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Overview: Testosterone is used to treat low testosterone levels in men caused by certain conditions. It may also be used for delayed puberty in boys or be used as part of breast cancer treatment. Common side effects include high blood pressure, headache, and changes in certain lab test results. Serious side effects may include blood clots, liver damage, and an increased risk of prostate cancer. Testosterone comes in several forms, including a capsule that is taken by mouth, an injection, and a pellet that is implanted under the skin.

Uses

What is testosterone used for?

Testosterone is commonly used to treat low testosterone levels in men caused by certain conditions, such as hypogonadism.

Certain testosterone injectable products and testosterone pellets may also be used to help start puberty in boys with delayed puberty.

Certain testosterone injectable products may also be used as part of breast cancer treatment.

These uses may vary depending on the specific testosterone product prescribed. Testosterone may also be used for other conditions as determined by your health care provider.

How does testosterone work (mechanism of action)?

Testosterone is a sex hormone that is made naturally in the body. Medicines that contain testosterone (also known as testosterone replacement therapy or TRT) work by adding more testosterone to a person’s body to help them achieve normal levels.

Testosterone is responsible for normal growth and development of male sex organs and sex characteristics, which can help start puberty in boys with delayed puberty.

In people with breast cancer, testosterone can help counter the effects of estrogen, a female sex hormone that often contributes to the growth of breast cancer.

How is testosterone supplied (dosage forms)?

Brands and other names

  • Aveed
  • Azmiro
  • Depo-Testosterone
  • Jatenzo
  • Kyzatrex
  • Testopel
  • Tlando
  • Xyosted

Dosage forms and strengths

  • 100 mg, 112.5 mg, 150 mg, 158 mg, 198 mg, 200 mg, 237 mg oral capsules
  • 50 mg/0.5 mL, 75 mg/0.5 mL, 100 mg/0.5 mL single-use autoinjectors

Testosterone is also available in other injectable forms or as pellets that are given by a health care provider.

See also: Testosterone nasal and Testosterone topical

How should I store testosterone?

Testosterone should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Some products should be protected from light and should not be frozen. Some products should be kept in their original carton until you are ready to use them. Ask your pharmacist if you are unsure how to store your testosterone product.

Certain testosterone injection products are usually given by a health care provider in a hospital or clinic. You will not store these at home.

Side Effects

What are the most common side effects of testosterone?

The most common side effects of testosterone are listed below. These side effects may vary depending on the product you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Increased blood pressure (see below)
  • Headache
  • Increased red blood cell levels (see below)
  • High prolactin levels (see below)
  • Increase in prostate-specific antigen (PSA) levels
  • Weight gain
  • Irritability and mood swings
  • Trouble sleeping
  • Muscle pain
  • Fluid retention (see below)
  • Pain, itching, swelling, redness, bruising, or hardness near the injection site
  • Enlarged breasts in men (see below)
  • Decreased sperm count (see below)
  • Enlarged prostate 
  • More frequent or longer-lasting erections
  • Menstrual cycle changes or development of masculine features, such as voice deepening (in women)
  • Depression (see below)
  • Acne
  • Tiredness
  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Diarrhea, heartburn, nausea, or burping

There may be other side effects of testosterone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of testosterone?

While less common, the most serious side effects of testosterone are described below, along with what to do if they happen. Some of these side effects may vary based on the testosterone product you are using and why you are using it.

Severe Allergic Reactions. Testosterone may cause allergic reactions, which can be serious. Stop using testosterone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Increased Blood Pressure (Hypertension). Testosterone may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Increased Red Blood Cell Levels. Testosterone may increase the levels of red blood cells, also called erythrocytosis or polycythemia. This can increase hemoglobin levels in your blood. In severe cases, it may increase your risk for blood clots, a heart attack, or stroke. Tell your health care provider right away if you have any of the following symptoms of erythrocytosis or polycythemia.

  • Blurred vision
  • Headaches
  • Confusion 
  • Itching 
  • Weakness or tiredness

Blood Clots. Testosterone may increase the risk of blood clots in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism, including a blood clot in the lungs (pulmonary embolism) or deep vein thrombosis (DVT). Stop using testosterone and get emergency help if you have any of the following signs of blood clots.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech
  • Pain, swelling, or tenderness in your arm or leg
  • Vision loss
  • Bulging eyes 
  • Double vision

Prostate Cancer. Testosterone may increase your risk of prostate cancer. Keep all appointments with your health care provider so they can monitor you while you are using testosterone.

Risk of Misuse. Misusing testosterone can lead to serious side effects, such as heart problems or mental health problems. Misuse means using a medicine in a way other than how it was prescribed or using too much. Use testosterone exactly as prescribed. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Chest pain or pressure or trouble breathing
  • Depression
  • Extreme energy and behavior (mania)
  • Having a hard time knowing what is real and what is imaginary (delusions)
  • Feeling paranoid or aggressive

Decreased Sperm Count. Testosterone may lower your sperm count. Talk to your health care provider if this is a concern for you.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using testosterone. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Fluid Retention (Edema). Testosterone can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Call your health care provider right away if you have any of the following symptoms.

  • Chest pain
  • Irregular heartbeat
  • Shortness of breath
  • Stretched or shiny skin
  • Swollen body parts, such as the belly or ankles

Enlarged Breasts. Testosterone may cause enlarged breasts in men (gynecomastia) that could be painful. Tell your health care provider if you have this symptom or if it is a concern for you.

Changes in Lipid (Fat) Levels. Testosterone can cause changes in the lipid (fat) levels in your blood, including cholesterol. Keep all appointments with your health care provider to have your blood checked.

