Polycythemia as a Complication of Testosterone Replacement Therapy in Nursing Home Men with Low Testosterone Levels

Drinka, Paul J.; Jochen, Albert; Cuisinier, Mary; Bloom, Rosemary; Rudman, Inge W.; Rudman, Daniel

doi:10.1111/j.1532-5415.1995.tb05534.x

Cited by 100 publications

(44 citation statements)

References 11 publications

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“…In three other subjects, there was a single measurement of a supranormal hematocrit returning to normal without intervention. Androgens stimulate erythropoiesis, and in most studies, a 2-5% increase in the hematocrit over baseline has been observed, with 6-25% of subjects developing erythrocytosis with hematocrits over 50% (16) (for review (17)). To our knowledge, the effect of testosterone administration on hemoglobin levels and hematocrit in FTM transsexuals has not been systematically studied, but polycythemia has been observed with traditional parenteral testosterone injections (personal observation J J and L G).…”

Section: Discussionmentioning

confidence: 99%

Safety aspects of 36 months of administration of long-acting intramuscular testosterone undecanoate for treatment of female-to-male transgender individuals

Jacobeit¹,

Gooren²,

Schulte³

2009

European Journal of Endocrinology

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Design: Testosterone treatment is essential for the induction and maintenance of virilization of femaleto-male (FTM) transsexuals. Aim: To test the safety of a novel testosterone preparation for this purpose. Methods: Parenteral long-acting testosterone undecanoate (TU) was administered to 17 FTM transsexuals over 36 months. Observations were made while subjects received treatment. Results: Serum testosterone rose from 0.50G0.25 to 6.2G1.3 ng/ml at 6 months and remained stable thereafter. The testosterone profiles were largely identical with those in hypogonadal receiving TU. There were no side effects. Over the 36 months of the study, there was a small but significant decrease in plasma cholesterol (from 218G47 to 188G42 mg/dl) and low-density lipoprotein-cholesterol (from 139G48 to 139G48 mg/dl), while plasma levels of high-density lipoprotein-cholesterol and triglycerides did not change significantly. Liver enzymes did not change during treatment. There was an increase of both levels in hemoglobin (from 13.6G1.2 to 16.0G1.5 g/dl) and hematocrit (from 41G4 to 46G4) upon administration but they remained almost without exception within the physiological range. No special measures were needed. Breast and gonads/internal genitalia did not show pathological changes over the observation period. Conclusion: This study reports that TU is suited for induction of virilization in FTM transsexuals without significant side effects over a longer term.

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Section: Discussionmentioning

confidence: 99%

Safety aspects of 36 months of administration of long-acting intramuscular testosterone undecanoate for treatment of female-to-male transgender individuals

Jacobeit¹,

Gooren²,

Schulte³

2009

European Journal of Endocrinology

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“…240 The resolution of erythrocytosis (hematocrit  52%), untreated obstructive sleep apnea, or untreated severe congestive heart failure, is required before starting on testosterone treatment. 19,58,304 Periodic hematological assessment is indicated (ie, before treatment, then at 3 to 4 months and at 12 mo in the first year of treatment and annually thereafter). While it is not yet clear what critical threshold is a desirable, dose adjustment and/or periodic phlebotomy may be necessary to keep hematocrit below 52% to 55%.…”

Section: Liver Problemsmentioning

confidence: 99%

The benefits and risks of testosterone replacement therapy: a review

Bassil¹,

Alkaade²,

Morley

2009

TCRM

140

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“…Sleep apnea in the elderly, particularly those with obesity or chronic lung disease, can be exacerbated by testosterone treatment, will cause nocturnal oxygen desaturation, and can thereby contribute to polycythemia [35,36].…”

Section: Potential Risks Of Testosterone Replacementmentioning

confidence: 99%

Androgen deficiency in the aging male: When to evaluate and when to treat

Nolten

2000

Curr Urol Rep

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Aging can be associated with an abnormal decline in testosterone production, mainly due to pituitary failure, and is reflected by low serum testosterone concentrations. Manifestations of testosterone deficiency can be subtle, can be misinterpreted as consequences of normal aging, and include lack of libido and energy, mood changes, impaired strength, and development of osteoporosis. The most important factor in the evaluation and treatment of this age-related, usually unrecognized abnormality is the public awareness of its frequent occurrence that will stimulate the use of appropriate screening tests, beginning with a morning testosterone level. Replacement therapy by parenteral or transdermal testosterone administration can be highly beneficial in alleviating the manifestations of hypogonadism and improving quality of life. Careful screening and meticulous follow-up are mandatory. The long-term effects of testosterone replacement on the cardiovascular system, the prostate, and on longevity are unknown.

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Polycythemia as a Complication of Testosterone Replacement Therapy in Nursing Home Men with Low Testosterone Levels

Cited by 100 publications

References 11 publications

Safety aspects of 36 months of administration of long-acting intramuscular testosterone undecanoate for treatment of female-to-male transgender individuals

Safety aspects of 36 months of administration of long-acting intramuscular testosterone undecanoate for treatment of female-to-male transgender individuals

The benefits and risks of testosterone replacement therapy: a review

Androgen deficiency in the aging male: When to evaluate and when to treat

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