13 Oct Testosterone

Available dosage forms:
Troches | Up to 200mg |
Capsules / MR | Up to 100mg |
Cream | Up to 15% |
Injection | 100mg/Ml, 10ml – 200mg/Ml, 1ml or 3ml – 250mg/Ml, 10ml |
Gel | 100mg/g – 200mg/g |
Implant | 50mg, 75mg, 100mg, 200mg |
Dear valued customer
What is Testosterone?
Testosterone is an essential hormone produced by both men and women and plays a crucial role in the health and wellbeing of our bodies. It is naturally produced by the testes in men and the ovaries and adrenal glands in women. Men, however, produce much larger quantities of testosterone than women.
Testosterone is classified as an androgen. Androgens are a group of hormones that control masculine sex characteristics, playing a role in the maintenance of systemic anabolic effects, particularly the metabolism of salts, fluid balance and bone growth. Testosterone exerts a positive effect on libido, sexual function, body shape and muscle mass, mood, energy levels and depression.
The benefits of testosterone supplementation has been researched and found to be effective and with newer treatment options available it can be tailored to meet individual requirements.
Bioidentical Testosterone
A bioidentical hormone refers to a substance which has the exact same chemical structure as a hormone which is naturally produced in the body. Natural hormones are produced by the body, bioidentical hormones are manufactured in a lab using chemical means. Most prescription testosterone, whether synthetic or bioidentical, is derived from soy beans or yams.
Bioidentical testosterone is used in our creams, troches, pellets (implants) and capsules. Our injectable forms of testosterone are synethetic, however, the chemical structure of the testosterone used makes it easier to formulate into injectable form and when it is injected into the bloodstream the chemical reverts back to its bioidentical structure.
Symptoms of testosterone deficiency
- Hypogonadism
- Fatigue, lethargy
- Mood changes
- Sexual dysfunction, poor erectile function
- Loss of libido
- Diminished muscle strength
- Osteoporosis
- Anaemia
Many of these symptoms, however, can be attributed to other causes such as low iron, thyroid issues, autoimmune diseases and so on, so please consult your doctor before commencing testosterone treatments.
Side Effects
Side effects depend upon the dose administered, hormone levels achieved, the duration of treatment and the route of administration.
Long term use of excess doses can cause masculinisation in women and associated symptoms of acne, menstrual disturbances and polycythemia. There are some risks of liver toxicity associated with high doses of the oral (capsule) form of synthetic testosterone. Use in pregnancy should be monitored closely.
Reference:
‘Testosterone for Men, Information on the use of Testosterone in males’, Lawley Pharmaceuticals 2010
‘Bioidentical Testosterone’, Hudson’s FTM Resource Guide, http://www.ftmguide.org/bioidenticalt.html, 2017
‘Testosterone and androgens in women’ Monash University, Oct 2010,
http://med.monash.edu.au/sphpm/womenshealth/docs/testosterone-and-androgens-in-women.pdf
Further Reading
General Information
Testosterone is the primary androgen found in the body. Endogenous testosterone is synthesized by cells in the testis, ovary, and adrenal cortex. Therapeutically, testosterone is used in the management of hypogonadism, either congenital or acquired. Testosterone is also the most effective exogenous androgen for the palliative treatment of carcinoma of the breast in postmenopausal women. Testosterone was in use in 1938 and approved by the FDA in 1939.
Mechanism of Action
Endogenous testosterone is responsible for sexual maturation at all stages of development throughout life. Synthetically, it is prepared from cholesterol. The function of androgens in male development begins in the fetus, is crucial during puberty, and continues to play an important role in the adult male. Women also secrete small amounts of testosterone from the ovaries. The secretion of androgens from the adrenal cortex is insufficient to maintain male sexuality.
Pharmacokinetics
Testosterone is administered intramuscularly (IM); via subcutaneous injection; to the skin as a topical gel, solution, ointment or transdermal systems for transdermal absorption; by implantation of long-acting pellets, or; via buccal systems.
Route-Specific Pharmacokinetics
Topical Route: Roughly 10% of an applied topical dosage of testosterone skin gel or ointment is systemically absorbed with once daily dosing; absorption of the gel and solution from the skin occurs continually over the 24 hour dosing interval, which indicates that the skin acts as a reservoir for sustained-release. Application of testosterone solution or gel delivers physiologic circulating testosterone that resembles normal concentration range seen in healthy men.4 5 Steady-state concentrations are achieved after approximately 14 days of solution application; when the solution is stopped, pre-treatment testosterone concentrations are achieved in approximately 7 to 10 days.
Indications
Testosterone Propionate injections are primarily used in men who do not make enough testosterone naturally (hypogonadism), as well as in specific adolescent cases to induce puberty in those with delayed puberty.
