Transdermal testosterone refers to any testosterone medication that is applied directly to the skin. For decades injectable testosterone was the only means of administering the primary male hormone with the first commercially available batches hitting the shelves in 1937. Soon after oral testosterone tablets would become available, but they were not as abundantly available and also highly toxic to the liver. For decades injectable testosterone was the only functional and available means of testosterone for most men that is until transdermal testosterone.
Testosterone based skin patches were developed in the 1980’s and soon improved upon greatly by the early 1990’s. In 1995 TheraTech’s Androderm would gain FDA approval and would in part be responsible for the increase we’ve seen in low testosterone treatment. However, in 2000 Unimed Pharmaceuticals would release AndroGel, a testosterone cream you rub on your body. It was this cream version of transdermal testosterone that truly changed the market and made testosterone replacement therapy (TRT) a reality for so many men.
Since the inception of Androderm in the U.S. ATMOS in Europe and AndroGel worldwide other forms of transdermal testosterone products have hit the market. Generic brands have become commonplace as has an underarm roll-on known as Axiron. The roll-on form does have its advantages in terms of application, but it hasn’t proven to be as effective as the other forms of transdermal testosterone.
Transdermal Testosterone Functions & Traits
Regardless of the form of transdermal testosterone used all forms are comprised of the primary male hormone testosterone. The testosterone hormone is the same in all forms. The testosterone used in transdermal testosterone is the same testosterone hormone in injectable testosterone. The only difference is the mode of administration, which can affect the effectiveness in the hormone depending on the man. Regardless of the form of transdermal testosterone or what you might hear or see in marketing material, there is nothing special about any brands form of product in terms of the hormone. Testosterone is simply testosterone; in fact, the body knows no difference in man made or naturally produced as it is carbon for carbon the exact same thing.
- Androderm/ATMOS: This type of transdermal testosterone is an alcoholic testosterone gel that is enclosed in a patch that is protected by a drug reservoir and attached to the skin. The patch is applied in the morning and the largest amounts of testosterone are released from the reservoir early in the day with small amounts throughout the rest. It was designed this way in order to mimic the natural of release of testosterone in the human body.
Androderm is found in two specific dosing forms, 2.5mg and 5mg patches. The smaller patch will provide 12.2mg of active testosterone with the larger providing 24.3mg. The number of patches applied at once (per day) can vary depending on the need of the patient.
- AndroGel: This type of transdermal testosterone is classified as a hydroalcoholic. It is simply a lotion like cream that contains the active testosterone hormone. As with patches transdermal gels and creams are applied first thing in the morning. AndroGel itself is available in 1% concentration in 2.5mg and 5mg sachets with 1.62% also being available in recent years. However, compounded forms of transdermal testosterone can be found in concentrations all the way from 5-20%.
The purpose of any transdermal testosterone is to provide testosterone that the body is lacking. We’re specifically referring to a low testosterone condition. There are many reasons a man’s testosterone levels might fall into a low or below optimal state. As we age our testosterone levels naturally decline making age related low testosterone perhaps one of if not the most common cause. It can also be caused by head trauma or testicular injury. There are many things that can cause low levels beyond the few we’ve mentioned, and in some cases it’s a combination of a few things that causes the problem. The primary causes of low levels that may bring about the need for transdermal testosterone include:
- Recreational drug use
- Prolonged use of pain killers (opiates)
- Statins (cholesterol meds)
- Testicular injury
- Pituitary tumor
- Head trauma
- Anabolic steroid use
- Over exposure to corticosteroids
- Exposure to various chemicals and pollutants
If a man suffers from low testosterone, symptoms will normally show and are very hard to miss. However, some do miss them as lethargy and apathy can be symptoms and as this is a condition that often gradually occurs the symptoms somehow become viewed as commonplace. Common low testosterone symptoms that may call for transdermal testosterone use and TRT include:
- Loss of Libido (can refer to partial or total loss)
- Erectile Dysfunction (inability to maintain or obtain and erection)
- Loss of Muscle Mass (despite diet & exercise)
- Loss of Strength (despite diet & exercise)
- Increased Body Fat (despite diet & exercise)
- Loss of Mental Clarity
- Decreased Ability to Focus
- Decreased Energy
- Weakened Immune System
The symptoms themselves can be very annoying. However, blood testing is needed to get a true grip on the situation. It’s also important to understand low testosterone may not be your only problem, it could be one of a few problems but all problems should be fixed. Transdermal testosterone can help with these problems, and while the above symptoms are not life threatening ignoring the condition can lead to more severe problems down the road. Prolonged low testosterone that is ignored has been linked at least in part to the following:
- Alzheimer’s Disease
- Heart Disease
Effects of Transdermal Testosterone
The effects of transdermal testosterone (positive) are very straightforward; you have low testosterone symptoms, you use transdermal testosterone and you no longer suffer from those symptoms. The individual should see significant improvements in his wellbeing with the use of transdermal testosterone; however, there are some very important things to note:
- TRT takes time. You cannot take testosterone and see all your symptoms vanish in a day or two. It takes several months for the full benefits of TRT to occur.
