Nelson Vergel
Founder, ExcelMale.com
CLOMIPHENE CITRATE RESULTS IN A SIGNIFICANTLY LOWER INCIDENCE OF POLYCYTHEMIA COMPARED TO EXOGENOUS TESTOSTERONE REPLACEMENT IN HYPOGONADAL MEN.
INTRODUCTION AND OBJECTIVES
It is established that exogenous testosterone replacement therapy (TRT) may be detrimental to a man's fertility. Clomiphene citrate (CC) is commonly used, off-label, to treat hypogonadal men in a fertility preserving manner. Polycythemia is a concerning side effect of direct TRT, however, there is no data regarding CC and polycythemia risk.
METHODS
The incidence of polycythemia was retrospectively assessed in men diagnosed with hypogonadism and treated with CC versus TRT at different institutions between 3/2011 - 4/2015. Polycythemia was defined as a hematocrit > 52%.
RESULTS
A total of 188 CC- and 175 TRT-treated men were included. CC treated men were younger (38 vs 51.5 years of age). TRT treated men had longer treatment durations than CC treated men, 19.6 months vs 9.2 months respectively. The incidence of polycythemia in men receiving CC was 1.7% versus 11.2% in men on TRT (p=0.0003). This significance remained after correction for age, site, smoking history, and pre-treatment hematocrit via logarithmic regression. The mean changes in Hct were 3.0% and 0.6%, and the mean changes in serum testosterone (T) were 333.1 ng/dL and 367.6 ng/dL in TRT-treated and CC-treated men, respectively.
CONCLUSIONS
The incidence of polycythemia in men treated with CC is markedly lower than that of TRT treated men. The improvement in absolute serum T levels was similar to TRT treated men. There is not a significant risk of polycythemia in men treated with CC for hypogonadism.
Source of Funding: None
The Journal of Urology
Volume 195, Issue 4, Supplement, April 2016, Pages e1007
2016 Annual Meeting Program Abstracts
AUA Annual Meeting
INTRODUCTION AND OBJECTIVES
It is established that exogenous testosterone replacement therapy (TRT) may be detrimental to a man's fertility. Clomiphene citrate (CC) is commonly used, off-label, to treat hypogonadal men in a fertility preserving manner. Polycythemia is a concerning side effect of direct TRT, however, there is no data regarding CC and polycythemia risk.
METHODS
The incidence of polycythemia was retrospectively assessed in men diagnosed with hypogonadism and treated with CC versus TRT at different institutions between 3/2011 - 4/2015. Polycythemia was defined as a hematocrit > 52%.
RESULTS
A total of 188 CC- and 175 TRT-treated men were included. CC treated men were younger (38 vs 51.5 years of age). TRT treated men had longer treatment durations than CC treated men, 19.6 months vs 9.2 months respectively. The incidence of polycythemia in men receiving CC was 1.7% versus 11.2% in men on TRT (p=0.0003). This significance remained after correction for age, site, smoking history, and pre-treatment hematocrit via logarithmic regression. The mean changes in Hct were 3.0% and 0.6%, and the mean changes in serum testosterone (T) were 333.1 ng/dL and 367.6 ng/dL in TRT-treated and CC-treated men, respectively.
CONCLUSIONS
The incidence of polycythemia in men treated with CC is markedly lower than that of TRT treated men. The improvement in absolute serum T levels was similar to TRT treated men. There is not a significant risk of polycythemia in men treated with CC for hypogonadism.
Source of Funding: None
The Journal of Urology
Volume 195, Issue 4, Supplement, April 2016, Pages e1007
2016 Annual Meeting Program Abstracts
AUA Annual Meeting
