WARNING

Taking testosterone, whether as a medical treatment or illicitly, carries several risks. Here’s a brief overview:

• Cardiovascular Risks: Increased testosterone levels can lead to higher red blood cell counts, which may increase the risk of blood clots, stroke, and heart attack.
• Endocrine Disruption: Supplemental testosterone can disrupt the body’s natural hormone balance, leading to testicular atrophy, infertility, and decreased sperm production.
• Liver Damage: Oral testosterone supplements can strain the liver, potentially leading to liver damage or dysfunction.
• Psychological Effects: Testosterone use may exacerbate mood disorders such as depression, aggression, and irritability. It can also contribute to dependency and addiction issues.
• Masculinization in Women: In females, excess testosterone can cause masculinizing effects such as facial hair growth, deepening of the voice, and irregular menstrual cycles.
• Acne and Skin Issues: Elevated testosterone levels may increase oil production in the skin, leading to acne and other dermatological issues.
• Fluid Retention: Testosterone use can cause fluid retention, leading to swelling in the extremities and exacerbating conditions like high blood pressure.
• Risk of Prostate Issues: There’s a potential link between testosterone supplementation and an increased risk of prostate enlargement (benign prostatic hyperplasia) or prostate cancer.
• Gynecomastia: Exogenous testosterone can lead to an imbalance in estrogen levels, causing breast tissue to grow in males (gynecomastia).
• Suppression of Natural Testosterone Production: Long-term use of exogenous testosterone can suppress the body’s natural testosterone production, leading to dependence on external supplementation.

It’s important for individuals considering testosterone therapy to consult with a healthcare professional to weigh the potential benefits against these risks and to ensure safe and appropriate usage.

Why is this medication prescribed?

Testosterone, such as testosterone undecanoate (brand name: Aveed, Nebido), are prescribed to treat conditions associated with low testosterone levels in men. These conditions include:

• Hypogonadism: Testosterone are commonly prescribed to treat hypogonadism, a condition where the body does not produce enough testosterone. Hypogonadism can result in symptoms such as decreased libido, erectile dysfunction, fatigue, decreased muscle mass, and mood changes.
• Delayed Puberty: In adolescent boys who experience delayed onset of puberty, testosterone may be prescribed to induce and promote normal puberty development, including the development of secondary sexual characteristics such as facial hair growth, deepening of the voice, and muscle development.

How should this medicine be used?

Testosterone are typically taken orally and absorbed through the gastrointestinal tract. Here’s how they are typically used:

• Dosage: The dosage of testosterone capsules will be determined by your healthcare provider based on factors such as your age, medical condition, testosterone levels, and response to treatment.
• Administration: Testosterone are usually taken with food to improve absorption and reduce the risk of gastrointestinal side effects. Swallow the capsule whole with a full glass of water. Do not crush, chew, or break the capsule.
• Frequency: The frequency of dosing depends on the specific formulation of the testosterone capsule. Some are taken once daily, while others may be taken less frequently, such as every 10-14 weeks for long-acting formulations like testosterone undecanoate.
• Consistency: Take testosterone at the same time each day to maintain consistent blood levels of the hormone.
• Follow-up: It’s important to attend regular follow-up appointments with your healthcare provider to monitor your response to treatment, adjust the dosage if necessary, and assess for any potential side effects or complications.

It’s crucial to use testosterone  exactly as prescribed by your healthcare provider to achieve optimal results and minimize the risk of adverse effects. If you have any questions or concerns about the use of testosterone, be sure to discuss them with your healthcare provider.

Other uses for this medicine

In addition to treating conditions such as hypogonadism and delayed puberty, testosterone may have other off-label or investigational uses. These could include:

• Gender Affirmation Therapy: Testosterone may be used as part of hormone therapy for transgender men (assigned female at birth) to induce masculinizing effects such as increased facial hair growth, deepening of the voice, and muscle development.
• Muscle Wasting Disorders: Testosterone therapy in capsule form may be considered for certain medical conditions characterized by muscle wasting, such as HIV/AIDS-related wasting syndrome or certain neuromuscular disorders.
• Bone Health: Some studies have explored the potential role of testosterone therapy in improving bone density and reducing the risk of osteoporosis-related fractures, particularly in older men with low testosterone levels.
• Depressive Disorders: Testosterone therapy has been investigated as a potential adjunctive treatment for depressive disorders in men with low testosterone levels. However, more research is needed in this area.

What special precautions should I follow?

Special Precautions for Testosterone:

• Medical Supervision: Testosterone therapy should only be initiated and monitored by a qualified healthcare provider, such as an endocrinologist or urologist, who can assess the need for treatment and monitor its effects on hormone levels and overall health.
• Cardiovascular Health: Testosterone therapy may increase the risk of cardiovascular events such as heart attack or stroke, particularly in older men with pre-existing cardiovascular risk factors. Therefore, individuals with a history of heart disease, hypertension, or other cardiovascular conditions should use testosterone with caution and under close medical supervision.
• Prostate Health: Testosterone therapy may exacerbate benign prostatic hyperplasia (enlarged prostate) or increase the risk of prostate cancer in certain individuals. Regular monitoring of prostate health through digital rectal exams and prostate-specific antigen (PSA) testing is recommended during testosterone therapy.
• Fluid Retention: Testosterone therapy can cause fluid retention, leading to edema (swelling) in the extremities. Individuals with conditions such as heart failure or kidney disease should use testosterone with caution and under medical supervision.
• Liver Function: Testosterone may affect liver function, particularly when taken orally. Individuals with liver disease or impaired liver function should use testosterone with caution and undergo regular monitoring of liver enzymes.
• Sleep Apnea: Testosterone therapy may worsen or contribute to sleep apnea, a condition characterized by interrupted breathing during sleep. Individuals with sleep apnea should be monitored closely during testosterone therapy.
• Other Medications and Conditions: Inform your healthcare provider about all medications, supplements, and medical conditions you have before starting testosterone therapy. Testosterone may interact with certain medications or exacerbate certain medical conditions, so it’s essential to discuss any potential risks with your healthcare provider.

