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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Thanks to an onslaught of commercials and online ads about low T (low testosterone), you might wonder if you have it yourself.
Low T has particular symptoms and is determined by a blood test or saliva sample that yields a testosterone level below a certain point. If you have low testosterone, your healthcare provider may recommend the testosterone patch.
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What is the testosterone patch?
The testosterone patch is an FDA-approved prescription treatment for low testosterone (also known as hypogonadism). It’s part of testosterone replacement therapy, or TRT for short. The patch is transdermal, meaning it’s applied to the skin where it releases a slow, continuous dose of hormones into the bloodstream.
The testosterone patch is sold under the brand name AndroDerm. It’s not available over-the-counter or as a generic medication. Clinical trials show that 97% of men with low T who tried the patch achieved a normal testosterone level (DailyMed, 2020).
Testosterone patches should be applied once a day to clean, dry, and intact skin. Common spots to place it include the back, abdomen, upper body, or thighs. You should not apply it to the scrotum. Make sure to change your application site to avoid skin irritation (DailyMed, 2020).
Risks and side effects of the testosterone patch
Like many prescription drugs, TRT comes with certain risks––some mild, some severe. The testosterone patch may cause issues including (Grech, 2014):
- Infertility and shrinking of the testicles
- Acne and oily skin
- Gynecomastia (enlarged male breasts)
- Calcification of blood vessels
- Blood clots
- Changes in urine flow, including difficulty with urination
- Sleep apnea
- Swelling in the legs or ankles
- Erythrocytosis (production of too many red blood cells)
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Other possible side effects of transdermal testosterone include redness, irritation, rash, or blisters at the application site (DailyMed, 2020).
Testosterone replacement therapy isn’t for everyone. It may not be right for you if you have certain medical conditions, such as breast or prostate cancer, a prostate nodule, or an elevated PSA level (Luthy, 2018).
TRT potentially heightens the risk of developing prostate cancer or an enlarged prostate (benign prostatic hyperplasia). The thought behind this is testosterone can drive prostate growth and increase what are called prostate-specific antigen (PSA) levels. Large-scale clinical trials haven’t been conducted on TRT and the risk of cancer or BPH, so right now it’s more of a theory (Grech, 2014; Miah, 2019).
Other risks may include cardiovascular problems, including an increased risk of heart attack or stroke. TRT also suppresses your body’s natural ability to make testosterone, which may trigger a rebound effect—meaning, you may feel worse if you stop taking the treatment (Petering, 2017).
This is not a complete list of risks and potential side effects of TRT. Seek medical advice from a healthcare professional or ask your pharmacist if you have questions about the potential risks and side effects of the transdermal patch.
How can I get the testosterone patch?
The testosterone patch is available by prescription only. Talk with a healthcare provider if you suspect you might have low T and see if the testosterone patch is right for you.
What is testosterone?
Testosterone is an androgen, or male sex hormone, which is present from birth in both men and women. In men, it’s produced by the testicles and adrenal glands, while in women, it’s produced by the ovaries and adrenal glands.
During puberty, testosterone levels surge, producing muscle growth, body hair, and in men, the development of sperm. Testosterone plays an important role in our health throughout life. It regulates key functions like libido, sexual response, bone density, muscle mass, and mood. Testosterone levels naturally decline with age.
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Testosterone levels: normal vs. low
Your testosterone level is measured with a blood test or a test kit involving a saliva sample. According to the American Urological Association (AUA), a total testosterone value below 300 ng/dL indicates low testosterone (Mulhall, 2018). However, the exact range of normal values varies, depending on the lab or resource that conducts the test.
How common is low testosterone?
Low testosterone (or testosterone deficiency) tends to appear in men as they get older, with testosterone levels decreasing about 1–2% per year after age 40. By the time they hit their 70s, around 35% of men have low testosterone (Miah, 2019).
Symptoms of low testosterone
- Decreased libido
- Erectile dysfunction (with loss of morning erections)
- Loss of muscle mass
- Increased body fat
- Loss of bone mass (osteoporosis)
- Depressed mood
- Fertility issues (like low sperm count)
Erectile dysfunction (ED) in young men: is ED in your 20s normal?
