Topical testosterone is a hormonal medication in the form of a topical gel or solution to be applied to the skin. It is prescribed for men who do not naturally make sufficient amounts of testosterone. These men, who suffer from a condition called hypogonadism, may experience symptoms like fatigue, depression, and sexual ability or desire. Testosterone also works to produce sperm and maintain bone and muscle mass.
A doctor will usually advise the patient to apply topical testosterone once daily, typically in the morning. Men may be prescribed 5 grams (g) daily, which the doctor may increase to no more than 10 g daily. The area of application may vary depending on the exact brand of topical testosterone the patient uses. For example, Testim® should be applied to only the upper arms or shoulders, while AndroGel® may be applied to those areas and the abdomen. This topical gel should never be applied to abraded or broken skin, or to the scrotum or penis.
Patients must thoroughly wash their hands before and after each application. Some men may use a packet, which contains one measured dose of the gel. Others may use a tube with a pump, which must be primed three times before using it for the first time. The topical testosterone that emerges from priming must be discarded down a sink drain. Patients may then measure their dose with the appropriate number of pumps and use a hand to apply the gel.
Certain precautions must be taken while using topical testosterone. A patient may transfer this gel to another person through skin-to-skin contact. All areas of application should be kept covered by clothing, or should be washed thoroughly before skin-to-skin contact is anticipated. Men should avoid transferring the medication to women and children, because they can develop adverse side effects from exposure, such as aggressive behavior and delayed development in children.
Some side effects may occur with the use of topical testosterone, which should be reported to the physician if they become severe. Patients may experience dizziness, nausea, and vomiting. Insomnia, changes in sexual desire, and hair loss may also occur. Acne, changes in skin color, and redness or swelling of the skin have also been reported.
More serious side effects require immediate medical attention. Men should see a doctor if they experience shallow or difficult breathing, breast enlargement or pain, and trouble urinating. Mood changes, changes in the appearance or size of the testicles, or testicle pain have also been reported. Some patients may notice calf swelling, swelling of the feet or ankles, or abdominal pain.
Before using topical testosterone, men must disclose their other medical conditions, medications, and supplements. Those with diabetes, prostate cancer, or other prostate problems, as well as those who are obese may be unable to use it. Women and children should never use this product. It may interact with other medicines, including blood thinners, diabetes drugs, and beta blockers.