- You must be dialed in. This means your dose may need to be adjusted up or down. You will need to have a solid balance between testosterone and estrogen levels in order for your symptoms to be eliminated.
- You must be consistent. If you regularly miss doses you aren’t going to improve. If you miss a dose one day it’s not the end of the world. Missing once in a blue moon isn’t going to have that big of an impact, but if missing regularly it will.
- You must recognize low testosterone may not be your only problem. Transdermal testosterone is not going to fix every issue you have and you may have other medical issues beyond low testosterone.
- You need to live a healthy lifestyle. If you live an unhealthy lifestyle you’re still not going to feel good.
Side Effects of Transdermal Testosterone
There are many possible side effects of transdermal testosterone use, and most of them are the same as with any other form of testosterone use. However, there are application issues that may exist with transdermal forms. More importantly, although possible side effects of transdermal testosterone do exist they can also be avoided with proper use. Remember this is testosterone, a hormone you’ve been making your entire life and one your body is very familiar with. This isn’t a hormone that you’re introducing to your body that it’s never seen before or is unaccustomed to. Your issue is that you no longer produce enough. In order that you might understand the side effects of transdermal testosterone and how to avoid them, we’ve broken them down into their respective categories below.
There are estrogenic side effects of transdermal testosterone use, but they can easily be avoided. Testosterone converts to estrogen. This occurs due to the testosterone hormone’s interaction with the aromatase enzyme. As men we do need some estrogen, it’s imperative to our health and physical function, but too much can lead to gynecomastia and water retention. If water retention is severe it can lead to high blood pressure.
Some men will need to use an Aromatase Inhibitor (AI) like Anastrozole (Arimidex) when using transdermal testosterone in order to keep a balance between their testosterone and estrogen levels. This is not something all men will need but many will. You should not take an AI as a preventative measure as you will risk lowering your estrogen too much. That can lead to many symptoms that are similar to low testosterone and in some cases even worse. The best course of action is to begin transdermal testosterone use and to have your levels checked 6-8 weeks later, adjust the dosing if needed and add AI’s if needed. You will want to have regular blood work done a few times a year to keep an eye on this. As our bodies naturally change your needed doses of testosterone and AI’s and need for AI’s at all may not always stay the same.
Important Note: The more testosterone you use the more there is to aromatize and convert to estrogen. Only the amounts needed to remedy the low level condition should be used.
There are possible androgenic side effects of transdermal testosterone use. Androgenic side effects are due to the testosterone hormone reducing to dihydrotestosterone (DHT). This occurs due to the hormone being metabolized by the 5-alpha reductase enzyme. Androgenic side effects can include hair loss in men predisposed to male pattern baldness, acne and body hair growth. If you are not predisposed to male pattern baldness hair loss is impossible. If you are predisposed you were going to lose it anyway, but the testosterone may speed it up. Interestingly enough low testosterone levels have been linked to hair loss, so avoiding needed testosterone may not prevent this issue for you. It all boils down to balance in hormone levels along with genetic predispositions.
