Testosterone Therapy: Applications, Safety Considerations, and Potential Adverse Effects

Testosterone Injections: Purposes, Security Concerns, and Potential Adverse Reactions

Testosterone medicinal injections serve various purposes, chief among them addressing sexual dysfunction in both males and females. Moreover, they are utilized in gender-affirming care for individuals transitioning. While testosterone injections can prove beneficial, healthcare professionals caution against using them to counteract the usual testosterone reduction in males as they age, due to unclear benefits.

Insight into testosterone injections

Testosterone injections represent a hormone treatment approach by injecting testosterone, a sex hormone, into the bloodstream. This hormone exists in both males and females, albeit with higher levels in males. Testosterone plays a vital role in several bodily functions, including sexual development, libido, mood, and energy levels.

Recently, testosterone injections have gained popularity in the United States; prescriptions for men over 60 years old increased by an astounding fourfold from 2001 to 2011. However, a considerable number of these patients did not suffer from low testosterone levels, as would be indicated by a diagnosable condition like hypogonadism. This suggests some doctors may be prescribing testosterone to patients who don't require it or have insufficient testosterone levels.

Applications of testosterone injections

We explore the uses of testosterone injections in these sections.

Hypogonadism

Doctors may suggest testosterone injections to treat low testosterone levels, otherwise known as hypogonadism, in adult males. Low testosterone can manifest in symptoms such as:

reduced libido
fewer spontaneous erections
loss of body hair, especially pubic hair
exhaustion
low mood or depression
loss of smell or appetite
hot flashes
smaller testicle size
lower sperm count or infertility

Testosterone therapy could relieve these symptoms, potentially leading to:

enhanced sexual function
improved mood
increased energy
better cognitive abilities

However, it is essential to remember that this therapy does not address the underlying reason for low testosterone and may not be suitable or safe in all instances.

Research indicates that many individuals taking testosterone for hypogonadism have never had their testosterone levels tested, or even if they have been tested, do not have low enough testosterone levels.

The FDA only approves testosterone for hypogonadism when it’s a result of an underlying medical condition, not natural aging.

Delayed puberty in males

Testosterone therapy is commonly used to help male children who experience delayed puberty. Puberty in males usually begins between the ages of 10 and 14, marked by testicle growth. When puberty fails to start naturally, it can happen for various reasons, such as genetic disorders or physical injuries.

Doctors may consider administering low-dose testosterone therapy as a temporary solution, especially when the child is dealing with distress or bullying due to delayed puberty.

Postmenopause symptoms in females

Testosterone therapy has emerged as a new, experimental treatment for postmenopause symptoms in women. Doctors might recommend testosterone therapy when:

Testosterone levels are low
The person experiences a low libido or sexual function issues
Estrogen and progesterone hormone replacement therapy failed to address the symptoms

Studies have found that testosterone therapy increased sexual desire, pleasure, and satisfaction in comparison to placebos or other hormone therapies.

Although testosterone does have a close relationship with masculinizing effects like hair growth and acne, no cases of these side effects were reported in the trials examined, involving over 8,000 participants in total.

However, testosterone did contribute to weight gain in some cases. Its overall impact on other postmenopause symptoms remains unclear.

Gender affirming care

Testosterone therapy promotes the development of male characteristics while reducing female traits. It is commonly used in gender-affirming care for transgender men and some nonbinary individuals. Testosterone therapy may lead to:

Facial hair growth
Increased body hair
More acne
A deeper voice
Changes in body fat distribution
Increased muscle mass
The cessation of menstrual periods
Male pattern baldness
Changes in emotional and social functioning

Research indicates that access to testosterone therapy in adults significantly reduced:

Gender dysphoria
Depression
Suicidality

Learn more about T therapy's role in gender affirming care.

Types of testosterone injection

Explore the various types of testosterone injections, including:

Testosterone cypionate (Depo-Testosterone)
Testosterone enanthate (Xyosted)
Testosterone undecanoate (Aveed)

How to use testosterone injections

Testosterone therapy can be administered either by visiting a doctor who will inject the hormones into the buttocks or by individuals self-administering the injection at home, using a needle in the thigh.

