About testosterone and topical testosterone

Testosterone is a typically male hormone that’s mainly produced in the testicles. If you’re a man, it helps your body develop sex organs, sperm, and sex drive.

The hormone also helps maintain male features such as muscle strength and mass, facial and body hair, and a deepened voice. Your testosterone levels typically peak in early adulthood and slowly decrease with age.

Topical testosterone is a prescription drug that’s applied to your skin. It’s used to treat hypogonadism, a condition that prevents your body from making enough testosterone.

The Food and Drug Administration (FDA) has approved topical testosterones in gel form. However, some men prefer compounded testosterone creams (where a pharmacy mixes testosterone with a creamy base), because they find them easier to use and less likely to be transferred by touch. Otherwise, the effects of gels vs. creams are not very different.

While topical testosterone can be helpful to men with hypogonadism, it can also cause unexpected topical and hormonal side effects.

The most common side effects of topical testosterone are skin reactions. Because you apply topical testosterone directly to your skin, you may develop a reaction at the application site. Symptoms can include:

  • burning
  • blistering
  • itching
  • soreness
  • swelling
  • redness
  • rash
  • dry skin
  • acne

Make sure you always apply the medication on clean, unbroken skin. Follow the application directions on the package carefully and report any skin reactions to your doctor.

Topical testosterone can also affect your urinary tract. Some men need to urinate more than usual, including during the night. You may feel an urgent need to urinate, even when your bladder isn’t full.

Other symptoms include trouble urinating and blood in the urine. If you’re using topical testosterone and have urinary trouble, talk to your doctor.

Hypogonadism can cause gynecomastia (enlarged breasts) in men. It’s rare, but the use of topical testosterone can bring on unwanted changes to the breasts. This is because your body changes some testosterone into a form of the hormone estrogen, which can result in your body forming more breast tissue. Changes to the breasts can include:

  • tenderness
  • soreness
  • pain
  • swelling

If you’re concerned about changes to your breasts while using topical testosterone, see your doctor right away.

Topical testosterone can leave you feeling a bit out of sorts. Symptoms aren’t common, but they can include feeling dizzy, lightheaded, or faint. Sometimes topical testosterone use can cause hot flashes or pounding sounds in the ears.

These symptoms may be fleeting and can disappear on their own. If they continue to be a problem, talk to your doctor.

Most men tolerate testosterone treatment quite well, but a small number develop emotional side effects from the hormonal changes. These can include:

Although emotional side effects are rare, they can be serious. Be sure to discuss any symptoms with your doctor.

Testosterone plays a big role in a man’s sex drive. But in rare cases, topical testosterone can negatively affect sexuality. It may cause problems such as:

  • loss of desire
  • inability to get or maintain an erection
  • erections that happen too often and last too long

Call your doctor if you have any of these symptoms and they bother you.

Topical testosterone can cause side effects in women and children who come in contact with it on your skin or clothing.

Children may develop aggressive behavior, enlarged genitals, and pubic hair. Women may develop unwanted hair growth or acne. Testosterone transfer is especially dangerous for pregnant women because it can cause birth defects.

Women and children who are exposed to testosterone products should call their doctor right away.

To prevent these problems, don’t allow skin-to-skin contact of the treated area with other people. Keep the treated area covered or wash it well before letting others touch you. Also, don’t allow others to touch any bedding and clothing that may have absorbed testosterone from your skin.

The FDA has issued a warning of potential increased risk of cardiovascular events among men using testosterone products. Be sure to consult with your healthcare provider about this potential issue.

Learn more about testosterone and your heart.

Topical testosterone is a powerful prescription drug that you should only use under your doctor’s supervision.

It may cause side effects other than the ones we’ve mentioned, so talk to your doctor if you have questions. Some side effects may clear up on their own, but some may require medical attention. Be sure to report any side effects to your doctor.

Also be sure to tell your doctor if you have any other health conditions, including:

  • diabetes
  • allergies
  • prostate cancer
  • heart disease

Tell them about other over-the-counter and prescription medications and supplements you’re taking and ask about any possible drug interactions.