Important Note: Some men choose to use 5-alpha reductase inhibitors like Finasteride in order to combat the androgenic side effects of transdermal testosterone, especially hair loss. These medications will significantly reduce the androgenicity of the testosterone hormone. However, they can also cause other hormone imbalances in many men and should be taken very seriously and only used if absolutely necessary.
Transdermal testosterone can cause cardiovascular strain; however, it should not if it is not abused and a healthy lifestyle is followed. Use may lead to a lowering of HDL cholesterol (good cholesterol) and may increase LDL cholesterol (bad cholesterol); however the latter is not common.
Testosterone use may also thicken the blood by raising hematocrit, hemoglobin and red blood cell count levels. Some men will need to perform a therapeutic phlebotomy a few times a year to combat this. Most will not need this but keeping an eye on your blood work is important.
If you live a healthy lifestyle and keep your cholesterol under control and keep an eye on blood thickness, there is no reason to have cardiovascular issues with transdermal testosterone use.
The use of transdermal testosterone will suppress the production of natural testosterone. For the low testosterone patient this is inconsequential as he isn’t making enough testosterone to begin with. If you discontinue use your natural testosterone production will begin again, but it will only be at the prior low level state. Because you will be older once you stop it may even be lower than it was before you began transdermal testosterone use.
Transdermal testosterone is not toxic to the liver in any form.
Some men may find the skin becomes irritated at the applied area. This appears to be more common with patches than gels or creams but can occur with all. You may need to experiment with different application spots or forms of transdermal testosterones in order to find what works best for you.
Transdermal Testosterone Administration
The type of transdermal testosterone used will affect how much you use and where, but in all cases it’s simply applied directly to the skin. In all cases it will be administered first thing in the morning. You should be clean and dry before administering the hormone; taking a shower before hand is best.
- Gels & Creams: Most commonly applied to the shoulders or upper arms or the abdomen. Doses normally start at 5mg per day and often increase towards 10mg per day. You should avoid physical contact with women and children for 12 hours to avoid secondary contact with the medication. It is best to shower before any sexual contact with a female partner.
- Patches: These are applied directly to the skin (adhesive) first thing in the morning. Most commonly applied to the shoulders or upper arms, back, and sometimes abdomen or thighs. The skin should be clean and dry. Doses normally range from 2.5-5mg per day.
Availability of Transdermal Testosterone
All forms of transdermal testosterone are widely available in the U.S. and worldwide. Name brands, especially gels will be very expensive. If you’re looking to save a lot of money you’ll find compounded creams are by far the most affordable. You will almost never find transdermal testosterone on the black market, especially patches, but some (very few) suppliers will carry gels and creams, but again it’s unlikely.
Buy Transdermal Testosterone Online - Warning
It’s not very easy to buy transdermal testosterone online as it’s not carried by most online vendors. You must have a prescription to legally purchase a transdermal testosterone in the U.S. and it’s not something that’s commonly found on the black market. If you do find black market transdermal testosterone understand a purchase will be breaking the law. Testosterone in any form is classified as a Schedule III controlled substance and any purchase made without a prescription is against the law. You will not only need a prescription but the rules behind how you can use the prescription are also very strict. Laws will vary significantly in other countries, but buying online is virtually unheard of.
Transdermal Testosterone Reviews
Transdermal testosterone is truly a remarkable thing when we stop and think about it. Apply a patch or a little lotion and you’ve giving your body testosterone. It is also one of the reasons many physicians and individuals have stopped ignoring low testosterone conditions, which severely diminish a man’s overall quality of life.
While transdermal testosterones are great products we cannot say they’re as wonderful as the original injectable forms. Transdermal testosterone in all forms carries a 20% fail rate, meaning it will not work in 20% of men who use them. It’s not an issue with the testosterone but rather they simply can’t absorb it. Another issue is transdermal fatigue; the medication works fine but the body begins to adapt and more and more is needed. These are not issues with injectable testosterone as it will work 100% of the time and indefinitely.
It is true, it’s easier to apply a little cream or a patch, but it must be done daily. Injections do seem almost scary for some but normally laughable once done a few times and generally only needed 1-2 times per week. However, transdermal testosterone still has its place. If it works well for you and is the difference between low and optimal testosterone levels, then it’s definitely worth considering.