Testosterone: Difference between revisions
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| legal = Schedule III (DEA, US) | | legal = Schedule III (DEA, US) | ||
| mechanism = Endogenous androgen binding to androgen receptors; mediates male secondary sex characteristics, anabolism, libido, erythropoiesis, and CNS effects on mood/energy/aggression. Aromatized peripherally to estradiol; reduced to DHT. | | mechanism = Endogenous androgen binding to androgen receptors; mediates male secondary sex characteristics, anabolism, libido, erythropoiesis, and CNS effects on mood/energy/aggression. Aromatized peripherally to estradiol; reduced to DHT. | ||
| intro = Testosterone is the principal endogenous androgen and the most prescribed hormone therapy in adult men. Delivered through an unusually wide range of formulations because endogenous half-life is short and oral bioavailability of native testosterone is essentially zero. Off-label use for "low T" symptoms in men with normal levels remains controversial; clear | | intro = Testosterone is the principal endogenous androgen and the most prescribed hormone therapy in adult men. Delivered through an unusually wide range of formulations because endogenous half-life is short and oral bioavailability of native testosterone is essentially zero. Off-label use for "low T" symptoms in men with normal levels remains controversial; clear problems are biochemical hypogonadism and gender-affirming care. | ||
| indications = | | indications = | ||
| dosing = | | dosing = | ||
Revision as of 01:37, 19 May 2026
Androgen / Anabolic Steroid
Testosterone
AndroGel, Testim, Axiron, Fortesta (gels); Androderm (patch); Aveed (IM); Striant (buccal); Natesto (nasal); Jatenzo, Tlando (oral undecanoate)
Testosterone is the principal endogenous androgen and the most prescribed hormone therapy in adult men. Delivered through an unusually wide range of formulations because endogenous half-life is short and oral bioavailability of native testosterone is essentially zero. Off-label use for "low T" symptoms in men with normal levels remains controversial; clear problems are biochemical hypogonadism and gender-affirming care.
Category X. Women of reproductive potential exposed via transdermal partner contact must wash immediately.
Total/free T (timed); H/H (polycythemia); PSA; lipids; LFTs (oral); sleep apnea screen.
Avoid skin-to-skin contact with women/children for several hours after gel application. Erythrocytosis is common — monitor hematocrit. Suppresses endogenous production and impairs fertility — discuss sperm banking in patients who may want children.
Flibanserin
Experience
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Problems
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+ Add a problemTitration strategies
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Effects
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Pharmacokinetics
Absorption
Bypasses first-pass via non-oral routes; oral undecanoate uses lymphatic absorption.Distribution
~98% bound (mostly SHBG, some albumin).Metabolism
Hepatic to inactive metabolites; aromatized to estradiol; reduced to DHT.Elimination
Renal as glucuronide and sulfate conjugates.Interactions
No interactions reported yet.
Pregnancy and lactation
Monitoring
Patient counseling
Relevant anecdote
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Relevant Literature
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See also
References
Summary
Classes
Androgen / Anabolic Steroid
Common uses
Male hypogonadism0, Gender-affirming HRT0, HSDD in postmenopausal women (off-label)0
Pharmacy
Starting dose
Formulation-dependent. Gels: 40–50 mg topically daily. Cypionate/enanthate IM: 50–100 mg weekly. Undecanoate IM: 750 mg q10w. Patch: 4 mg/d.
Preparations
Gels, patches, IM cypionate/enanthate/undecanoate, buccal tabs, nasal gel, oral undecanoate, subcutaneous pellets
US FDA Max
Formulation-dependent
Pharmacology
Routes
Topical (gel/patch), IM, buccal, nasal, oral (undecanoate only)
Onset
Hours (transdermal); days (IM esters)
Duration
Hours (nasal); ~24 h (gel/patch); 1–2 weeks (cypionate/enanthate IM); ~10 weeks (undecanoate IM)
Half-life
Highly variable by formulation; native T is hours
Bioavailability
Oral non-undecanoate has essentially zero bioavailability (hepatic first-pass)
Pregnancy
Category X — contraindicated; teratogenic (virilization of female fetus)
Legal status
Schedule III (DEA, US)
Purported mechanism
Endogenous androgen binding to androgen receptors; mediates male secondary sex characteristics, anabolism, libido, erythropoiesis, and CNS effects on mood/energy/aggression. Aromatized peripherally to estradiol; reduced to DHT.