A healthcare provider will guide you on self-administration methods if that's your preference. During the therapy, regular visits to the doctor, usually every few months, are necessary for supervision.

The duration of treatment could vary from long-term to short-term, depending on an individual's situation.

Is testosterone injection therapy risk-free?

Testosterone injections might be safe for certain individuals, as long as they adhere to the doctor's instructions.

However, studies have linked testosterone therapy to various health issues, such as:

an enhanced risk of cardiovascular illnesses
an increased risk of venous thrombosis, or blood clots
decreased sperm count, which sometimes persists even after discontinuing testosterone therapy

Furthermore, testosterone use may elevate blood pressure, potentially increasing the risk of heart attack or stroke.

Testosterone is not an appropriate or safe option for individuals with:

prostate cancer
a past history of breast cancer
gynecomastia and other breast disorders
uncontrolled heart failure
uncontrolled obstructive sleep apnea
a history of cardiovascular incidents within the past 6 months
undiagnosed prostate nodules
plans for conception in the near future

Testosterone injection side effects

Potential side effects of testosterone include:

bruising, pain, bleeding, or swelling at the injection site
prostate enlargement
weight gain
increased appetite
hot flashes
acne
mood swings, such as depression or irritability
agitation or aggression
fatigue or weakness
excessive sweating

A person may experience more serious symptoms if their testosterone levels exceed the normal range, including signs of liver toxicity.

When to seek assistance

Individuals considering testosterone injections should discuss this with an experienced doctor. They can provide insights into whether this therapy could potentially benefit someone with potential low testosterone levels or refer them to a gender care specialist.

Doctors also play a crucial role in monitoring the safety of hormone therapies and any side effects that develop. It is advisable to seek medical help immediately if severe side effects emerge.

If someone experiences any of the following symptoms, it is best to seek urgent medical attention:

shortness of breath
slurred speech
chest pain or pressure
weakness or numbness in an arm or leg
pain in the arms, neck, back, or jaw
lower leg pain, swelling, or warmth
difficulty breathing
fainting or loss of consciousness
suicidal thoughts

Recap

Doctors might prescribe testosterone injections to manage low testosterone levels in men due to certain medical conditions. These injections do not cure the base condition but may help alleviate some symptoms.

People can also use testosterone injections to treat delayed puberty or certain menopause symptoms. Testosterone therapy is also a part of gender affirming care.

It is essential to be aware of the possible complications of testosterone injections. Doctors should perform a comprehensive evaluation and, if testosterone replacement therapy is a feasible option, should discuss the benefits and risks with the individual before prescribing it.

Testosterone injections can be beneficial in treating symptoms of hypogonadism, such as reduced libido and depression, but it's important to ensure that the individual truly has low testosterone levels before starting the therapy. The FDA only approves testosterone for hypogonadism due to an underlying medical condition, not natural aging.

Testosterone therapy is also used for delayed puberty in males, as well as for postmenopause symptoms in women, especially when estrogen and progesterone hormone replacement therapy fails to address the symptoms. Testosterone therapy for these conditions has shown to increase sexual desire and satisfaction.

In the field of gender affirming care, testosterone injections are used to promote the development of male characteristics and reduce female traits. This can lead to improved mental health, with testosterone therapy significantly reducing gender dysphoria, depression, and suicidality in adults.

However, testosterone injections can also have side effects, such as cardiovascular illnesses, increased risk of venous thrombosis, and decreased sperm count. Those with certain medical conditions, like prostate cancer and heart failure, should not use testosterone injections.

Individuals considering testosterone injections should discuss their options with an experienced doctor, who can provide insights into the potential benefits and risks. Doctors also play a crucial role in monitoring the safety of hormone therapies and any side effects that develop. It's advisable to seek medical help immediately if severe side effects emerge.