How do you manage testosterone replacement therapy-induced erythrocytosis?

Testosterone is a known risk for thromboembolism. What is not known is whether it is the hematocrit or the testosterone itself that is the trigger for thrombosis. Note also that epidemiologically, the age group that generally is prescribed testosterone also has a high prevalence of thrombosis.

My ap...

I recommend discontinuing testosterone, treating the underlying cause in patients with secondary testicular failure, and using PDE inhibitors.

I would strongly urge patients to discontinue testosterone. It has no proven health benefit and the symptomatic improvement is likely functional. I would urge patients to try PDE inhibitors if sexual performance is an issue; they are much more safe and efficacious in that regard. I agree that the da...