#testosterone gel

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What is the goal of testosterone therapy?

Testosterone has two main jobs: It causes masculinizing changes to occur throughout the body, and it suppresses the production of estrogen. Some of the changes caused by testosterone are permanent (they would remain if testosterone was stopped), and other changes are reversible.

How is testosterone administered?

Testosterone is available as injections, cream, or gel. Injections are administered either every two weeks intramuscularly (into the muscle) or every week subcutaneously (under the skin). Nursing staff provides injection training here at clinic. Creams and gels are absorbed through the skin and applied daily.

What are the irreversible effects of testosterone?

Testosterone causes voice deepening, clitoral growth, body/facial hair growth, and sometimes male-pattern balding (also influenced by age and genetics). Testosterone may irreversibly affect fertility. Desires for fertility should be considered prior to starting hormones, and for those seeking fertility preservation (or education about fertility preservation), referrals can be made to Lurie’s fertility preservation team.

What are some of the reversible effects of testosterone?

Testosterone causes increased muscle tone, fat redistribution (hips to stomach area), skin oiliness and acne. Mood changes (often irritability, having a “shorter fuse”) and heightened sex drive may occur. Menstrual cycles will change and eventually stop after some time. There may be genital changes caused by low estrogen levels.

What are some of the known side effects and risks of testosterone?

Testosterone may increase your metabolic risk profile — that is, the risk for conditions such as heart disease, diabetes, high cholesterol or blood pressure. The risk for heart disease is higher for people who smoke cigarettes, are overweight or have a family history of heart disease.

Testosterone causes hematocrit, the proportion of red blood cells in a volume of blood, to increase. This blood thickening, at high levels, can be life-threatening, causing stroke or a heart attack.

Testosterone can also cause increased appetite, headaches, and acne.

A low-detail diagram of the upper half of three bodies is displayed. From left to right, the bodies represent having been on testosterone for little to no time (a month or less), a medium amount of time (six to eight months) and a greater amount of time (a year or more).

The diagram is a visual representation of testosterone effects on the body. Hip mass shifts to the stomach area, The adam’s apple grows. Muscle mass grows and shoulders become broader. Facial and body hair grows on the arms, face, and assumably the legs not displayed in the image. The skin gets oily and acne appears on the face.

Testosterone affects: skin, muscle mass, body fat, body hair, voice change.

Increased skin oiliness and acne starts within 1-6 months of testosterone. Its complete effect can be within 1-2 years.

Increased muscle mass and strength starts within 6-12 months of testosterone. Its complete effect can be within 2-5 years. This effect is highly dependent on the amount of exercise one does.

Voice pitch deepening starts within 6-12 months of testosterone. Its complete effect can be within 1-2 years.

Body fat redistribution starts within 3-6 months of testosterone. Its complete effect can be within 2-5 years.

Facial and body hair growth starts within 6-12 months of testosterone. Its complete effect can be within 3-5 years.

Monthly periods stop within 2-6 months of testosterone.

Clitoral enlargement of 0.5 inches to 1 inch begins within 3-6 months of testosterone. Its complete effect can be within 1-2 years.

Male pattern hair loss starts when you have been on testosterone for over a year. Its complete effect date is variable. It depends on age and genetics, and can be minimal.

Sex drive also increases.

How do we monitor for safety?

Labs (bloodwork) are collected prior to starting hormones and every three months for the first year of treatment. In the second year, labs are checked every six months. Tests that are monitored include cholesterol, liver tests, hematocrit, and hormone levels. These labs can be drawn at Lurie’s or a local facility.

How quickly will changes develop?

Remember, it’s normal to want to see changes occur rapidly, but (just like in puberty) these changes take time! Most changes start to begin around 3-6 months after starting testosterone and take years to fully develop.

Will I look like my friend _____?

Remember, everyone experiences puberty differently. Factors other than testosterone (such as genes!) affect appearance. It’s impossible to predict exactly what changes will develop.

It’s important to take the prescribed dose of testosterone. Taking more increases health risks.