Unexpected study results on testosterone – no reduction in fracture risk

Testosterone treatment is known to increase bone density and bone quality. However, a study now suggests that supplementation with the male sex hormone does not reduce the risk of fractures, but rather increases it. The researchers behind the study were surprised by this result.

By Samuel Lagercrantz

January 22, 2024 8:41 AM

In a study published in the New England Journal of Medicine, 5,204 men between 45 and 80 years of age were randomised into two equal groups. One group was given daily treatment with testosterone gel and the other group was given placebo gel instead.

All study participants had a history of cardiovascular disease or a high risk of cardiovascular disease with at least one indication of hypogonadism. They also had testosterone concentrations of less than 300 ng per decilitre in fasting plasma samples.

After a median follow-up of 3.19 years, in total 91 of the participants (3.5 %) had fractures in the testosterone group. In the placebo group, the corresponding figure was 64 participants (2.46 %).

The researchers were surprised by the results.

“We did not expect these results, because most previous studies showed that testosterone improved many measures of bone structure and quality,” they write. They point out that the results should be seen in the context of the benefits of testosterone treatment, such as increased haemoglobin levels, improved sexual function and positive mood effects.

We did not expect these results, because most previous studies showed that testosterone improved many measures of bone structure and quality

An editorial published alongside the study emphasises the importance of future studies investigating the relation between testosterone treatment and fracture risk.

The study was funded by the pharmaceutical company AbbVie, which manufactures the testosterone gel AndoGel.

Read the study:

Testosterone Treatment and Fractures in Men with Hypogonadism

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