Testosterone supplementation is becoming increasingly popular so we have put together some short information for you to review.

     Fortesta gel is applied to the thighs…and Axiron solution to the underarms. These locations are to help reduce skin-to-skin transfer…but they don’t eliminate it.

Testosterone for older men is controversial. It’s a tough call.  Testosterone sometimes improves energy, strength, sexual function, and feeling of well-being in men over 65.

Testosterone MIGHT increase the risk of cardiovascular disease and prostate cancer. Plus it can worsen BPH, gynecomastia, sleep apnea, and edema.

The problem is we don’t have good outcome studies for testosterone therapy…like we have with women’s hormone therapy.

Many men say it should be up to them to decide risk vs benefit.

We suggest holding off unless the man has low testosterone PLUS symptoms significant enough to affect his quality of life.

When needed, we recommend a product based on patient preference and insurance…most topicals cost around $300 per month.

The usual starting doasages are: Fortesta 4 pumps…Axiron 2 pumps…AndroGel or Testim gel 5 g…or Androderm 5 mg/day.

We advise men to follow through with orders to check levels 4 to 12 weeks after starting therapy…to help with dose titration.

Also, we recommend monitoring for an increase in certain lab values such as: hematocrit, PSA, and prostate exam at baseline, 3 to 6 months, and then yearly.

We also advise men to wash hands after applying the gel or solution…and cover the site with clothing to reduce transfer to women or kids.

Francis Al. Rubino, PharmD