Low Testosterone Treatment Risks

Low testosterone can result from a number of conditions, and can cause detrimental physiological and psychological changes in men. Treatment usually involves administering synthetic testosterone, which is not indicated for men who suffer from certain pre-existing health conditions, and can result in various side effects, some of them life-threatening.

Identification

• In men, testosterone is a steroid hormone produced naturally in the testicles and in smaller amounts by the adrenal glands. It causes the development of masculine characteristics during puberty, produces sperm and exhibits anabolic effects that increase muscle mass and bone density.

  Men with low testosterone levels (hypogonadism) may experience decreased muscle mass (accompanied by increased body fat), loss of bone density, erectile dysfunction, lower libido, fatigue, depression, poor memory, inability to concentrate, gynecomastia (the development of increased breast tissue), hypertension and changes in blood serum cholesterol.

Treatment

• Congenital causes of low testosterone include the lack of testicles at birth; Klinefelter's syndrome, which involves an extra X chromosome; and Kallmann syndrome, which involves low levels of testosterone precursors produced by the hypothalamus. Testosterone deficiency can also be brought about by stress, obesity, hypertension, excess alcohol consumption, diabetes, chemotherapy, radiation and injuries to the hypothalamus, pituitary gland or testicles.

  Doctors can administer the testosterone precursors human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone to treat Kallmann syndrome. All other causes of low testosterone are treated by using synthetic testosterone. When treatment is used to reverse or alleviate low testosterone symptoms brought about by the aging process, this treatment is referred to as hormone-replacement therapy.

Contraindications

• As synthetic testosterone can enlarge the prostate, elderly men and males or suffer from or are genetically predisposed to prostate cancer should not take testosterone. Men with breast cancer should also avoid taking testosterone.

  Because testosterone can cause changes in blood-sugar levels, diabetics should consult their doctors before use and monitor their glucose closely during treatment. Other patients who should carry weigh the pros and cons of testosterone treatment with their physician include men with liver disease, coronary disease, chest pain, high cholesterol and heart failure.

  Finally, some of the ingredients in synthetic testosterone---such as benzyl alcohol---can cause allergic reactions.

Hepatotoxicity

• Long-term treatment with synthetic testosterone may cause peliosis hepatis, a potentially fatal condition in which blood-filled cysts develop inside the liver, kidneys or both organs. Liver toxicity can also result from synthetic testosterone modified by the process of 17-alpha-alkylation (the addition of an alkyl group, which lengthens testosterone's effects). Testosterone also alters normal liver enzymes.

  Testosterone can also cause the body to retain excess water and sodium, which places additional strain on the liver and kidneys.

Other Side Effects

• Testosterone affects blood serum cholesterol, which may lead to high blood pressure, arteriosclerosis and heart disease. It may also cause enlarged prostate, difficulty urinating, jaundice and swelling of the feet and ankles.

  Psychological effects may include excitability, increased aggression, depression and headaches.

Complications Resulting From Delivery Methods

• The delivery methods of testosterone treatment can result in side effects that include hepatotoxicity (from oral tablets); abscess, infection and fluctuation in libido, mood and energy (from injectable testosterone); and rashes, skin irritation and male pattern baldness (from the application of testosterone creams, sprays or patches).

Other Complications