In transgender men undergoing testosterone therapy, an increase in red blood cells can raise the risk of blood clots.
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‘The risk factor for blood clots occurs in more than 10 percent of transgender men using testosterone.’
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“Erythrocytosis is common in transgender men treated with testosterone, especially in those who smoke, have high body mass index (BMI) and use testosterone injections,” said lead study author Milou Cecilia Madsen, M.D., of the VU University Medical Center Amsterdam in the Netherlands. “A reasonable first step in the care of transgender men with high red blood cells while on testosterone therapy is to advise them to quit smoking, switch injectable testosterone to gel, and if BMI is high, to lose weight.” 
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The researchers analyzed the medical and laboratory records of 1,073 transgender men using testosterone from the Amsterdam Cohort of Gender study (ACOG). Eleven percent of transgender men using testosterone showed erythrocytosis during 20 years of follow-up. However, less than one percent of these men had very high levels of red blood cells with a high risk of complications.
Other authors of the study include: Dennis van Dijk, Chantal Maria Wiepjes, Elfi Barbara Conemans, Abel Thijs and Martin den Heijer of the VU University Medical Center Amsterdam.
The manuscript received no external funding.
The manuscript, “Erythrocytosis in Trans Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence and Determinants," was published online, ahead of print.
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Source-Eurekalert