Slowed Growth in Young Boys. In young boys who have not yet gone through puberty, testosterone may slow down or stop growth, causing them to be shorter than expected as adults. Tell your health care provider if you or your child have concerns about height and growth.

High Prolactin Levels (Hyperprolactinemia). Testosterone may cause an increased level of the hormone prolactin in your blood. Increased levels of prolactin could lead to fertility or bone problems. Contact your health care provider if you have any of the following symptoms.

  • Vaginal dryness
  • Irregular or no periods 
  • Production of breastmilk when not pregnant or nursing
  • Inability to get or keep an erection
  • Enlarged breast size (gynecomastia)
  • Decreased muscle mass and body hair

Depression and Suicidal Thoughts and Actions. Testosterone may cause depression and suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior

Sleep Apnea. Testosterone may increase your risk of sleep apnea, which is a condition where breathing stops and starts again while sleeping. You may be at a higher risk of sleep apnea if you have obesity or lung problems, such as asthma or chronic obstructive pulmonary disease (COPD). Tell your health care provider if you or your bed partner notices that you have symptoms such as snoring, sleepiness during the day, restless sleeping, or waking up suddenly after gasping or choking.

Lung Problem. One specific type of testosterone undecanoate injection may cause a serious lung problem called pulmonary oil microembolism (POME). This happens when tiny droplets of oil travel to the lungs. You will need to be monitored by your health care provider for 30 minutes after each dose of this medicine, and it is only available through a special program and can only be given at a hospital or clinic. If you have questions about this program, you can go to www.AveedREMS.com or call 855-755-0494. Tell your health care provider right away if you have symptoms of POME, such as cough, shortness of breath, sweating, throat tightening, chest pain, or dizziness.

Warnings & Precautions

Who should not use testosterone?

Allergies to Ingredients. People who are allergic to any of the following should not use testosterone.

  • Aveed
  • Azmiro
  • Depo-Testosterone
  • Jatenzo
  • Kyzatrex
  • Testopel
  • Testosterone
  • Tlando
  • Xyosted
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific testosterone products they stock.

Certain Types of Cancer. Testosterone should not be used if you have prostate cancer or certain types of breast cancer.

Pregnancy. Do not use testosterone if you are pregnant. If you become pregnant, contact your health care provider right away. See the Pregnancy section for more details.

Low Testosterone Without Certain Medical Conditions. Testosterone should only be used to treat low testosterone levels caused by certain genetic conditions or issues with the testes or glands or changes in other hormone levels. It should not be used to treat low testosterone levels that are not caused by one of these conditions.

Serious Heart, Liver, or Kidney Problems. A certain type of testosterone injection, called testosterone cypionate, should not be used if you have any serious problems with your heart, liver, or kidneys.

What should I know about testosterone before using it?

Do not use testosterone unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share testosterone with other people, even if they have the same condition as you. It may harm them.

Keep testosterone out of the reach of children. Testosterone is a controlled substance because it can be misused or lead to dependence. Store testosterone in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

There are multiple forms of testosterone available. Read and follow the instructions for the product you have and make sure you understand how to prepare, use, and throw it away properly. If you have any questions, talk to your health care provider.

People who are 65 and older can be at greater risk of some side effects from testosterone. Talk to your health care provider about your risks if you are in this age group.

Keep all appointments with your health care provider, including for blood tests, blood pressure checks, and other tests, before starting and while you are using testosterone. This will help your health care provider make sure it is safe for you to use testosterone.

What should I tell my health care provider before using testosterone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if testosterone is right for you.

In particular, make sure that you discuss any of the following.

Benign Prostatic Hyperplasia (BPH). Tell your health care provider if you have an enlarged prostate or BPH. Testosterone can worsen symptoms of BPH or may increase the risk of prostate cancer. Tell your health care provider if you have any worsening prostate symptoms, such as having a hard time peeing or a weak flow, more frequent peeing, or having an urgent need to pee.

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • High blood pressure 
  • Heart problems
  • High red blood cell or hemoglobin levels
  • Kidney or liver problems
  • Mental health problems, including anxiety, depression, mood changes, or suicidal thoughts or actions
  • Sleep apnea
  • Lung problems, such as asthma or chronic obstructive pulmonary disease (COPD) 
  • Cancer
  • Trouble moving around
  • Diabetes

Other Medicines and Supplements. Testosterone may interact with other medicines and supplements. Before using testosterone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. People who can become pregnant are not usually prescribed testosterone. Testosterone may cause harm to a fetus.

Breastfeeding. People who may breastfeed are not usually prescribed testosterone. It is not known if testosterone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop testosterone.

Interactions

Does testosterone interact with foods or drinks?

There are no known interactions between testosterone and foods or drinks. Testosterone capsules should be taken with food.

It is unknown if drinking alcohol will affect testosterone.

Does testosterone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using testosterone.

  • Insulin, which is a medicine used for diabetes
  • A blood thinner, such as warfarin, which is a medicine used to treat or prevent blood clots
  • A corticosteroid, such as dexamethasone, methylprednisolone, or prednisone, which is a medicine for certain inflammatory conditions
  • A medicine that may increase blood pressure, such as some medicines to treat pain or cold symptoms

This may not be a complete list of medicines that can interact with testosterone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much testosterone?

If you or someone else has used too much testosterone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of testosterone?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.

Testosterone pellets and some testosterone injections are given by a health care provider in a hospital or clinic. If you miss an appointment to get your dose, call to make another appointment as soon as possible.