Is it safe for men with history of PE and on blood thinners to start testosterone ?

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Nelson Vergel

Founder, ExcelMale.com
There are no published studies conducted on men with a history of pulmonary embolism (PE) who are taking blood thinners and want to use testosterone replacement therapy (TRT). However, they do provide a broad overview of the relationship between TRT and the risk of venous thromboembolism (VTE), which includes conditions like deep vein thrombosis (DVT) and PE. Here are some key points from the sources:
  1. Increased Risk of VTE with TRT:
    • Some studies suggest that TRT is associated with an increased short-term risk of VTE, particularly within the first six months of therapy. This risk is thought to be due to increased hematocrit levels, which can lead to higher blood viscosity and a greater likelihood of clot formation.
  2. Conflicting Evidence:
    • There is conflicting evidence regarding the risk of VTE with TRT. Some studies and meta-analyses have found no significant increase in VTE risk with TRT, while others have reported an increased risk.
  3. Mechanisms and Coagulation Effects:
    • TRT can affect the coagulation system in various ways. Some studies have found that TRT can make men with hypogonadism less likely to bleed, while others have found that it can make people more likely to bleed, especially when taking high doses or abusing anabolic androgenic steroids.
  4. FDA Warnings:
    • The FDA has issued warnings about the potential risk of blood clots with testosterone products, particularly in men with polycythemia, a condition characterized by an increased number of red blood cells.
  5. Need for Further Research:
    • There is a consensus that more research is needed to fully understand the risks and benefits of TRT, especially in specific populations such as men with a history of VTE or those on anticoagulant therapy.
Given the lack of specific studies on men with a history of PE who are taking blood thinners and considering TRT, it is crucial for such individuals to consult with their healthcare providers. Personalized medical advice and close monitoring are essential to balancing the potential benefits of TRT with the risks of thromboembolic events.


Citations:
[1] Testosterone Therapy and Venous Thromboembolism Risk in Men With and Without Hypogonadism
[2] Testosterone therapy increases the anticoagulant potential in men with opioid-induced hypogonadism: a randomized, placebo-controlled study
[3] Testosterone replacement therapy and the risk of venous thromboembolism: A systematic review and meta-analysis of randomized controlled trials - PubMed
[4] Testosterone Therapy, Thrombophilia, Venous Thromboembolism, and Thrombotic Events
[5] https://www.mayoclinicproceedings.org/pb/assets/raw/Health Advance/journals/jmcp/jmcp_pr90_7_3-1437418156810.pdf
[6] Testosterone therapy increases the anticoagulant potential in men with opioid-induced hypogonadism: a randomized, placebo-controlled study
[7] Testosterone Replacement Therapy & Blood Clots | Vein Specialists of the South
[8] Testosterone Therapy and Blood Clots: What You Need to Know
[9] FDA warns about blood clot risk with testosterone products - Harvard Health
[10] Testosterone treatment and risk of venous thromboembolism: population based case-control study
[11] Testosterone Usage Leading to Pulmonary Embolisms and Deep Vein Thrombosis: A Case Report and Review of the Literature
[12] No Link Between TRT for Hypogonadism and Blood Clots, Study Finds
[13] Policies and Disclaimers - NCBI
[20] Testosterone Replacement Therapy and Blood Clots
 
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