Breaking News — Testosterone Treatment and Fractures in Older Men

This editorial discusses findings from the TRAVERSE trial, which examined the effects of testosterone therapy on fractures in older men with hypogonadism. The trial, involving 5,204 men (median age 64 years), revealed a higher incidence of clinical fractures in the testosterone group (3.50%) compared to placebo (2.46%), primarily due to trauma related fractures (ankle, rib). The authors suggest behavioral changes (e.g., increased physical activity) rather than bone structural effects as a potential explanation, given the rapid onset of fracture risk divergence. Limitations include low fracture incidence, possible pseudohypogonadism in obese participants, and lack of bone density data. The findings highlight the need for caution when prescribing testosterone to aging or obese men with low testosterone, emphasizing that osteoporosis-specific treatments remain essential for high risk patients.

This editorial discusses findings from the TRAVERSE trial, which examined the effects of testosterone therapy on fractures in older men with hypogonadism. The trial, involving 5,204 men (median age 64 years), revealed a higher incidence of clinical fractures in the testosterone group (3.50%) compared to placebo (2.46%), primarily due to trauma related fractures (ankle, rib). The authors suggest behavioral changes (e.g., increased physical activity) rather than bone structural effects as a potential explanation, given the rapid onset of fracture risk divergence. Limitations include low fracture incidence, possible pseudohypogonadism in obese participants, and lack of bone density data. The findings highlight the need for caution when prescribing testosterone to aging or obese men with low testosterone, emphasizing that osteoporosis-specific treatments remain essential for high risk patients.