Side Effects Side Effects of Male Sex Hormones / Testosterone

SIDE EFFECTS

Ø Virilization, excess body hair and menstrual irregularities in women; many effects, e.g. voice change may be permanent after prolonged therapy.

Ø Acne: in males and females.

Ø Frequent, sustained and often painful erections in males in the beginning of therapy, subside spontaneously after sometime.

Ø Oligozoospermia with moderate doses given for a few weeks.

Ø Precocious puberty and shortening of stature due to early closure of epiphysis—if given to children for more than a few weeks.

Ø Edema: especially when large doses are used in patients with heart or kidney disease. It is rare with the doses used for hypogonadism.

Ø Cholestatic jaundice: occurs with methyltestosterone and other 17alkyl substituted derivatives (fluoxymesterone and some anabolic steroids like oxymetholone, stanozolol) in a dose dependent manner, but not with parenterally used esters of testosterone. For this reason, the latter are preferred, especially for prolonged therapy. However, jaundice is reversible on discontinuation.

Ø Hepatic carcinoma: incidence is higher in patients who have received long-term methyltestosterone or other oral androgens.

Ø Gynaecomastia: may occur, especially in children and in patients with liver disease. This is due to peripheral conversion of testosterone to estrogens. Dihydrotestosterone does not cause gynaecomastia because it is not converted to estradiol.

Ø Lowering of HDL and rise in LDL levels, especially with 17αalkylated analogues.

Contraindications

Androgens are contraindicated in carcinoma of prostate and male breast, liver and kidney disease and during pregnancy (masculinization of female foetus). They should be used cautiously in patients who may be adversely affected by fluid retention—such as CHF, epilepsy, migraine.