The Side Effects of Testosterone Gel

March 26, 2024

4 mins

Testosterone gel is an effective mode of testosterone replacement therapy, but like any medication, it may come with some potential side effects. 

In this article, we’ll discuss the common and more severe side effects of testosterone gel, as well as how to manage and mitigate them. 

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Common Side Effects of Testosterone Gel

When considering the use of testosterone gel for testosterone replacement therapy, it's important to be aware of potential side effects. Understanding these side effects can help you make informed decisions about your treatment plan and know when to seek medical advice. Here are some the common side effects associated with testosterone gel:

Physical Side Effects

Skin reactions: Testosterone gel can sometimes cause skin irritation or allergic reactions at the application site. This may manifest as redness, itching, or rash. 

Acne: Elevated testosterone levels can stimulate oil production in the skin, leading to acne breakouts. 

Hair growth: Testosterone is associated with increased hair growth, which can be both a desired effect and a potential side effect. While some may appreciate the development of facial or body hair, excessive hair growth or changes in hair patterns may occur – particularly in women.

Fluid retention: Testosterone therapy can lead to fluid retention, causing swelling in the extremities or bloating. This side effect is typically mild but should be monitored, especially in individuals with pre-existing heart or kidney conditions.

Hormonal Side Effects

Changes in libido: Testosterone plays a significant role in regulating libido (sex drive) in both men and women. These changes may mean an increase or a decrease in sexual desire. 

Mood swings: Hormonal fluctuations induced by testosterone therapy can impact mood stability. Some may experience mood swings, including irritability, anxiety, or depression. These mood changes should be discussed with a healthcare provider if they become disruptive or persistent.

Increased aggression: Testosterone has been associated with increased aggression or irritability in some individuals. While not everyone experiences this side effect, it's essential to be mindful of changes in behavior and seek guidance from a healthcare provider if concerns arise.

Breast enlargement (gynecomastia): Testosterone therapy can disrupt the balance of hormones in the body, potentially leading to gynecomastia, the development of breast tissue in males. This side effect can be distressing for some individuals and should be addressed with a healthcare provider.

Less Common but Serious Side Effects of Testosterone Gel

While testosterone gel is generally well-tolerated by most individuals, it's essential to be aware of less common but potentially serious side effects that may occur. Understanding these risks can help individuals and healthcare providers make informed decisions about testosterone therapy. Here are some less common but serious side effects associated with testosterone gel:

Cardiovascular risks

Increased risk of heart disease: Testosterone therapy has been associated with an increased risk of cardiovascular events such as heart attack or stroke – particularly in older men with pre-existing cardiovascular risk factors. It's crucial for individuals considering testosterone gel therapy to discuss their cardiovascular health history with their healthcare provider.

Potential impact on cholesterol levels: Testosterone can affect lipid metabolism, potentially leading to changes in cholesterol levels. While some studies suggest that testosterone therapy may improve cholesterol profiles by increasing high-density lipoprotein (HDL) cholesterol levels, it may also elevate low-density lipoprotein (LDL) cholesterol levels in some individuals. Monitoring cholesterol levels regularly is important for managing cardiovascular risk.

Prostate Health Concerns

Enlargement of the prostate: Testosterone therapy can stimulate the growth of prostate tissue, leading to benign prostatic hyperplasia (BPH) or enlargement of the prostate gland. This can result in urinary symptoms such as increased frequency or urgency. Those with a history of prostate issues should discuss the potential risks of testosterone therapy with their healthcare provider.

Potential risk of prostate cancer: There is ongoing debate and research regarding the association between testosterone therapy and prostate cancer risk. While some studies have suggested a possible link between testosterone therapy and an increased risk of prostate cancer, others have not found a significant correlation. Healthcare providers should carefully assess individual risk factors before initiating testosterone therapy in men with a history of prostate cancer or elevated prostate-specific antigen (PSA) levels.

Other Potential Risks

Sleep apnea: Testosterone therapy may exacerbate sleep apnea or contribute to the development of this sleep disorder – particularly in individuals with underlying risk factors such as obesity or upper airway abnormalities. Monitoring for symptoms of sleep apnea, such as excessive daytime sleepiness or loud snoring, is essential during testosterone therapy.

