Transdermal Testosterone Improves Sexual Function, Mood, and Strength
in Men with Low Testosterone Levels
Testosterone replacement therapy in men whose levels of natural testosterone have declined improves sexual function, decreases body fat, increases lean muscle mass and function, and increases bone mass. These beneficial effects are accompanied by slight lowering of HDL cholesterol levels, and increases in blood hematocrit and hemoglobin. Using the skin as the route of administration (i.e. transdermal), adequate amounts of testosterone can be administered to mimic the normal daily production rate. The effects of testosterone replacement using a transdermal gel versus a patch were studied at 16 medical centers, including UCLA, Johns Hopkins, University of Pennsylvania, Baylor, and Duke. Male patients were between 19-68 years old and at screening, had single morning serum testosterone levels below 300 ng/dL, meaning they were testosterone deficient or "hypogonadal". Both the gel and patch forms of testosterone replacement improved sexual function and mood, increased lean mass and muscle strength (principally in the legs), and decreased fat mass in hypogonadal men, but the transdermal gel formulation resulted in less skin irritation (5% of men treated with testosterone gel versus 66% of men who used the patch) and therefore fewer discontinuations of therapy compared with the recommended dose of the patch.
Testosterone patches have other disadvantages. The scrotal patch requires clipping or shaving of the hair on a large surface of scrotal skin. The nonscrotal body patches do not adhere optimally in some patients. When testosterone gel is applied over a larger area of skin in an open system, it rarely produces problems of skin irritation. Use of gel formulations provides more flexibility in dosing.
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