Is Testosterone Therapy Safer Than We Think?

(First Posted on MedBridgeGlobal.org May 2025.

Testosterone therapy has been a controversial topic in men's health, particularly when it comes to concerns about cardiovascular and clotting risks. In places like Australia, these concerns have led to strict regulations and a general hesitancy around prescribing testosterone—even to men with clear signs of deficiency.

But a recent study published in The Journal of Clinical Endocrinology & Metabolism is helping to shift that narrative. Researchers from Italy followed a group of men with confirmed low testosterone and treated them with testosterone injections over a six-month period. Their goal? To see whether testosterone therapy actually increases the risk of blood clots—a common fear linked to hormone replacement in men.

The study (Lanzi et al., 2024) found that testosterone therapy did not worsen the blood clotting profile in these men. In fact, men with low testosterone already had signs of a slightly "stickier" blood profile, and this didn’t change significantly with treatment. Put simply, testosterone didn’t make things worse—and might even be less risky than previously thought.

This matters. We're living in a time when male fertility and testosterone levels are steadily declining across the globe. Symptoms like low energy, reduced libido, muscle loss, and mood changes are increasingly common. Yet many men who could benefit from testosterone therapy are either denied treatment or put off by the fear of side effects.

This new study adds to a growing body of evidence suggesting that testosterone therapy, when properly prescribed and monitored, may be safer than we’ve been led to believe—at least in the short term. While long-term studies are still needed, the findings support a more balanced, evidence-based approach to managing male hypogonadism.

For clinicians working in men’s health and optimization medicine, this is an encouraging sign: clinicians are best placed to assess the clinical needs of their patient. The blanket fear around testosterone may no longer be justified.

Reference:
Lanzi V, Elli A, Bandera E, et al. Testosterone Therapy Does Not Affect Coagulation in Male Hypogonadism: A Longitudinal Study Based on Thrombin Generation. J Clin Endocrinol Metab. 2024;109(2):319–328.