Acute Portal and Superior Mesenteric Vein Thrombosis with Topical Testosterone Therapy: An Adverse Drug Event Case Report

This is a case report of a 55-year-old Caucasian male prescribed topical testosterone therapy for 12 months prior to admission, when he was diagnosed with acute thrombosis in the portal vein (PVT) and superior mesenteric vein (SMV). The patient had a negative thrombophilia workup, including Factor V Leiden, Prothrombin G20210A, and JAK2 V617F mutations. There were no other pertinent laboratory markers that raised concern for the cause of thrombus. No strong familial history of venous thromboembolism (VTE) was reported during the patient’s initial workup. With this in mind, the patient’s use of topical testosterone therapy was considered the most likely risk factor for the PVT and SMV thrombus. During hospitalization, the patient was initiated on therapeutic anticoagulation with a heparin drip and discharged to home on apixaban for 3 months with extended therapy to be determined by outpatient hematologist. With no other identified VTE risk factors, probability that this patient’s VTE was attributed to testosterone was evaluated using the Naranjo scale with a calculated score of 6, which classifies the adverse reaction as “likely.” Clinicians should be aware of the possibility that topical testosterone therapy may be a risk factor for venous thrombosis in unusual sites.

Types of Testosterone Therapy and their Effects on the Voices of Transgender Singers

Hormone therapy (HT) is the administration of hormones in an attempt to relieve gender dysphoria by obtaining the phenotype and vocal quality of one’s gender identi-ty. The information contained in this article is designed to help transgender singers and their voice teachers understand what to expect vocally during initial changes that occur on testosterone therapy in order to build awareness around and facilitate the accommodation of this period of rapid vocal change.

Local and Systemic Complications of Local Testosterone Patches and Gels

In recent decades, testosterone therapy has gained the attention of many researchers due to the increased demand for this modality worldwide, the increased average age of the different populations, and increased awareness of the potential uses of the modality in clinical settings. Using testosterone therapy aims to treat erectile dysfunction, libido disorders, and potentially enhance physical strength and general body functions. It should be noted that the administration of this treatment modality has been reported with various adverse outcomes despite the remarkable efficacy and wide rates of administration among the different populations. In the present literature review, we have discussed the potential local and systemic complications of applying local testosterone patches and gel. The main advesre events that were reported for both formulas have been skin reactions at the site of application. However, these reactions are not usually serious, and only a few patients discontinued the therapy due to these reactions. In general, evidence indicates that the exogenous administration of testosterone has been associated with many systemic complications as cardiovascular diseases, prostate cancer, obstructive sleep apnea, and elevated hematocrite value. However, evidence regarding this association is still controversial, and additional studies are needed for verfication.

Testosterone Therapy for Late-Onset Hypogonadism Improves Erectile Function: A Systematic Review and Meta-Analysis

<b><i>Introduction:</i></b> Randomized controlled trials (RCTs) of testosterone therapy (TTh) for late-onset hypogonadism are systematically reviewed and a meta-analysis to assess the efficacy of TTh in improving erectile function is performed. <b><i>Methods:</i></b> The PubMed, Cochrane Library, and Web of Science databases were searched to identify RCTs published from 2007. RCTs that assessed erectile function using the erectile function domain of the International Index of Erectile Function (IIEF-EFD) were included in the meta-analysis. <b><i>Results:</i></b> The systematic review included 18 RCTs and the meta-analysis included 6 studies that enrolled a total of 1,458 patients. The overall meta-analysis revealed that the IIEF-EFD score was significantly improved in the TTh group compared with the placebo group (mean difference 1.86; 95% confidence interval 1.01–2.72; <i>p</i> &#x3c; 0.0001). Compared with patients receiving placebo, there was a significant improvement in the IIEF-EFD of patients who received TTh using testosterone gel, those who received TTh for over 30 weeks, and those without diabetes mellitus or metabolic syndrome. <b><i>Conclusion:</i></b> TTh achieved a significant improvement in the IIEF-EFD score of hypogonadal men compared with placebo, especially in those who received testosterone gel, were treated for over 30 weeks, and had no comorbidities.