{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:03:55Z","timestamp":1794258235101,"version":"4.9.0"},"reference-count":13,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Testosterone replacement therapy (TRT) is widely used in the management of male hypogonadism to restore physiological androgen levels and improve related symptoms. Although generally considered safe under appropriate monitoring, its association with pulmonary embolism (PE) remains controversial. We report a case of a 50-year-old man who independently and progressively shortened testosterone injection intervals due to recurrent hypogonadal symptoms. Despite the absence of overt cardiopulmonary symptoms, diagnostic workup revealed bilateral PE. This case highlights an atypical presentation of PE in a male patient receiving TRT, in whom nonspecific symptoms such as fatigue and reduced exercise tolerance were initially attributed to hypogonadism, potentially masking an underlying life-threatening thromboembolic event. It underscores the importance of periodic reassessment of TRT, clinical vigilance for thrombotic complications, and improved risk-stratification tools to guide monitoring and management.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag312","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:02:59Z","timestamp":1790769779000},"source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic challenge of pulmonary embolism during testosterone replacement therapy for primary hypogonadism"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4634-5755","authenticated-orcid":false,"given":"Hamza","family":"El Hadi","sequence":"first","affiliation":[{"name":"Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster , 48149 Muenster ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke Dorothea","family":"H\u00f6lscher","sequence":"additional","affiliation":[{"name":"Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster , 48149 Muenster ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-3881","authenticated-orcid":false,"given":"Jonel","family":"Trebicka","sequence":"additional","affiliation":[{"name":"Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster , 48149 Muenster ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4522-2706","authenticated-orcid":false,"given":"Elena","family":"Vorona","sequence":"additional","affiliation":[{"name":"Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster , 48149 Muenster 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steroids","volume":"19","author":"Liljeqvist","year":"2008","journal-title":"Eur J Intern Med"},{"issue":"8","key":"2026101301302269600_luag312-B7","article-title":"Pulmonary embolism secondary to testosterone-enhancing herbal supplement use","volume":"9","author":"Nguyen","year":"2017","journal-title":"Cureus"},{"issue":"S3","key":"2026101301302269600_luag312-B8","doi-asserted-by":"crossref","first-page":"S287","DOI":"10.21037\/tau.2019.04.03","article-title":"Changes in testosterone prescribing patterns after FDA warning","volume":"8","author":"Lokeshwar","year":"2019","journal-title":"Transl Androl Urol"},{"issue":"1","key":"2026101301302269600_luag312-B9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3390\/jcm8010011","article-title":"Testosterone therapy, thrombophilia, venous thromboembolism, and thrombotic events","volume":"8","author":"Glueck","year":"2019","journal-title":"J Clin 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orchiectomy alone or bleomycin, etoposide, and cisplatin","volume":"4","author":"Bandak","year":"2018","journal-title":"Eur Urol Focus"},{"issue":"4","key":"2026101301302269600_luag312-B13","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1530\/EJE-07-0684","article-title":"Risk factors for post-treatment hypogonadism in testicular cancer patients","volume":"158","author":"Eberhard","year":"2008","journal-title":"Eur J Endocrinol"}],"container-title":["JCEM Case 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