Testosterone is a hormone responsible for male characteristics. It is also a cancer-fighting treatment and an anabolic steroid. Testosterone is used as an androgen hormone replacement for male patients experiencing delayed puberty. In women, testosterone is used for treatment of postpartum breast engorgement and as a palliative care measure for females with postmenopausal mammary cancer.
General Side Effects
Sensitivity reactions to testosterone can occur and may be mild or severe. These include the possibility of anaphylaxis, a life-threatening allergic reaction. Testosterone gel may cause excitation and insomnia in some patients, as well as increased libido.Testosterone gel may cause acne and localized skin irritation at the medication application site. Patients, particularly older adults, may experience sodium and water retention which will cause swelling and weight gain. Serum calcium and cholesterol levels may become elevated while taking testosterone; routine lab work is recommended to monitor for this adverse effect. Testosterone may lower a patient's white blood cell count. This side effect can place a patient at greater risk for infection, therefore, routine lab work should be conducted to screen for this problem, as well.
Testosterone use may cause acute and intermittent episode of porphyria. This is a condition of multiple disorders related to the metabolism of nitrogen-containing organic compounds. Patients experiencing this adverse effect might experience photosensitivity, acute abdominal pain and neurologic disturbances.
Gastrointestinal Side Effects
Testosterone gel may cause some patients to experience nausea, vomiting and anorexia. Gastric abdominal pain may also be noted, and possibly diarrhea. Jaundice has been reported in some cases. If jaundice develops, seek medical attention.
Endocrine System Side Effects
Females taking testosterone will experience suppression of ovulation, menstruation or lactation. The voice may deepen or become hoarse, an effect that is often irreversible. Oily skin, excessive hair growth in unusual places, clitoral enlargement, regression of breasts and male-pattern baldness may also be experienced by female patients. Testosterone gel use in female patients might also cause flushing, sweating, vaginal dryness, itching or bleeding.
In males, if testosterone gel is taken before puberty, there may be premature closing of epiphyseal growth areas. This can inhibit bone growth. Testosterone gel use in males can also cause an enlarged penis and extended erection. After puberty, use of testosterone gel may cause testicular atrophy, decreased or no sperm count, decreased ejaculatory volume, impotence or enlarged breasts.
Warnings
People taking testosterone should use caution if they have a history of cardiovascular disease, liver disease or kidney impairment. Routine lab work should be conducted to screen for problems related to these conditions. Patients should be instructed to weigh daily in order to monitor for water retention, a sign of serum sodium elevation.
References
- Pearson Nurse's Drug Guide 2010; Wilson, B. A., Shannon, T. M., & Shields, K. M.; 2010.
- Taber's Cyclopedic Medical Dictionary; Thomas, Clayton L.; 1989.