Contraindications/Precautions
Who should not take this medication? Children should not use testosterone unless directed otherwise by a physician. Your health care provider needs to know if you have any of these conditions: breast cancer; breathing problems while sleeping; diabetes; heart disease; if a female partner is pregnant or trying to get pregnant; kidney disease; liver disease; lung disease; prostate cancer, enlargement; any unusual or allergic reactions to testosterone or other products; pregnant or trying to get pregnant; breast-feeding. Your healthcare provider will need to have regular bloodwork drawn while on testosterone. This medication is banned from use in athletes by most athletic organizations.
Pregnancy
Testosterone is contraindicated during pregnancy because of probable adverse effects on the fetus (FDA pregnancy risk category X). Women of childbearing potential who are receiving testosterone treatments should utilize adequate contraception. Because testosterone is not used during pregnancy, there should be no particular reason to administer the products to women during labor or obstetric delivery; safety and efficacy in these settings have not been established.8
Breast-feeding
Testosterone topical solution, transdermal patches, and gels are contraindicated in lactating women who are breast-feeding.82 It is recommended that other testosterone formulations be avoided during breast-feeding as well.19 12 Testosterone distribution into breast milk has not been determined; it is unclear if exposure would increase above levels normally found in human milk. Significant exposure to this androgen via breast-feeding may have adverse androgenic effects on the infant and the drug may also interfere with proper establishment of lactation in the mother.20 Historically, testosterone/androgens have been used adjunctively for lactation suppression.20 Alternative methods to breast-feeding are recommended in lactating women receiving testosterone therapy.
Interactions
Possible interactions include: certain medicines for diabetes; certain medicines that treat or prevent blood clots like warfarin; oxyphenbutazone; propranolol; steroid medicines like prednisone or cortisone. This list may not describe all possible interactions.
NOTE: Testosterone is a substrate for hepatic cytochrome P450 (CYP) 3A4 isoenzyme.21 Testosterone is also both transported by and an inhibitor of P-glycoprotein transport.22
Adverse Reactions/Side Effects
Male patients can experience feminization during prolonged therapy with testosterone, which is believed to result from inhibition of gonadotropin secretion and conversion of androgens to estrogens. These effects are more pronounced in male patients with concurrent hepatic disease and include mastalgia and gynecomastia.
How is this medication best taken?
This medicine is applied at the same time every day to clean, dry, intact skin of the wrists or inner thighs or as directed by your physician. Follow the directions on the prescription label. If you take a bath or shower in the morning, apply the medicine after the bath or shower. Allow the skin to dry a few minutes after application before putting on clothing. Wash your hands after use. Avoid bathing or swimming for at least 2 hours after you apply the medicine. Talk to your pediatrician regarding the use of this medicine in children.
What do I do if I miss a dose?
If you are given your dose at a clinic or doctor’s office, call to reschedule your appointment. If you give your own injections and you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
Storage
Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the expiration date. Do not flush unused medications or pour down a sink or drain.
General statements
Do not share or take any one else’s medicine. Talk with your healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins. This medication was compounded specifically for you. This patient information summarizes the most important information about your medication; if you would like more information, talk with your doctor.
Note: Patients using testosterone should seek medical attention immediately if symptoms of a heart attack or stroke are present, such as: chest pain, shortness of breath or trouble breathing, weakness in one part or one side of the body, slurred speech.
Abuse of testosterone, usually at doses higher than those typically prescribed and usually in conjunction with other AAS, is associated with serious safety risks affecting the heart, brain, liver, mental health, and endocrine system. Reported serious adverse outcomes include heart attack, heart failure, stroke, depression, hostility, aggression, liver toxicity, and male infertility. Individuals abusing high doses of testosterone have also reported withdrawal symptoms, such as depression, fatigue, irritability, loss of appetite, decreased libido, and insomnia.
References
1. Krauser JA, Guengerich FP. Cytochrome P450 3A4-catalyzed testosterone 6beta-hydroxylation stereochemistry, kinetic deuterium isotope effects, and rate-limiting steps. J Biol Chem 2005;280:19496-506.
2. Androderm (testosterone transdermal system) package insert. Corona, CA: Watson Pharma, Inc.; 2014 Jun.
3. Barnes KM, Dickstein B, Cutler GB Jr, et al. Steroid transport, accumulation, and antagonism of P-glycoprotein in multidrug-resistant cells. Biochemistry 1996;35:4820-7.
4. Axiron (testosterone) topical solution, package insert. Indianapolis, IN: Lilly USA, LLC; 2011 Dec.
5. Fortesta (testosterone) gel, package insert. Chadds Ford, PA: Endo Pharmaceuticals Inc.; 2010 Dec.
6. Axiron (testosterone) topical solution, package insert. Indianapolis, IN: Lilly USA, LLC; 2011 Dec.
7. DELATESTRYL (Testosterone Enanthate Injection, USP) package insert. Lexington, MA: Indevus Pharmaceuticals, Inc.; 2007 July.
8. Axiron (testosterone) topical solution, package insert. Indianapolis, IN: Lilly USA, LLC; 2011 Dec.
9. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012;60:616-31.
10. Vigen R, O’Donnell CI, Baron AE, et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA. 2013;310:1829-1836.