The sex hormone testosterone is important for the development and maintenance of male sex characteristics. Testosterone is present in women as well, but not at the same levels as in men. Low testosterone levels can cause numerous symptoms, such as loss of muscle and bone mass, a decrease in libido in men, and decreased libido and hot flashes in women. Testosterone replacement therapy is prescribed for men more commonly than for women.
Acne
According to the Cleveland Clinic, daily testosterone therapy can cause skin changes such as oily skin or acne in some patients. The elevated levels of the hormone cause these problems, which are usually related to the length of treatment and dosage. Both men and women who use testosterone skin patches may develop skin irritation such as itching or redness at the patch site.
Prostate Tissue Growth
The prostate may begin to get larger as a result of daily testosterone treatments. Dr. Michael Werner notes on his website that the increased exposure to testosterone may cause benign prostatic hyperplasia which could lead to problems with urination, or the levels of testosterone can also encourage the growth of any cancerous prostate cells.
Sleep Apnea
Sleep apnea causes patients stop breathing for varying amounts of time during sleep at night and then experience daytime sleepiness. Daily testosterone treatments have been found to make sleep apnea worse, as noted in a 2009 article in "Therapeutics and Clinical Risk Management." The article authors also note that any sleep apnea should be treated prior to starting testosterone therapy.
More Red Blood Cells
Testosterone therapy can cause elevated numbers of red blood cells, a condition called polycythemia, according to Dr. Werner. This condition is especially likely to occur in older men, increasing the risk of heart attacks or strokes in these patients. Blood donations or adjustments of the testosterone dosage may manage this side effect.
Fluid Retention
At the beginning of testosterone therapy, patients may begin retaining excess fluid, as noted by Dr. Werner. For some patients, this leads to swelling of the legs and feet; for others, there could be problems with increased blood pressure or congestive heart failure.
Breast Enlargement
For some men on testosterone therapy, the tissue in the breast may enlarge or become tender, as noted by the Cleveland Clinic. Some of the testosterone becomes estrogen in the body, causing the changes in the breast tissue. Adjustment of the dosage may manage this side effect.
Fertility Issues
Taking testosterone daily is not suggested for men who plan to have children, notes Dr. Werner. The body creates its own testosterone to stimulate the production of sperm. In a man taking daily testosterone, the body stops producing its own hormone, which shuts down sperm creation. This is an important concern for younger men.
References
- Cleveland Clinic: Testosterone Replacement Therapy
- Michael A. Werner, M.D.: Negative Effects of Testosterone Replacement Therapy
- "Therapeutics and Clinical Risk Management"; The benefits and risks of testosterone replacement therapy: a review; Bassil N, et al.; June 2009
- "Testosterone Replacement Therapy For Male Aging: ASA Position Statement"; The American Society of Andrology; 2004
