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Updated: Jun 26, 2025
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Published on: June 4, 2020
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Testosterone Therapy Does Not Affect Coagulation in Male Hypogonadism: A Longitudinal Study Based on Thrombin
Valeria Lanzi1,2, Rita Indirli1,2, Armando Tripodi3,4
1Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Summary
Testosterone replacement therapy (TRT) did not worsen global coagulation in hypogonadal men. These men showed an initial procoagulant imbalance that was not exacerbated by short-term TRT.
Area of Science:
- Endocrinology
- Hematology
- Thrombosis Research
Background:
- Testosterone therapy's link to thrombotic risk is debated, with limited data on its effects on overall blood coagulation.
- Hypogonadism is common and often treated with testosterone replacement therapy (TRT).
Purpose of the Study:
- To compare global coagulation parameters in hypogonadal men before and after TRT.
- To assess changes in thrombin generation and related factors in hypogonadal men compared to healthy controls.
Main Methods:
- An observational prospective cohort study involving 38 hypogonadal men and 38 healthy controls.
- Thrombin generation assay (TGA) was used to measure parameters like endogenous thrombin potential (ETP) and thrombin peak.
- Assays for Protein C, antithrombin, Factor VIII, and fibrinogen were also performed.
Main Results:
- Hypogonadal men exhibited higher ETP and fibrinogen, and lower antithrombin levels compared to controls, indicating a procoagulant imbalance.
- No significant changes in TGA parameters were observed after 6 months of TRT.
- ETP and antithrombin levels correlated with testosterone levels.
Conclusions:
- Hypogonadal men present with an inherent procoagulant imbalance.
- Short-term TRT appears safe regarding global coagulation, as it did not worsen the procoagulant state.
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