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Testosterone Therapy: Benefits, Dosage, and Treatment Options
Summary of Key Points
Testosterone is a hormone replacement therapy (HRT) used to treat conditions such as low testosterone levels, delayed puberty, and other hormone-related issues. It can help relieve symptoms like fatigue, sexual dysfunction, and muscle loss. Testosterone is available in various forms, including injections, gels, and patches. Always consult your healthcare provider before starting or adjusting your dose. You can easily schedule a telemedicine appointment with one of our providers to discuss your treatment options.
Names of Medication
US Brand Names: AndroGel, Testim, Depo-Testosterone, Fortesta, Axiron, Striant, Androderm
The generic name of the medication refers to the chemical name of the active ingredient. In this case, the generic name is testosterone (testosterone).
Pharmacologic Category
Androgens
Hormone Replacement Therapy (HRT)
Dosing for Testosterone Therapy
Testosterone is prescribed for a variety of conditions, and the dosage depends on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can schedule a telemedicine appointment with us to discuss your individual needs.
Hypogonadism (Low Testosterone Levels)
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Testosterone Deficiency
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Delayed Puberty
Typical Dose: 50-200 mg of testosterone injected intramuscularly every 2-4 weeks for 4-6 months.
Osteoporosis
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Anemia
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks.
Muscle Wasting (Due to Chronic Illness)
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Sexual Dysfunction
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Fatigue
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Depression (Related to Low Testosterone)
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Metabolic Syndrome
Typical Dose: 50-100 mg of testosterone injected intramuscularly every 1-2 weeks, or 5-10 g of testosterone gel applied daily.
Dosage Forms and Strengths of Testosterone
Injection: 100 mg/mL, 200 mg/mL
Gel: 1%, 1.62% (varies by brand)
Patch: 2 mg/24 hours, 4 mg/24 hours
Buccal Tablet: 30 mg
Pellets: 75 mg, 100 mg
Administration Instructions for Testosterone Therapy
Testosterone can be administered in several ways, depending on the form prescribed. Injectable testosterone is typically given intramuscularly by a healthcare provider, while gels and patches are applied to the skin. Buccal tablets are placed between the gum and cheek. Always follow the specific instructions provided by your healthcare provider or pharmacist. If you have any questions about how to use testosterone, schedule a telemedicine appointment with one of our providers for guidance.
Contraindications for Testosterone Use
A contraindication is a specific situation where a medication should not be used because it may cause harm. If you have any of the following conditions, testosterone may not be safe for you. Always consult your healthcare provider before starting any new medication. If you have concerns, you can schedule a telemedicine appointment with one of our providers for personalized advice.
Prostate cancer or breast cancer: Testosterone can stimulate the growth of hormone-sensitive cancers, such as prostate or breast cancer.
Severe heart, liver, or kidney disease: Testosterone may worsen fluid retention, which can be dangerous for people with severe heart, liver, or kidney conditions.
Allergy to testosterone or its ingredients: If you have a known allergy to testosterone or any of its components, taking it could cause a serious allergic reaction.
Pregnancy: Testosterone is not safe during pregnancy as it can harm the developing fetus (see more in the pregnancy section below).
Untreated sleep apnea: Testosterone can worsen sleep apnea, a condition where breathing repeatedly stops and starts during sleep.
High red blood cell count (polycythemia): Testosterone can increase red blood cell production, which may lead to dangerous blood clots or other complications in people with already high levels.
Drug-to-Drug Interactions with Testosterone
Testosterone can interact with other medications, potentially affecting its effectiveness or increasing the risk of side effects. Inform your healthcare provider of all medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with testosterone:
Warfarin (Coumadin): Testosterone may enhance the effects of blood thinners like warfarin, increasing the risk of bleeding.
Insulin or oral diabetes medications: Testosterone can lower blood sugar levels, so adjustments to your diabetes medication may be necessary.
Corticosteroids (e.g., prednisone): Using testosterone with corticosteroids may increase fluid retention, which can be dangerous for people with heart, kidney, or liver disease.
