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testosterone - Androgel, Androderm, Testoderm, injectable testosterone

General Information Testosterone is the male hormone produced in the testicles that gives males sex drive, erectile function, muscle mass, bone strength, and it  prevents depression.  Testosterone may not be produced in normal amounts due to AIDS, certain medication, or other conditions. 

The testosterone level in the blood should be measured when low levels are suspected.  If the natural testosterone level is low, supplemental testosterone should be considered.  Supplemental testosterone is not a cure-all for male fatigue or sexual dysfunction.  Supplemental testosterone will only lower the body's own production of testosterone in persons who have normal levels, perhaps resulting in no net gain in levels.

Specifics Testosterone supplementation is scientifically validated, and this medication has an excellent track record.

Testosterone administration substitutes for low production of natural testosterone by the human body.

Dosing Currently there is no oral form of testosterone.  Anabolic steroids such as Anadrol or Oxandrin do not substitute for testosterone.  However, there are oral medications under development which may stimulate testosterone production.

Testosterone is available mainly as a gel, cream, or patch.  The drug is usually applied once a day.

The dose varies but it is usually one application of one pack, one tube, or one patch per day.

Once testosterone supplementation is begun, your healthcare provider can measure your blood testosterone level to determine if you are getting the correct dosage.

It is very important to apply testosterone to the body above the waist and to wash one's hands after each application.

Testosterone injections should be avoided if possible.  Injecting testosterone produces abnormal levels of the hormone: very high levels immediately after the injection and subnormal levels immediately before the next injection.   One could think of this as an unpleasant testosterone rollercoaster.  Men feel VERY GOOD immediately after the injection and then not so good immediately before the next which leads them to want to push the injections closer together and to get higher doses.  On the other hand, gels, creams, and patches produce levels of testosterone which stay fairly constant much like the body does naturally or "physiologically."  Physiological supplementation should be the goal of testosterone therapy.  Testosterone injection also subjects patients and nursing personnel or others to unnecessary risks such as blood exposure or injury.


This refers to your willingness, ability, and actual performance in taking your medications.

It is very important to take every dose that is prescribed unless instructed by your healthcare provider.

Do not adjust the amount of the dose or the frequency of testosterone without speaking to your healthcare provider first.

Possible Side Effects
The package insert for most drugs including testosterone is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take testosterone without any side effects.  

Many side effects get better with time.

The most frequent side effects of testosterone are decreased testicle (male gonads in the scrotum) size (atrophy) and irritative reactions to the adhesive on patches.  The area beneath a patch form of testosterone can become red, irritated, and itchy. 

Testosterone supplementation can also cause an excess of red blood cells rarely.  An excess of red blood cells can predispose to heart attacks, stroke, or blood clots.  Testosterone can also cause or worsen acne on the face, chest, and back.  There have been a few reports of testosterone supplementation being associated with prostate cancer.

Abnormally high levels of testosterone may produce irritability and aggressive behavior.

Testosterone gel can dry to leave a fine white powder which can be mistaken for dry skin.  This can be brushed off easily.

Testosterone injections may be addictive to some men.  Addiction may also occur rarely with the gel or patches; if so, there would be a tendency to apply too much of the hormone.


This refers to the way that testosterone affects other medications and how other medications might affect testosterone.

Make sure that your healthcare provider is aware of all the medications you are taking so that important and possibly dangerous interactions are not overlooked.

You can download this handout in printable PDF format by clicking HERE.
Author: James A Zachary MD
Last Update: 11.10.2006