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PL 934.1 Testosterone Replacement Therapy

This leaflet provides information about testosterone replacement therapy for patients with hypogonadism, detailing its purpose, benefits, risks, and monitoring requirements. It explains the symptoms of low testosterone and the potential side effects of treatment, as well as alternative methods of administration. Patients are encouraged to discuss any concerns with their healthcare providers and are informed about the importance of confirming their identity for safety.

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Shendy Setiawan
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7 views8 pages

PL 934.1 Testosterone Replacement Therapy

This leaflet provides information about testosterone replacement therapy for patients with hypogonadism, detailing its purpose, benefits, risks, and monitoring requirements. It explains the symptoms of low testosterone and the potential side effects of treatment, as well as alternative methods of administration. Patients are encouraged to discuss any concerns with their healthcare providers and are informed about the importance of confirming their identity for safety.

Uploaded by

Shendy Setiawan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Testosterone

replacement therapy
Information for patients
This leaflet answers some of the questions you may have about having
testosterone replacement therapy. It explains the reason for treatment
and the aims of treatment. It will also provide information concerning
monitoring and possible side effects. If you have any other questions or
concerns, please speak to the doctors or nurses caring for you.

Confirming your identity


Before you have a treatment or procedure, our staff will ask you your
name and date of birth and check your ID band. If you don’t have
an ID band we will also ask you to confirm your address.
If we don’t ask these questions, then please ask us to check.
Ensuring your safety is our primary concern.

www.kch.nhs.uk
What is testosterone replacement therapy?
Hypogonadism is the medical term for testosterone deficiency and
simply means having a low testosterone level. It happens when the
testes do not function normally. This can be due to a problem in
the testes, where testosterone is made, or a problem in the pituitary
gland underneath the brain, which controls the function of the
testes. Low testosterone can happen in men of any age. However,
there is a progressive decline in testosterone levels as men get older.

If your own body does not make enough testosterone, you may
benefit from having supplemental testosterone. If indicated,
testosterone replacement therapy will be initiated by your
endocrinologist. Testosterone is commonly given by three monthly
injections using testosterone undecanoate (Nebido®) but can also be
given using alternative forms of testosterone at different intervals.

Why do I need this treatment?


If you have been having symptoms of low testosterone or blood
testing has shown that your testosterone is low, you may be advised
to start testosterone replacement therapy.

Symptoms of low testosterone may include:


• fatigue
• lethargy
• depression
• anxiety
• irritability
• low libido
• erectile dysfunction
• reduced exercise tolerance and strength
• excessive sweating and night sweats
• poor concentration or memory
• needing to shave less often

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There may be other causes of these symptoms so it is worth noting
that testosterone replacement therapy may not resolve some of
these symptoms.

What are the benefits?


Testosterone replacement therapy aims to improve the symptoms
that you may have been experiencing, such as those listed on
page 2. If your bone density has reduced because of low
testosterone we may also be aiming to improve your bone density
with the treatment.

An improvement in symptoms may occur with treatment, but bear


in mind this is not the case for every person.

Testosterone levels will be measured routinely to monitor if the


treatment is safe and effective.

What are the risks?


Testosterone replacement therapy may cause increased levels of
haemoglobin or haematocrit indicating a thickening of the blood.
This may be associated with an increased risk of heart attack,
stroke and blood clots. Your blood will be tested prior to treatment
and routinely during treatment to monitor your haemoglobin and
haematocrit level.

Testosterone treatment can also cause an enlarged prostate or


other prostate disorders. During treatment, your prostate specific
antigen (PSA) will be measured to monitor for any changes. This is
particularly important in men over 45 years of age.

Other side effects may include:


• weight gain
• increased appetite

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• hot flushes
• acne
• depression
• restlessness
• irritability
• aggression
• tiredness
• general weakness
• excessive sweating

As a result of using testosterone replacement, your natural


production of testosterone may be reduced. This may also lead to a
reduction in sperm production. This will mean that your fertility will
be affected by going onto testosterone replacement therapy. If you
are considering having children in the future you should discuss this
with your endocrinologist prior to starting treatment.