Liver toxicity: Some testosterone formulations can exert stress on the liver and may lead to liver toxicity or abnormalities in liver function tests. While testosterone gel is not typically associated with liver toxicity, individuals with underlying liver conditions should exercise caution and undergo regular monitoring of liver function.

Factors Influencing Side Effects

Several factors can influence the occurrence and severity of side effects associated with testosterone gel therapy. 

The dosage and application method play a role in determining the potential side effects experienced by an individual. Higher doses of testosterone gel may increase the likelihood of adverse reactions, while improper application techniques can lead to localized skin reactions or inconsistent absorption of the hormone. 

Age, pre-existing medical conditions, and overall health status, can impact testosterone users’ susceptibility to side effects. For example, those with a history of cardiovascular disease may be at higher risk of experiencing cardiovascular complications associated with testosterone therapy. 

The duration of use is another critical factor to consider. Prolonged use of testosterone gel may increase the cumulative exposure to the hormone and potentially elevate the risk of developing certain side effects over time. 

It's essential for healthcare providers to carefully assess these factors and tailor testosterone therapy plans to each individual's specific needs and circumstances. Regular monitoring and open communication between patients and healthcare providers are essential for managing and minimizing the occurrence of side effects while optimizing the benefits of testosterone gel therapy.

Managing and Minimizing Side Effects

Effectively managing and minimizing side effects associated with testosterone gel therapy is essential for ensuring a safe and successful treatment experience. Here are key strategies to consider:

Regular monitoring

Regular monitoring of hormone levels and overall health status is crucial for identifying any potential side effects early on. Healthcare providers may recommend periodic blood tests to assess testosterone levels, monitor lipid profiles, and evaluate other relevant markers. 

Additionally, individuals should be vigilant in monitoring for any changes in symptoms or adverse reactions and promptly report them to their healthcare provider.

Proper application techniques

Proper application techniques can help minimize the risk of skin irritation and ensure consistent absorption of testosterone gel. It's essential to follow the manufacturer's instructions carefully and apply the gel to clean, dry skin on the shoulder or upper arms as directed. 

Be sure to avoid areas with broken or irritated skin and rotating application sites can help prevent skin reactions and optimize hormone absorption.

Lifestyle modifications

Certain lifestyle modifications can help mitigate side effects and support overall health during testosterone gel therapy. 

Maintaining a healthy diet, engaging in regular physical activity, managing stress levels, and getting adequate sleep are important factors in optimizing treatment outcomes. 

Additionally, avoiding tobacco use and excessive alcohol consumption can help reduce the risk of cardiovascular complications associated with testosterone therapy.

Open communication with healthcare provider

Open communication with a healthcare provider is essential throughout the course of testosterone gel therapy. 

It’s beneficial to your health to find a provider you feel comfortable discussing any concerns, questions, or unexpected symptoms. This includes disclosing any changes in health status, medication use, or lifestyle habits that may impact treatment effectiveness or safety.

Healthcare providers can offer guidance, monitor progress, and adjust treatment plans as needed to address side effects and optimize outcomes.

By implementing these strategies and maintaining open communication with healthcare providers, individuals can effectively manage and minimize side effects associated with testosterone gel therapy, ensuring a safe and successful treatment experience.

How Rex MD Can Help

Testosterone gel may be prescribed to men experiencing symptoms of low testosterone (hypogonadism). 

If you think that you may be experiencing low levels of testosterone, you may want to consider a blood test and find out if your levels are deficient or abnormal for your age. 

The most popular testosterone replacement gel is called AndroGel^® 1.62%. It’s a controlled substance available by prescription only for men. 1.62% refers to the strength of testosterone in each dose (40.5 mg of testosterone).

With the Rex MD TestoRx program, you’ll have access to quality care and testosterone replacement therapies like generic Androgel (when clinically appropriate) that can help you feel like yourself again. 

To find out if the program is right for you, just answer some questions about your symptoms and medical history. Your provider will order lab work for you to help determine if you’re eligible for AndroGel^® or another testosterone solution available through the program. Then, you’ll be able to schedule a virtual call with the Rex MD care team to further discuss your results, eligibility, and which treatment option would be most suitable for you, if any.

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