Other treatments for low testosterone
There are several other options available for men with low T.
Besides the testosterone patch, other treatments you can apply to the skin include testosterone gels (brand names AndroGel, Testim, and Fortesta) and solutions (brand name Axiron). The benefit of topical treatments is that they’re absorbed slowly, making levels in the blood are very stable.
A healthcare provider usually administers the injectable forms of testosterone. They can last anywhere from a week to a few months.
The buccal testosterone system (brand name Striant) is a medication designed to stick to your gums. The main disadvantage is that it can cause irritation.
Testosterone pellets (brand name Testopel) are implanted in the hip (just under the skin). Over 3–6 months, they slowly release testosterone into the body.
Testosterone gel uses and side effects
Nasal testosterone gel (brand name Natesto) is applied to each nostril three times a day. Many healthcare providers are waiting for long-term safety data before prescribing this.
Many healthcare providers recommend trying topical gels first because they provide stable testosterone levels and are relatively easy to use. But studies don’t show much difference in user satisfaction between TRT gels, injections, or pellets (Kovac, 2014).
If you suspect you may have low testosterone levels, be sure to speak with your healthcare provider to find out if TRT is right for you.
- DailyMed. (2020). Androderm–testosterone patch. Retrieved on Jan. 26, 2022 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e58a5328-fdd9-40cb-a19f-8ed798989b9c
- Fernández-Balsells, M. M., Murad, M. H., Lane, M., Lampropulos, J. F., Albuquerque, F., Mullan, R. J., et al. (2010). Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 95(6), 2560–2575. doi:10.1210/jc.2009-2575. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20525906
- Grech, A., Breck, J., & Heidelbaugh, J. (2014). Adverse effects of testosterone replacement therapy: an update on the evidence and controversy. Therapeutic Advances in Drug Safety, 5(5), 190–200. doi:10.1177/2042098614548680. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212439/
- Harman, S. M., Metter, E. J., Tobin, J. D., Pearson, J., & Blackman, M. R. (2001). Longitudinal effects of aging on serum total and free testosterone levels in healthy men. The Journal of Clinical Endocrinology & Metabolism, 86(2), 724–731. doi:10.1210/jcem.86.2.7219. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11158037
- Kovac, J. R., Rajanahally, S., Smith, R. P., Coward, R. M., Lamb, D. J., & Lipshultz, L. I. (2014). Patient satisfaction with testosterone replacement therapies: the reasons behind the choices. The Journal of Sexual Medicine, 11(2), 553–562. doi:10.1111/jsm.12369. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24344902
- Luthy, K. E., Williams, C., Freeborn, D. S., & Cook, A. (2017). Comparison of testosterone replacement therapy medications in the treatment of hypogonadism. The Journal for Nurse Practitioners, 13(4), 241-249. doi:10.1016/j.nurpra.2016.11.016. Retrieved from https://www.npjournal.org/article/S1555-4155(16)30716-4/pdf
- Miah, S., Tharakan, T., Gallagher, K. A., Shah, T. T., Winkler, M., Jayasena, C. N., et al. (2019). The effects of testosterone replacement therapy on the prostate: a clinical perspective. F1000Research, 8. doi:10.12688/f1000research.16497.1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392157/
- Mulhall, J. P., Trost, L. W., Brannigan, R. E., et al. (2018) Evaluation and management of testosterone deficiency: AUA guideline. Journal of Urology, 200, 423. Retrieved from https://www.auanet.org//guidelines-and-quality/guidelines/testosterone-deficiency-guideline
- Petering, R. C. & Brooks, N. A. (2017). Testosterone therapy: review of clinical applications. American Family Physician, 96(7), 441–449. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29094914/
- Sizar, O. & Schwartz, J. (2021). Hypogonadism. [Updated Jun 29, 2021]. In: StatPearls [Internet]. Retrieved on Jan. 28, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK532933/