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| Category | Details |
|---|---|
| Main Side-effects | |
| Transdermal Preparations | Local skin irritation |
| Intramuscular Dosing | • Fluctuations in mood and sexual behaviour • Intermittent supra-physiological testosterone levels • Polycythaemia • Gynaecomastia • Over-stimulation of the prostate |
| General Side-effects | • Polycythaemia (more common in older men with injectable testosterone) • Increases in haematocrit and haemoglobin • Gynaecomastia • Oedema • Acne and other skin reactions |
| Monitoring Guidance for GPs | |
| Purpose | • Alleviate symptoms of testosterone deficiency • Monitor for potentially androgen-dependent symptoms/conditions |
| Importance | • Limited but potentially relevant side-effects • Unclear incidence and clinical relevance |
| Follow-up Visits | |
| Assessments | At 3, 6, and 12 months after treatment onset, then annually |
| Monitoring | • Testosterone levels • Haematocrit levels (at 3, 6, 12 months, then annually) may vary based on local policy |
| Adjustments | • Decrease testosterone dosage or switch from intramuscular to topical, or perform venesection if haematocrit > 0.54% • Stop testosterone if haematocrit remains high, then reintroduce at a lower dose once normalized |
Contraindications for testosterone replacement therapy
| Contra-Indications to Testosterone Therapy | Rationale for Contra-Indication |
|---|---|
| Carcinoma of the breast or known or suspected carcinoma of the prostate | Testosterone therapy could accelerate tumour growth. |
| Those who wish to retain fertility | Testosterone therapy suppresses sperm production, affecting fertility.... |
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