By following these precautions and working closely with a healthcare provider, individuals can minimize risks and optimize the benefits of testosterone therapy when medically indicated. Always consult with a healthcare professional for personalized advice and guidance tailored to your specific needs and circumstances.

What special dietary instructions should I follow?

There are no specific dietary instructions for testosterone. However, maintaining a balanced diet rich in nutrients such as protein, healthy fats, vitamins, and minerals can support overall health and optimize the benefits of testosterone therapy. If you have any specific dietary concerns or restrictions, discuss them with your healthcare provider.

What should I do if I forget a dose?

If you forget to take a dose of testosterone, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you’re unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Testosterone, like other forms of testosterone replacement therapy, can cause various side effects, though not everyone will experience them. It’s essential to be aware of these potential side effects and discuss any concerns with your healthcare provider. Common side effects of testosterone may include:

• Acne: Increased oil production in the skin can lead to acne breakouts, particularly on the face, chest, and back.
• Fluid Retention: Testosterone therapy can cause fluid retention, leading to swelling in the feet, ankles, or hands.
• Breast Tenderness or Enlargement: Testosterone can be converted into estrogen in the body, potentially leading to gynecomastia (enlarged breast tissue) or breast tenderness.
• Hair Loss: Some individuals may experience male pattern baldness or accelerated hair loss, particularly if they have a genetic predisposition to this condition.
• Changes in Libido: Testosterone therapy can increase libido in individuals with low testosterone levels, but it may also lead to fluctuations in sexual desire.
• Mood Changes: Testosterone can affect mood and behavior, leading to mood swings, irritability, or increased aggression in some individuals.
• Sleep Apnea: Testosterone therapy may worsen or contribute to sleep apnea, a condition characterized by interrupted breathing during sleep.
• Skin Reactions: Some individuals may experience skin reactions such as itching, redness, or irritation at the site of application.
• Headache: Headaches are a common side effect of testosterone therapy, though they are typically mild and transient.
• Gastrointestinal Symptoms: Some individuals may experience gastrointestinal symptoms such as nausea, vomiting, or diarrhea.
• Elevated Red Blood Cell Count: Testosterone therapy can stimulate the production of red blood cells, increasing the risk of polycythemia (elevated red blood cell count), which may contribute to blood clots, stroke, or heart attack.
• Liver Toxicity: Oral forms of testosterone, may strain the liver and increase the risk of liver damage or dysfunction.
• Prostate Issues: There is some concern that testosterone therapy may exacerbate benign prostatic hyperplasia (enlarged prostate) or increase the risk of prostate cancer in certain individuals.

It’s important to note that not everyone will experience these side effects, and they may vary in severity from person to person. If you experience any persistent or severe side effects while taking testosterone, it’s essential to inform your healthcare provider promptly. They can offer guidance on managing side effects and may adjust your treatment regimen if necessary.

What should I know about storage and disposal of this medication?

Storage and disposal of testosterone:

Storage:

• Follow Instructions: Store testosterone according to the instructions provided by your healthcare provider or the medication’s packaging. Typically, this involves keeping them at room temperature away from light and moisture.
• Keep Away from Children: Store testosterone in a secure location out of reach of children and pets to prevent accidental ingestion.
• Avoid Extreme Conditions: Do not expose testosterone to extreme temperatures or humidity, as this may affect their stability and effectiveness.

Disposal:

• Check Expiry Date: Check the expiration date on the testosterone capsule packaging. Do not use past their expiration date.
• Dispose Properly: Dispose of expired or unused testosterone properly. Follow local regulations or guidelines for medication disposal.
• Take-back Programs: Some pharmacies or healthcare facilities may offer medication take-back programs. If available, utilize these programs for safe disposal of unused testosterone.
• Mix with Unwanted Substance: If a take-back program is not available, mix the testosterone with an undesirable substance (e.g., coffee grounds, cat litter) in a sealed container before disposing of them in the household trash. This helps prevent accidental ingestion by others.

In case of emergency/overdose

• Seek Medical Help: In case of a suspected overdose or adverse reaction to testosterone, seek immediate medical attention or contact your local poison control center.
• Symptoms: Symptoms of a testosterone capsule overdose may include nausea, vomiting, headache, dizziness, rapid heartbeat, and changes in mood or behavior.
• Avoid Self-treatment: Do not attempt to self-treat or manage a testosterone capsule overdose without medical supervision. Prompt medical intervention is essential.

What other information should I know?

• Follow Prescribed Dosage: Take testosterone exactly as prescribed by your healthcare provider. Do not exceed the prescribed dose or alter the dosing schedule without medical guidance.
• Regular Monitoring: Attend regular follow-up appointments with your healthcare provider to monitor your response to testosterone therapy and assess for any potential side effects or complications.
• Inform Healthcare Providers: Inform all healthcare providers involved in your care about your use of testosterone, including primary care physicians, specialists, and pharmacists.
• Stay Informed: Stay informed about the potential side effects, interactions, and precautions associated with testosterone. If you have any questions or concerns, discuss them with your healthcare provider.

By adhering to these guidelines and staying informed, you can help ensure the safe and effective use of testosterone as part of your treatment regimen. Always consult with a healthcare professional for personalized advice and guidance tailored to your specific needs and circumstances.