Testosterone Hormone Therapy
Testosterone Trans dermal
Why is this medication prescribed?
Testosterone trans dermal patches are used to treat the symptoms of low testosterone in men whose bodies do not produce enough natural testosterone. Testosterone, a hormone that is usually produced by the body, contributes to the growth, development, and functioning of the male sexual organs and typical male characteristics. Symptoms of low testosterone include decreased sexual desire and ability, extreme tiredness, low energy, depression, and loss of certain male characteristics such as muscular build and deep voice. Testosterone patches work by providing a steady supply of testosterone through the skin to the body.
How should this medicine be used?
Transdermal testosterone comes as a patch to apply to the skin. It is usually applied each night between 8:00 p.m. and midnight and left in place for 24 hours. Apply testosterone patches at around the same time every evening. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use testosterone patches exactly as directed. Do not apply more or fewer patches or apply the patches more often than prescribed by your doctor.
Choose a spot on your back, stomach, thighs, or upper arms to apply your patch(es). Be sure that the spot you have chosen is not oily, hairy, likely to perspire heavily, over a bone such as a shoulder or hip, or likely to be under pressure from sitting or sleeping. Do not apply to the scrotum or to a skin area with open sores, wounds, or irritation. Also be sure that the patch will stay flat against the skin and will not be pulled, folded, or stretched during normal activity. Choose a different spot each night and wait at least 7 days before applying another patch to a spot you have already used.
Wear your testosterone patch(es) at all times until you are ready to apply the new patch(es). Do not remove your patch(es) before swimming, bathing, showering, or sexual activity.
If a patch becomes loose, smooth it down with your fingers. If a patch falls off before noon, apply a new patch. If a patch falls off after noon, do not apply a new patch until your next scheduled application time that evening.
Testosterone patches may control your condition but will not cure it. I Continue to use testosterone patches even if you feel well. Do not stop using testosterone patches without talking to your doctor. If you stop using testosterone, your symptoms may return.
To use testosterone patches, follow these steps:
- Clean and dry the spot where you will apply the patch.
- Tear the foil pouch along the edge and remove the patch. Do not open the pouch until you are ready to apply the patch.
- Peel the protective liner and silver disc off the patch and throw them away.
- Place the patch on your skin with the sticky side down and press down firmly with your palm for 10 seconds. Be sure the patch is completely stuck to your skin, especially around the edges.
- When you are ready to remove the patch, pull it off the skin and throw it away in a trash can that is out of the reach of children and pets. Children and pets can be harmed if they chew on or play with used patches.
- Apply a new patch immediately by following steps 1-4.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before using testosterone patches,
- tell your doctor and pharmacist if you are allergic to testosterone or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin) and insulin (Humalin, Humalog, Novolin, others . Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you or anyone in your family has or has ever had breast or prostate cancer, and if you have or have ever had a blood disorder, diabetes, or heart, kidney, or liver disease.
- you should know that transdermal testosterone is only for use in men. Women should not use this medication, especially if they are or may become pregnant or are breast-feeding. Testosterone may harm the baby.
- tell your doctor if you will be having a magnetic resonance imaging exam (MRI; a medical test that uses powerful magnets to take pictures of the inside of the body). Your doctor will probably tell you to remove your testosterone patch(es) before you have the exam.
- you should know that testosterone patches may be worn during sexual activity. It is very unlikely that your partner will be exposed to more than slight amounts of testosterone. Call a doctor immediately if your female partner develops new or increasing acne, or grows hair in new places on her body.
- you should know that your skin may become irritated in the place where you apply the patch(es). If this happens, you may apply a small amount of hydrocortisone cream to the area after removing your patch(es). Only use hydrocortisone cream; do not use an ointment. If your skin remains irritated after this treatment, call your doctor. Your doctor may prescribe a different cream to apply to the irritated area.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Apply the missed patch(es) as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra patches to make up for a missed dose.
What side effects can this medication cause?
Transdermal testosterone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- burn-like blisters, pain, redness, hardness, burning, or itching in the place you applied the patches
- enlarged or tender breasts
- frequent urination
- difficulty urinating
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- erections that happen more than usual or that do not go away
- yellowing of the skin or eyes
- swelling of the ankles
- black, tarry stools
- red blood in stools
- bloody vomit
- vomit that looks like coffee grounds
- difficulty breathing or swallowing
Medications similar to testosterone that are taken by mouth for a long time may cause serious damage to the liver or liver cancer. Transdermal testosterone has not been shown to cause this damage. Testosterone may increase the risk of developing prostate cancer. Talk to your doctor about the risks of using this medication.
Testosterone may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online at https://www.fda.gov/Safety/MedWatch or by phone [1-800-332-1088].
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).Use testosterone patches immediately after opening the protective pouch. Testosterone patches may burst if exposed to extreme heat or pressure. Do not use damaged patches. Throw away any patches that are outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
If you wear too many patches, or wear patches for too long, too much testosterone may be absorbed into your bloodstream. In that case, you may experience symptoms of an overdose.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- slow or difficult speech
- weakness or numbness of an arm or leg
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to testosterone. Go to the same laboratory every time that your doctor orders tests because different laboratories may perform the tests in slightly different ways.
Testosterone can interfere with the results of certain laboratory tests. Before having any tests, tell your doctor and the laboratory personnel that you are using testosterone patches.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Low Testosterone May Raise Risk of Early Death
Hormone therapy (HT) is a medical treatment with a medication containing one or more female hormones, commonly estrogen plus progestin (synthetic progesterone), and sometimes testosterone. Some women, usually those who have had their uterus removed, receive estrogen-only therapy.
