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What is Testosterone
Testosterone is the primary androgen found in the body.
Endogenous testosterone is synthesized by cells in the testes, ovaries, and the adrenal cortex.
Therapeutically, testosterone is used in the management of primary or acquired hypogonadism in males (adolescent or adult), and use is also appropriate for selected adolescent males with constitutional delay of growth and puberty (CDGP).
In prepubertal males with hypogonadism, testosterone treatment is directed at initiating pubertal development at the appropriate age, then maintaining virilization.
Per guidelines, adult men with low testosterone concentrations due to medical conditions, and not exclusively due to aging, are appropriate candidates for testosterone replacement therapy (TRT) if certain criteria are met.
Historical uses of testosterone have included the palliation of advanced breast cancer in postmenopausal women.
Testosterone is commonly used off-label in transgender males (female to male) to support virilization.
In postmenopausal women, testosterone has been used off-label in selected patients with low libido, but this use is not sufficiently studied and is not recommended due to the potential for virilizing effects that may be irreversible.
The FDA has alerted of a possible increased risk of cardiovascular events or stroke associated with approved and unapproved uses of testosterone products in men; however, no clinical studies have been of sufficient size or duration to definitively establish the effects of testosterone therapy on cardiovascular health in men.
Testosterone injections have been commercially marketed for medical use since the mid-twentieth century.
In 1995, the FDA initially approved testosterone transdermal dosage forms; many unique dosage delivery forms, including buccal and subcutaneous implants and injections, have been FDA approved since that time.
Indications
- delayed puberty
- hypogonadism
- palliative treatment of breast cancer
For androgen replacement therapy in males with hypogonadism (primary and hypogonadotropic types)
for the treatment of hypogonadism (primary and hypogonadotropic types)
Side Effects
- abdominal pain
- abnormal dreams
- acne vulgaris
- alopecia
- amenorrhea
- amnesia
- anaphylactoid reactions
- anxiety
- apnea
- appetite stimulation
- arthralgia
- asthenia
- azoospermia
- back pain
- breast cancer
- bronchospasm
- bullous rash
- chills
- confusion
- contact dermatitis
- cough
- dental pain
- depression
- diarrhea
- dysgeusia
- dyspepsia
- dyspnea
- dysuria
- edema
- elevated hepatic enzymes
- emotional lability
- epiphyseal closure
- epistaxis
- eructation
- erythema
- erythrocytosis
- fatigue
- feminization
- fluid retention
- folliculitis
- furunculosis
- gastroesophageal reflux
- gingivitis
- gynecomastia
- hair discoloration
- headache
- hearing loss
- hematuria
- hirsutism
- hostility
- hot flashes
- hypercalcemia
- hypercholesterolemia
- hyperglycemia
- hyperhidrosis
- hypertension
- hypertriglyceridemia
- hypoglycemia
- impotence (erectile dysfunction)
- infection
- infertility
- injection site reaction
- insomnia
- irritability
- jaundice
- lacrimation
- libido decrease
- libido increase
- maculopapular rash
- malaise
- mastalgia
- memory impairment
- musculoskeletal pain
- myalgia
- myocardial infarction
- nasal congestion
- nasal dryness
- nasal irritation
- nausea
- new primary malignancy
- nocturia
- oligomenorrhea
- oligospermia
- osteopenia
- osteoporosis
- paresthesias
- parosmia
- peliosis hepatis
- pelvic pain
- peripheral edema
- pharyngitis
- physiological dependence
- polycythemia
- polyuria
- priapism
- prostatic hypertrophy
- prostatitis
- pruritus
- psychological dependence
- pulmonary embolism
- pulmonary oil microembolism
- rash
- rhinorrhea
- seborrhea
- sinusitis
- skin irritation
- skin necrosis
- skin ulcer
- spermatogenesis inhibition
- stomatitis
- stroke
- suicidal ideation
- syncope
- teratogenesis
- testicular atrophy
- thromboembolism
- tinnitus
- urticaria
- vesicular rash
- virilization
- vomiting
- weight gain
- wheezing
- xerosis
- xerostomia
Monitoring Parameters
- blood pressure
- hemoglobin/hematocrit
- LFTs
- serum cholesterol profile
- serum gonadotropin concentrations
- serum testosterone concentrations
Contraindications
- accidental exposure
- benzoic acid hypersensitivity
- benzyl alcohol hypersensitivity
- breast cancer
- breast-feeding
- cardiac disease
- children
- contraception requirements
- coronary artery disease
- depression
- diabetes mellitus
- females
- geriatric
- heart failure
- hepatic disease
- hypercalcemia
- hypertension
- infants
- infertility
- intravenous administration
- labor
- magnetic resonance imaging (MRI)
- myocardial infarction
- nasal polyps
- nasal septal perforation
- nasal surgery
- nasal trauma
- neonates
- obesity
- obstetric delivery
- polycythemia
- polyoxyethylated castor oil hypersensitivity
- pregnancy
- prostate cancer
- prostatic hypertrophy
- pulmonary disease
- pulmonary oil microembolism
- renal disease
- reproductive risk
- rhinorrhea
- serious hypersensitivity reactions or anaphylaxis
- sesame oil hypersensitivity
- Sjogren’s syndrome
- sleep apnea
- soya lecithin hypersensitivity
- stroke
- substance abuse
- suicidal ideation
- thromboembolism
Interactions
- Abarelix
- Acarbose
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Ambrisentan
- Aprepitant, Fosaprepitant
- Atazanavir
- Atazanavir; Cobicistat
- Boceprevir
- Cabozantinib
- Canagliflozin
- Canagliflozin; Metformin
- Carvedilol
- Cobicistat
- Cobimetinib
- Conivaptan
- Corticosteroids
- Cyclosporine
- Dabigatran
- Daclatasvir
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darbepoetin Alfa
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Degarelix
- Dipeptidyl Peptidase-4 Inhibitors
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Dronedarone
- Edoxaban
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Epoetin Alfa
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Everolimus
- Fluconazole
- Fosamprenavir
- Glipizide; Metformin
- Glyburide; Metformin
- Goserelin
- Histrelin
- Hydrochlorothiazide, HCTZ; Propranolol
- Idelalisib
- Incretin Mimetics
- Insulins
- Isavuconazonium
- Ixabepilone
- Lamivudine; Tenofovir Disoproxil Fumarate
- Leuprolide
- Leuprolide; Norethindrone
- Linagliptin
- Linagliptin; Metformin
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Maraviroc
- Meglitinides
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methoxy polyethylene glycol-epoetin beta
- Miglitol
- Mitotane
- Nafarelin
- Ombitasvir; Paritaprevir; Ritonavir
- Oritavancin
- Oxymetazoline
- Pazopanib
- Pexidartinib
- Posaconazole
- Pramlintide
- Propranolol
- Ranolazine
- Rifaximin
- Riluzole
- Ritonavir
- Rivaroxaban
- Romidepsin
- Sapropterin
- Saw Palmetto, Serenoa repens
- Saxagliptin
- SGLT2 Inhibitors
- Simvastatin; Sitagliptin
- Sitagliptin
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Somatropin, rh-GH
- St. John’s Wort, Hypericum perforatum
- Sulfonylureas
- Telaprevir
- Telotristat Ethyl
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiazolidinediones
- Ticagrelor
- Tolvaptan
- Triptorelin
- Vemurafenib
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Voriconazole
- Warfarin
- Zonisamide