Are there any alternatives?


Testosterone undecanoate (brand name Nebido®) is commonly
used for testosterone replacement therapy. This injection is
given intramuscularly (into the muscle) every 12 weeks by the
endocrinology nursing team. This interval can be altered if advised
by your endocrinologist.

Alternatively, replacement therapy can be given using Sustanon®


(a combination of four forms of testosterone) by more frequent
injections (every two to four weeks).

The advantage of having injections is reduced frequency. The


disadvantages include pain at injection site, the need for a health
professional to administer the injection and end-of-dose fluctuation
in symptoms.

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Testosterone can also be replaced using a testosterone gel that is
absorbed through the skin. There are various formulations available
which are applied in different ways.

For Tostran®
Apply gel on clean, dry, intact skin of abdomen (tummy) or both
inner thighs, preferably in the morning. Gently rub in with a finger
until dry before dressing. Wash hands with soap and water after
applying gel. Avoid washing application site for at least two hours.
Not to be applied on genital area.

For Testogel® 50mg/5g


Apply thin layer of gel on clean, dry, healthy skin such as shoulders,
arms or abdomen, immediately after sachet is opened. Not to be
applied on genital area as high alcohol content may cause local
irritation. Allow to dry for 3 to 5 minutes before dressing. Wash
hands with soap and water after applying gel. Avoid a shower or
bath for at least 6 hours.

For Testogel® 16.2mg/g


Apply thin layer of gel on clean, dry, healthy skin over right and
left upper arms and shoulders. Not to be applied on genital area as
high alcohol content may cause local irritation. Allow to dry for 3 to
5 minutes before dressing. Wash hands with soap and water after
applying gel, and cover the site with clothing once gel dried. Avoid a
shower or bath for at least 2 hours.

For Testavan®
Manufacturer advises applying one pump of gel evenly onto clean,
dry, intact skin over upper arm and shoulder using the applicator,
without getting any gel on the hands. Repeat on opposite upper
arm and shoulder if two pumps are required, and repeat again on

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initial upper arm and shoulder if three pumps are required. Allow
to dry completely before dressing and cover application site with
clothing. Wash hands with soap and water immediately if gel was
touched during application. Avoid a shower or bath for at least
2 hours.

The advantages of using testosterone gel include self-administration


and stable blood levels of testosterone. The disadvantages include
skin irritation and the need to limit skin-to-skin contact with others
at the site of application.

Contact
If you have any queries or concerns please contact the Programmed
Investigation Unit (PIU).

Tel: 020 3299 3034 or 020 3299 1385. Opening hours: 8am to
6pm, Monday to Friday.

Sharing your information


We have teamed up with Guy’s and St Thomas’ Hospitals in a
partnership known as King’s Health Partners Academic Health
Sciences Centre. We are working together to give our patients the
best possible care, so you might find we invite you for appointments
at Guy’s or St Thomas’. To make sure everyone you meet always has
the most up-to-date information about your health, we may share
information about you between the hospitals.

Care provided by students


We provide clinical training where our students get practical
experience by treating patients. Please tell your doctor or nurse
if you do not want students to be involved in your care. Your
treatment will not be affected by your decision.

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PALS
The Patient Advice and Liaison Service (PALS) is a service that offers
support, information and assistance to patients, relatives and
visitors. They can also provide help and advice if you have a concern
or complaint that staff have not been able to resolve for you. The
PALS office is located on the ground floor of the Hambleden Wing,
near the main entrance on Bessemer Road - staff will be happy to
direct you.

PALS at King’s College Hospital, Denmark Hill, London SE5 9RS


Tel: 020 3299 3601
Email: [email protected]

You can also contact us by using our online form at


www.kch.nhs.uk/contact/pals

If you would like the information in this leaflet in a different


language or format, please contact PALS on 020 3299 1844.

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PL934.1 March 2021 Ambulatory Care
Review date March 2024 Corporate Comms: 2508

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