HT is most often used to treat symptoms of menopause, such as hot flashes, vaginal dryness, mood swings, sleep disorders, and decreased sexual desire. Hormone therapy comes as a pill, patch, injection, or vaginal cream.
Hormone therapy used to be widely regarded as a very safe treatment for menopause. However, several major studies have shown that hormone therapy creates risks for certain medical conditions and problems, including heart disease, stroke, and cancer.
However, hormone therapy may help relieve some of the bothersome symptoms of menopause, such as hot flashes, vaginal dryness and pain with intercourse, and long-term complications of estrogen loss, such as osteoporosis.
You and your doctor should decide whether hormone therapy is right for you. The key is to weigh the risks associated with taking hormone therapy against your risk of heart disease or osteoporosis without taking hormone therapy. Every woman is different. Your doctor should be aware of your entire medical history when considering prescribing hormone therapy.
At this time, short-term use (up to 5 years) of hormone therapy at the lowest possible dose to treat the symptoms of menopause still appears to be safe for many women.
BENEFITS OF HORMONE THERAPY
Perhaps the largest benefit women receive from hormone therapy is relief from:
- Hot flashes
- Night sweats
- Sleep difficulties
- Vaginal dryness
Usually, hot flashes and night sweats are less severe after a couple of years, especially if hormone therapy is slowly reduced.
A woman's body produces less estrogen during and after menopause, which may affect her bone strength. Hormone therapy may also prevent the development of osteoporosis.
Studies have not been able to definitely show that hormone therapy helps with urinary incontinence, Alzheimer's disease or dementia, or colon cancer.
RISKS OF HORMONE THERAPY
Doctors have long known that taking estrogen increases a person's risk for blood clots. Generally, this risk is higher if you use birth control pills, which contain high doses of estrogen. Your risk is even higher if you smoke and take estrogen. The risk is not as high when estrogen skin patches (transdermal estrogen) are used.
Breast cancer: Woman who take estrogen therapy for a long period of time have a small increase in risk for breast cancer. Most guidelines currently consider hormone therapy safe for breast cancer risk when taken for up to 5 years.
Endometrial/uterine cancer: The risk for endometrial cancer is more than five times higher in women who take estrogen therapy alone, compared with those who do not. However, taking progesterone with estrogen seems to protect against this cancer. Endometrial cancer does not develop in women who do not have a uterus.
Heart disease: Estrogen may increase the risk of heart disease in older women. However, it may still be somewhat protective in preventing heart disease when given under certain circumstances. Estrogen is probably the safest for women under 60 years of age.
Deep venous thrombosis (DVT or blood clot in a vein) and pulmonary embolus (PE or blood clot in the lungs) are more common in women who take oral estrogen.
Stroke: Women who take estrogen have an increased risk for stroke.
Several studies have shown that women who take estrogen/progestin therapy have an increased risk for developing gallstones.
SIDE EFFECTS OF HORMONE THERAPY
As with all medicines, side effects are possible. Some women taking hormone therapy may have water retention, bloating, nausea, breast soreness, mood swings, and headaches. Changing the dose or form of hormone therapy may help reduce these side effects.
Some women have irregular bleeding when they start taking hormone therapy. Changing the dose often eliminates this side effect. Close follow-up with your doctor is important when you have any unusual bleeding.
FORMS OF HORMONE THERAPY
Hormone therapy is available in various forms. It may be necessary to try more than one form before finding the one that works best for you.
Estrogen comes in the following forms:
- Nasal spray
- Pills or tablets, taken by mouth
- Skin gel
- Skin patches, which are applied to the thigh or belly area
- Vaginal creams or vaginal tablets, to help with dryness and pain with sexual intercourse
- Vaginal ring
Most women who take estrogen and who have not had their uterus removed also need to take progesterone. Taking these medicines together helps reduce the risk of endometrial (uterine) cancer.
Progesterone or progestin comes in the following forms:
- Skin patch
- Vaginal cream
When estrogen and progesterone are prescribed together, your doctor will recommended one of the following schedules:
- Cyclic hormone therapy is often recommended when a woman is starting menopause. With this therapy, estrogen is taken in pill or patch form for 25 days, with progestin added somewhere between days 10 - 14. The estrogen and progestin are used together for the remainder of the 25 days. Then, no hormones are taken for 3 - 5 days. There may be monthly bleeding with cyclic therapy.
- Continuous, combined therapy involves taking estrogen and progestin together every day. Irregular bleeding may occur when starting or switching to this therapy. Most women stop bleeding within 1 year.
Additional medications may be recommended for some women with severe symptoms from menopause, or women who are at very high risk for osteoporosis or heart disease. One of these supplemental drugs might be testosterone, a hormone that is more plentiful in males, to improve sex drive. Non hormonal medications are sometimes used either in addition to, or instead of, hormone therapy.
In addition to hormone therapy, a woman can take other steps to adjust to the changes in life during menopause. Eating healthy foods and getting regular exercise will also help decrease bone loss and maintain healthy heart muscle.
CALLING YOUR HEALTH CARE PROVIDER
It is important to have regular checkups with your health care provider when taking hormone therapy. If you have vaginal bleeding during hormone therapy or other unusual symptoms, call your health care provider.