ClotCare: Blood Clots, Stroke, Heart Attack
Sunday, July 14, 2024
Home   |   DVT/PE   |   Blood Clots   |   Coumadin/Warfarin   |   New Patients   |   Self Testing   |   Email List   |   Donate

Pick a Topic:

Find info on a:

We subscribe to the HONcode principles of the HON Foundation. Click to verify.
ClotCare complies with the HONcode standard for trustworthy health
verify here.

ClotCare is a member of the Coalition to Prevent Deep Vein Thrombosis (DVT Coalition)  ClotCare is a member organization of the Coalition to Prevent Deep Vein Thrombosis. Click here to learn more about the Coalition to Prevent Deep Vein Thrombosis and DVT Awareness Month, which is held each March.

Testosterone Supplementation and the Risk of Venous Thrombosis and Osteonecrosis

Charles J. Glueck, MD
March, 2014

Editor's Note from Henry I. Bussey, Pharm.D.: Dr. Charles J. Glueck of the Jewish Hospital of Cincinnati ( who has previously shared his work on the relationship of testosterone supplementation and venous thrombosis and osteonecrosis (see and has provided ClotCare with the following summary of updated information.

We have recently published three studies documenting the relationship between exogenous testosterone therapy (TT) and thrombotic events (1-3). We evaluated thrombophilia-hypofibrinolysis in 14 men and 1 woman referred to us after developing deep venous thrombosis (DVT)-pulmonary emboli (PE) and hip-knee osteonecrosis (n=5) that developed after testosterone therapy (median 11 months) (1). The subjects had been previously healthy with no antecedent thrombosis. Of the 14 patients, 3 had factor V Leiden heterozygosity, 3 had high factor VIII, 3 and PAI-4G4G homozygosity, 2 had high factor XI, 2 had high homocysteine, 1 had low antithrombin III, 1 had the lupus anticoagulant, 1 had high ACLA. In 4 men with thrombophilia, DVT-PE recurred despite therapeutic INR on warfarin.

In a study of 3 postmenopausal women receiving TT for low libido, central retinal vein thrombosis (n=1), and osteonecrosis (n=2) developed at 16 days, 2 months, and 11 months after starting TT. The women were found to have G20210A Prothrombin gene heterozygosity, high homocysteine, and 4G4G PAI-1 homozygosity respectively (2)

In an assessment of 596 men hospitalized for DVT-PE, we found that 1.2% of the cohort had taken TT before and at the time of their admission, with DVT-PE occurring within 2 months (median) after starting TT. All 5 men who had evaluation of coagulation were found to have previously undiagnosed familial or acquired thrombophilia-hypofibrinolysis (3).


  1. Glueck CJ, Richardson-Royer C, Schultz R, et al. Testosterone, thrombophilia, and thrombosis. Clin Appl Thromb Haemost 2014;20:22-30.

  2. Glueck CJ, Bowe D, Valdez A et al. Thrombosis in three postmenopausal women receiving testosterone therapy for low libido. Women’s Health 2013;9:405-410.

  3. Glueck CJ, Richardson-Royer C, Schultz R, et al. Testosterone therapy, thrombophilia-hypofibrinolysis, and hospitalization for deep venous thrombosis-pulmonary embolus: an exploratory, hypothesis-generating study. Clin Appl Thromb Hemost 2014;20;244-249.
Ask a question about blood clots or anticoagulant medications Have questions? Ask ClotCare. Send questions by email to

ClotCare is a 501(c)(3) non-profit organization generously supported by your tax-deductible donations and grants from our industry supporters.

Blood Clot Activities Calendar

New Postings:

Click here to view full list of new postings
ClotCare Home | New Postings | Patient Postings | Clinician Postings | Join Our Email List | Useful Web Links
CE Opportunities | Training Programs | DVT & PE Stories | Editorial Board | Financial Support
About ClotCare | DVT Coalition | Donate to ClotCare | Contact Us
Key topics discussed on ClotCare include: Blood Clots | Deep Vein Thrombosis (DVT) | Pulmonary Embolism (PE) | Atrial Fibrillation (A. Fib or AF) | Heart Attack | Stroke | Transient Ischemic Attack (TIA) | Mini Stroke | Bleeding Complications | Vascular Surgery | Surgical Blood Clot Removal | Warfarin | Coumadin | Lovenox | Low Molecular Weight Heparin (LMWH) | Heparin | Anticoagulants | Plavix | Aspirin | Antiplatelets | Blood Thinners
Copyright 2000-2018 by ClotCare. All rights reserved.
Terms, Conditions, & Privacy | Image Copyright Information
19260 Stone Oak Parkway, Suite 101 | San Antonio, TX 78258 | 210-860-0487
Send comments to
Sunday, July 14, 2024