Cyclosporine (Neoral, Sandimmune): Testosterone may raise cyclosporine levels in your blood, increasing the risk of side effects from this immunosuppressant medication.
Testosterone in Pregnancy
Is it safe to take testosterone when pregnant?
No, testosterone is not safe during pregnancy. It can harm the developing fetus, potentially leading to abnormal genital development. If you are pregnant or planning to become pregnant, it is important to avoid using testosterone. If you suspect you might be pregnant while taking testosterone, contact your healthcare provider immediately for guidance.
Testosterone while Breastfeeding
Is it safe to take testosterone while breastfeeding?
No, testosterone is not recommended during breastfeeding. While it is unclear whether testosterone passes into breast milk, it may affect milk production or pose risks to a nursing infant. If you are breastfeeding, consult your healthcare provider to discuss safer alternatives.
Estimated Cost of Testosterone Medication
The cost of a 30-day supply of testosterone can vary depending on the form (gel, injection, patch) and dosage. Without insurance, using a GoodRx coupon, the price typically ranges from $30 to $150. For the most accurate pricing, check with your pharmacy, and consider using a GoodRx coupon to help lower the cost.
Possible Alternatives to Testosterone Therapy
If testosterone therapy isn’t suitable for you, or if you’re exploring other options, there are alternative treatments and lifestyle changes that may help manage conditions commonly treated with testosterone. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine consultation with one of our providers to explore your options.
Hypogonadism
Clomiphene citrate or human chorionic gonadotropin (hCG) may be considered as alternatives to testosterone therapy. Additionally, lifestyle changes such as weight loss, regular exercise, and stress management can help alleviate symptoms of low testosterone.
Testosterone Deficiency
In addition to testosterone replacement therapy, lifestyle modifications like improving sleep quality, reducing alcohol consumption, and increasing physical activity can help naturally boost testosterone levels.
Delayed Puberty
In some cases, low-dose testosterone therapy may be used, but other options include monitoring for natural development or using hormonal treatments such as gonadotropins.
Osteoporosis
Medications like bisphosphonates (e.g., alendronate) or denosumab can help strengthen bones. Weight-bearing exercises and ensuring adequate calcium and vitamin D intake are also crucial for maintaining bone health.
Anemia
Iron supplements or erythropoiesis-stimulating agents (ESAs) may be used to treat anemia. A balanced diet rich in iron, folate, and vitamin B12 can also support healthy blood production.
Muscle Wasting
Resistance training and a high-protein diet can help build muscle mass. In some cases, medications like selective androgen receptor modulators (SARMs) may be considered as alternatives to testosterone therapy.
Sexual Dysfunction
Phosphodiesterase inhibitors (e.g., sildenafil) or counseling for psychological causes of sexual dysfunction may be effective alternatives to testosterone therapy.
Fatigue
Addressing underlying causes such as sleep apnea, depression, or anemia may help alleviate fatigue. Regular physical activity and a balanced diet can also improve energy levels.
Depression
Antidepressants, counseling, and lifestyle changes such as regular exercise and mindfulness practices may be effective alternatives to testosterone therapy for managing depression.
Metabolic Syndrome
Weight loss, a healthy diet, and regular exercise are key strategies for managing metabolic syndrome. In some cases, medications to control blood pressure, cholesterol, and blood sugar levels may also be necessary.
Recent Updates on Testosterone Research
Recent studies have explored the potential benefits and risks of testosterone therapy in various populations. Some research suggests that testosterone replacement therapy may improve cardiovascular health in men with low testosterone levels, while other studies raise concerns about an increased risk of heart attack and stroke. Ongoing research is also examining the long-term effects of testosterone therapy on bone health, mood, and cognitive function.
There is also growing interest in testosterone therapy for women with low libido or sexual dysfunction, though more research is needed to fully understand the benefits and risks in this population.
As new studies emerge, staying informed and having regular discussions with your healthcare provider about the risks and benefits of testosterone therapy is essential. If you have questions about the latest research or your treatment plan, schedule a telemedicine appointment with one of our providers today.
