Does Testosterone Therapy Prevent Fractures in Older Men with Mild Hypogonadism?

Testosterone therapy is thought to increase bone density in older men with relatively low testosterone levels, but whether it prevents fractures is unclear. To address this question, researchers conducted a “subtrial” within TRAVERSE, the previously published randomized trial designed primarily to examine the cardiovascular (CV) safety of testosterone supplementation (NEJM JW Gen Med Jul 15 2023 and N Engl J Med 2023; 389:107).

In TRAVERSE, 5200 middle-aged and older men (mean, 63 years) with testosterone levels <300 ng/dL (median, 227 ng/dL) received testosterone gel or placebo. During median follow-up of about 3 years, the overall incidence of fractures (excluding sternum, fingers, toes, skull, and face) was significantly higher in the tes…