease, including deep venous thrombosis or pulmonary embolism 1.
Key Points to Consider
- The relationship between testosterone and platelet count is complex and influenced by factors such as baseline hormone levels, dosage, and administration method.
- Some studies suggest that testosterone therapy may increase platelet counts in individuals with initially low testosterone levels, potentially due to its influence on thrombopoietin production.
- However, the most recent evidence from high-quality studies indicates that testosterone treatment does not significantly increase the risk of thromboembolic events, including deep venous thrombosis or pulmonary embolism 1.
- Monitoring of complete blood count, including platelet levels, is recommended for patients on testosterone therapy, especially during the initial treatment period, to detect any concerning changes that may require dose adjustment or discontinuation.
- This monitoring is particularly important for individuals with pre-existing cardiovascular risk factors or clotting disorders.
Evidence Summary
The evidence from recent studies, including those published in the Annals of Internal Medicine 1, suggests that testosterone treatment is not associated with a significant increase in thromboembolic risk. While some studies reported mixed results, the highest quality and most recent evidence supports the safety of testosterone therapy in terms of thromboembolic events. The study by 1 is particularly notable, as it found no increased risk for pulmonary embolism or deep venous thrombosis in men treated with testosterone.
Clinical Implications
Based on the most recent and highest quality evidence, clinicians should not be overly concerned about the risk of thromboembolic events when prescribing testosterone therapy, but should still monitor patients' complete blood counts and adjust treatment as necessary to minimize potential risks 1.
From the Research
Testosterone and Platelet Count
- The provided studies do not directly address the effect of testosterone on platelet count.
- However, they do discuss the relationship between testosterone therapy and thrombotic events, erythrocytosis, and venous thromboembolism 2, 3, 4, 5.
- Testosterone therapy has been associated with an increased risk of thrombotic events, particularly in individuals with underlying thrombophilia 2, 3, 5.
- Erythrocytosis, an increase in red blood cell count, is a common side effect of testosterone therapy and may contribute to an increased risk of thrombotic events 4, 6.
- While the studies do not specifically examine the effect of testosterone on platelet count, they suggest that testosterone therapy can have significant effects on blood composition and increase the risk of vascular complications 2, 3, 4, 5, 6.