Testosterone therapy can be considered safe for recovery after surgery in many cases, but its safety depends on individual patient factors, the type of surgery, and the presence of any underlying risks, particularly related to blood clotting. Testosterone plays a significant role in tissue repair and wound healing, which can potentially aid postoperative recovery. However, careful evaluation and monitoring are essential to balance benefits and risks.
Testosterone is a key sex hormone that influences various physiological processes, including muscle mass maintenance, bone density, and importantly, tissue repair mechanisms. Studies have shown that testosterone can stimulate fibroblast proliferation and angiogenesis—the formation of new blood vessels—which are critical for wound healing. This suggests that testosterone therapy might enhance the body’s ability to recover after surgical procedures by promoting faster and more effective tissue regeneration.
In the context of surgery, continuing testosterone therapy perioperatively (around the time of surgery) is generally considered safe, especially if the patient does not have significant risk factors for venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE is a serious complication that can occur after surgery due to immobility and changes in blood coagulation. While estrogen therapies are more strongly linked to increased VTE risk, testosterone therapy has a less clear association. Some reports have noted venous thromboembolic events in patients using testosterone, but these are relatively rare and often linked to other risk factors. Therefore, clinicians often recommend continuing testosterone therapy but with vigilant monitoring for signs of clotting problems, especially in patients with pre-existing risk factors.
For patients undergoing surgery, the decision to continue or pause testosterone therapy should be individualized. If a patient has a history of clotting disorders, cardiovascular disease, or other risk factors, doctors may consider stopping testosterone before surgery or implementing aggressive VTE prophylaxis measures, such as blood thinners or mechanical devices to improve circulation. On the other hand, abrupt discontinuation of testosterone can lead to withdrawal symptoms and potentially impair wound healing, so the risks and benefits must be carefully weighed.
In transgender men receiving testosterone as part of hormone replacement therapy, evidence suggests that testosterone does not significantly increase thrombotic risk, unlike estrogen therapy in transgender women, which is associated with a higher risk of blood clots. This distinction is important when planning surgery and perioperative care for transgender patients.
Additionally, testosterone therapy has some potential side effects that need consideration during recovery. For example, high doses or prolonged use of androgens can affect liver function and may increase the risk of cardiovascular events. Testosterone can also influence prostate health in older men, so monitoring is necessary. Skin reactions at the site of testosterone application (such as with transdermal patches) can occur but are generally manageable.
In summary, testosterone therapy can support postoperative recovery by enhancing wound healing and tissue repair, but its use around the time of surgery requires careful assessment of thrombotic risk and other health factors. Patients on testosterone therapy should be closely monitored by their healthcare providers during the perioperative period to ensure safety and optimize recovery outcomes.
