Low Testosterone

To correctly apply the gel please follow the procedure below:

• Wash and dry the area of skin where you are going to apply the gel thoroughly - normally your upper arm or shoulder.
• Wash your hands and apply a thin layer of gel, using one sachet as directed by the doctor.
• There is no need to rub the gel into the skin, it will absorb naturally and after a few minutes it will have dried enough for you to get dressed.
• If you have been advised that you need to apply two sachets of testosterone gel per day, you should apply one sachet to each shoulder.
• Allow the area to dry before dressing (this usually takes a few minutes). To ensure maximum absorption, do not wash the site of application for at least 6 hours. If you need to bathe or shower occasionally 1-6 hours after application, this should not affect your treatment.
• Wash your hands to ensure they are gel free. This is important so you do not transfer the gel to others.

Testosterone gel is to be applied to the upper arm or shoulder (or abdomen in the case of Tostran) once a day. It is preferable to do this in the morning as this imitates the natural cycles of testosterone in the body. If this is not possible, it should be applied at the same time each day.

Do not apply testosterone gel to the genitals or the chest area. The gel contains a high alcohol content and is irritating to sensitive areas like the genitals.

Blood tests are needed at the following times:

• Before you start treatment
• After three weeks of treatment
• After six months of treatment
• Yearly thereafter

The initial blood test is performed to establish a baseline testosterone level and to determine if you have a low testosterone. The range is varied and individual levels can be different depending on age and other factors. All consultations are assessed individually. The result of your blood test is used in conjunction with your symptoms to help to establish a diagnosis.

Another blood test is performed after three weeks to determine if the medicine is having the right effect and the levels have gone up. This, combined with an improvement in your symptoms, ensures it is right for you to continue with the treatment.

Further blood tests are carried out after six months and then yearly during treatment to ensure that the treatment is still effective and your testosterone remains within a normal range.

There are some changes that you may notice within the first few weeks of treatment (e.g. more energy and improved sexual function). This happens because you are absorbing the gel and your body is also producing testosterone. After a couple of weeks you may notice that it isn’t working as effectively as before because you body has adapted to the higher levels of testosterone in your system and cut back on production. This is normal and you need to give you treatment time to stabilize.

Long term effects, like increased metabolism and weight loss may be seen after a couple of months of regular use.

To ensure you get the best from your medication, it is best to apply it regularly as instructed.

It is important to keep notes of your symptoms to compare how you feel after three weeks of using the medicine to when you started. You can compare the symptoms, alongside the testosterone test results, before and after using the gel to see if there has been an improvement.

It is always important to tell your prescriber, online or face-to-face, if you are taking any other medication or herbal treatments from the doctor or pharmacy. However insignificant you may think it is, it’s better to double check.

Testosterone treatments are best not taken with steroids or blood thinners like warfarin. However this is not a complete list, please check the Patient Information Leaflet for your testosterone gel to ensure that there is no problem with any medicines you currently take. This should also be checked by your prescriber - this is why you should always disclose any other medicines you take.

Changes in testosterone levels can improve type-2 diabetes meaning that adjustment of blood sugar controlling medication may be necessary. If you suffer with diabetes (type-1 or type-2) and you lose weight, you should always see your doctor to re-assess your medication.

To avoid the transfer of testosterone gel to other people ensure you wash your hands after every application and cover the area after it is dry with clothing. Prolonged exposure to uncovered treated skin could cause unwanted hair on the face, a deep voice and a change in the menstrual cycle of your partner.

Pregnant women should not come into contact with the testosterone gel under any circumstances as it has harmful effects on the baby and is present in breast milk. If your partner becomes pregnant follow the advice above.

Testosterone gels can cause side effects like all medicines, but this doesn’t mean that you will necessarily see any of the effects below.

The most common side effects include:

• Itching, a rash, acne or dryness of the skin in the areas where the gel has been applied -This may affect up to 10 in 100 men.

Additionally it may also cause:

• Hair loss.
• Development of painful and tender breast tissue.
• This may affect 1 in 100 men using the medication.

Apply the next dose when you remember and then continue as normal. If it is nearly time for your next dose, skip the missed dose and continue as usual. Do not apply twice the recommended amount to make up for the missed dose.

If your symptoms do not improve after applying the gel regularly then contact your prescriber for further medical advice. We may need to review your treatment to ensure the dose is correct for you and ensure you are applying it correctly.

Symptoms of low testosterone can overlap with a number of other condition including diabetes, hypothyroidism, anxiety and depression. If your symptoms do not improve but your testosterone levels increase with treatment, it may indicate that low testosterone is not the cause of your symptoms. In this case you should see your doctor for further tests.

The old concepts that there are definite links between prostate cancer and testosterone treatment have been dismissed.

Initially, a study in 1981 looked at men with prostate cancer who were given testosterone treatment. These men either had no testosterone in their system or were given treatments to reduce the testosterone production to zero. Reintroducing testosterone or removing the treatment blocking the production might increase the chance of the residual cancer to grow again.

In 2008, a study of 9000 men (3000 with prostate cancer and 6000 without) showed no correlation between prostate cancer and the levels of free testosterone, bound testosterone or any other androgens (male hormones).

Many studies now conclude that there is no evidence to prove or disprove a link between using testosterone replacement gel and prostate cancer.

It is recommended that any man using testosterone replacement gel has a prostate exam before the end of the first year of treatment.

Testosterone gel is best left for six hours after application to be fully absorbed. During this time do not wash the area. The gel is usually dry after 3 to 5 minutes and then clothes can be placed over the top to protect the area.

It is a common symptom to have erectile dysfunction issues when you are suffering with low testosterone. Not achieving an erection or the inability to maintain one can be distressing. Using testosterone replacement gels should help to improve any erectile problems.

You may find that erections are stronger and last longer directly after application of the gel and for a few hours after. However, there may be a need for erectile dysfunction treatment, like Viagra or Cialis, if you would like to have sex at different times. We also provide treatment and information on Erectile Dysfunction.

Despite that fact that it often leads to fatigue and reduced energy levels, low testosterone can also cause insomnia and other changes to your sleep patterns, leaving you tired and unable to sleep. Testosterone replacement therapy can also contribute to (or cause) sleep apnea. If you’re suffering from insomnia, try our range of insomnia treatments.

Low testosterone can sometimes occur in young adults and boys as they reach puberty. Usually as boys reach their teens, testosterone levels peak, which is what often leads to acne. However, there are various factors that can lead to a drop in testosterone in the young, including diabetes, chronic liver or kidney disease, COPD, or pituitary gland problems. It can also be hereditary, as with Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy.

Low testosterone can affect fertility in young men, as testosterone is needed for sperm production. If you suspect your testosterone levels are lower than average, consult your doctor or urologist. Consider also whether you could have a zinc deficiency. Sometimes treating low testosterone is as simple as figuring out what your diet is lacking.

It’s quite rare to hear the words ‘bodybuilding’ and ‘low testosterone’ in the same sentence, but as any bodybuilder knows, testosterone is one of the most important hormones for building muscle from your workout. Some put their zero gains down to being an ‘ectomorph’, but sometimes lack of muscle gain can also be a result of low testosterone. It’s important to beware of dangerous ‘muscle gain’ supplements that promise fast results – nine times out of ten, these supplements do not work.

While testosterone is usually associated with men, women actually need small amounts of testosterone as well. Female sexual health can be seriously impacted by low testosterone levels, with other symptoms including tiredness, weight gain, loss of sex drive, mood swings, anxiety, hair loss and difficulty concentrating. Many women living with low testosterone simply assume it is part of getting older, but there are treatments available, just as there are for men.