Worsening sleep apnea, a potentially serious sleep disorder in which breathing stops and starts repeatedly. A relatively small number of men experience the immediate side effects of testosterone supplements, such as acne, breathing disorders while sleeping (worsening sleep apnea), breast swelling or tenderness, or ankle swelling. Doctors also monitor high red blood cell counts, which may increase the risk of blood clots.
Testosterone replacement
therapy (TRT) has been used in millions of men worldwide to treat decreased libido and erectile dysfunction, and to improve strength and physical function.The estimated likelihood of long-term adverse effects of TRT is still essentially unknown, since there is a lack of high-quality general evidence based on prospective randomized trials that recommend or does not recommend its use in most men with testosterone (TD) deficiency. Evidence to suggest that TRT increases the risks of cardiovascular morbidity and mortality is scarce, as results vary depending on the populations studied and their baseline comorbidities. While TRT can increase serum levels of prostatic specific antigens in some men, it often stays within clinically acceptable limits and has not been shown to increase the risk of prostate cancer. The current literature supports that TRT does not substantially worsen lower urinary tract symptoms and, in fact, may improve symptoms in some men.
Limited evidence suggests that TRT may initially worsen obstructive sleep apnea in some men, but that this is not a lasting effect. TRT may cause erythrocytosis in some men; however, long-term studies have not reported significant adverse effects (e.g., strokes, vascular occlusive events, or venous thromboembolism). Future research will need to focus exclusively on evaluating large multiethnic cohorts of men using prospective trials to better elucidate the risk-to-risk ratios of TRT with regard to cardiovascular diseases, prostate cancer, lower urinary tract symptoms, obstructive sleep apnea, erythrocytosis and other theoretical risks to be determined in men with or without cardiovascular risk equivalents. To date, few studies have addressed the potential long-term adverse effects associated with TRT. This article will summarize current evidence, focusing on the possible risks associated with CVD, increased prostatic specific antigen (PSA) and prostate cancer, lower urinary tract symptoms (LUTS), obstructive sleep apnea (OSA) and erythrocytosis, with the objective of analyzing the literature on the safety of TRT and identifying areas where future research is needed.
Similar to the possible increased risk of prostate cancer, it has long been postulated that TRT causes an increase in prostate volume and a worsening due to benign prostatic hyperplasia (BPH). Until now, the current literature has been heterogeneous, but it tends to show that TRT does not worsen LUTS and, in fact, it can improving symptoms in some cohorts. Available evidence indicates that TRT is considered largely safe in most men, with a small inherent risk of adverse events in selected populations of high-risk men with multiple medical comorbidities. TD is associated with an increased risk of developing cardiovascular and metabolic diseases; however, the nature of the relationship remains unclear and recent evidence suggests that TRT may increase the risk of adverse cardiovascular events in men with significant comorbidities.
TRT has been associated with occasional moderate increases in serum PSA, although within safe clinical parameters and without convincing and substantial evidence to support an increased risk of prostate cancer. The LUT seems to remain stable or to improve slightly with the use of the TRT, offering a different point of view than the opinions held previously. There is little data left on TRT in relation to the long-term outcomes of OSA; however, current evidence suggests that TRT may transiently worsen the objective parameters of OSA and then disappear. TRT appears to be associated with erythrocytosis, but data are lacking on the importance of this trend in relation to patient outcomes.
Testosterone replacement therapy (TRT) is a treatment widely used in men with symptomatic hypogonadism. The benefits of TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscles, and cardioprotective effects, are well documented. TRT is contraindicated in men with untreated prostate and breast cancer. Men treated with TRT should be monitored for side effects such as polycythemia, peripheral oedema, and heart and liver dysfunction. A known risk is that testosterone can cause blood to become too thick, also known as a high hematocrit count, which can lead to a stroke, heart attack, or other conditions.
This can be a particular problem if you are taking a dose that is too high for the body's metabolism. This can be prevented by maintaining an appropriate dose and using blood tests to monitor blood and hormone levels. This medication should not be used by women, especially those who are pregnant or may become pregnant. Testosterone can cause congenital anomalies if a pregnant woman comes into contact with the medication.
Make sure your doctor knows if your sexual partner is pregnant. If you become pregnant while using this medication, tell your doctor right away. This medication may cause blood clotting problems. Tell your doctor right away if you have pain, redness, or swelling in your arm or leg, sharp chest pain, or trouble breathing. This medication may increase the risk of heart or vascular problems, such as a heart attack or stroke. Tell your doctor right away if you have chest pain that may spread to your arms, jaw, back, or neck, fainting, headache, nausea, vomiting, trouble breathing, problems seeing or speaking, or unusual sweating.
This medication may cause some people to become agitated, irritable, or show other abnormal behavior. It can also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.
Studies looking at the onset of polycythemia as a negative side effect in men receiving testosterone therapy are rare. While this study also demonstrates the desired effect of decreasing prostate volume, it has not demonstrated any significant improvement in symptom scoring or objective measures of urinary function. These hormones can cause mood changes, bloating and other side effects, so it's recommended that you discuss these medications in more detail with your provider if you are going to use them. Thinking about your goals will help you communicate more effectively with your medical provider as you work together to plan your care plan.
Now that you've learned about the effects of masculinizing hormone therapy, as well as the risks and specific medication options, the next step will be to talk to your provider about what approach is best for you. The most common side effects of this medication are edema, acne, pain at the injection site, cough, or shortness of breath during the injection or immediately after the injection. Testosterone has many beneficial effects, such as increasing bone strength and density, inducing hematopoiesis, boosting sexual function and libido, providing a cardioprotective effect and increasing muscle strength. There have been no appropriate studies on the relationship between age and the effects of testosterone in the geriatric population.
In addition, your healthcare professional may be able to tell you about ways to prevent or reduce some of these side effects. Bagatell CJ, Heiman JR, Matsumoto AM, Rivier JE, Bremner WJ (199) Metabolic and behavioral effects of high doses of exogenous testosterone in healthy men. Anderson FH, Francis RM, Faulkner K (199) Androgen supplementation in eugonadal men with osteoporosis: effects of 6 months of treatment on bone mineral density and factors of cardiovascular risk. Tripathy D, Shah P, Lakshmy R, Reddy KS (199) Effect of testosterone replacement on whole-body glucose utilization and other cardiovascular risk factors in men with idiopathic hypogonadotrophic hypogonadism.
Later, this study evaluated the effect of TRT on the mortality of men in the group with low testosterone levels, which was divided into men who received it and those who did not receive it. Regardless of the type of testosterone you're taking, it's important to know that taking more testosterone won't make your changes go faster, but it could lead to serious side effects or complications. Using this medication with any of the following medications may increase the risk of certain side effects, but using both drugs may be the best treatment for you.
