If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to testosterone. Before having any laboratory test, tell your doctor and the laboratory personnel that you are using testosterone topical. Do not let anyone else use your medication. Testosterone topical is a controlled substance.
Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Generic alternatives may be available. Testosterone Topical pronounced as tes tos' ter one. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow?
What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication?
Brand names. To use testosterone topical products, follow these steps: Be sure that the skin in the place where you plan to apply testosterone topical is clean and completely dry. Open your testosterone topical container. If you are using a packet, fold the top edge at the perforation and tear across the packet along the perforation. If you are using a tube, unscrew the cap. Always discard the extra medication that comes out after priming the pump down a drain or in a trash can that is safe from children and pets.
Squeeze the packet or tube or press down on the top of the pump the right number of times to place the medication on the palm of your hand. It may be easier to apply testosterone gel if you squeeze the medication onto your palm and apply it to your skin in small portions.
Apply the medication to the area you have chosen. Dispose of the empty packet or tube in a trash can safely, out of the reach of children and pets. Wash your hands with soap and water right away. This is often the first sign that the TRT is starting to work. Stick with it and you should soon see improvements in many other aspects of your life. You should notice a reduction in depression after three to six weeks, although it might take several months to fully recover.
For men who have diabetes, or pre-diabetes, testosterone replacement therapy may bring dramatic and rapid improvements. After just a few days, your insulin sensitivity could measurably improve.
However, full blood sugar control takes longer often between three and twelve months. Continue taking your diabetes medications even if you feel better, and visit your doctor regularly to find out whether you need to adjust your dose.
Although the first testosterone therapy effects appear quickly, you need to keep up with the course of treatment for an extended period of time to reap the full benefits. Your sex life should improve over time as you receive testosterone replacement therapy. Although most men notice increased interest in sex after just a few weeks, it could take as much as six months for your erections to improve firmness.
Taking TRT for several months can change the way your body looks. After three or four months , you should notice an increase in lean body mass. If you miss a dose of this medicine, apply it as soon as possible.
However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep the medicine in a safe place.
Do not give it to anyone else, even if you have the same symptoms. Throw away the empty pump, tube, or packet in a place where children and pets cannot reach it. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.
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In a study in patients with Crohn's disease, CRP levels continued to decline over 24 months Asymmetric dimethylarginine is an endogenous NO synthase inhibitor and appears to decline upon testosterone administration after 10 days 66 or after 4 weeks Effects on libido, sexual desire, sexual thoughts and fantasies and satisfaction with sexual life manifest themselves rather rapidly: after 3 weeks 68 or 30 days Some studies have measured these effects only after 3 months Effects on erection also appear rather rapidly: after 3 weeks Increase in morning erections occur after 3 weeks An increase in percentage of full erections and sexual performance and satisfaction with erections was noticed after 30 days 14, 69 , an increase of ejaculations and sexual activity after 2 weeks 70 and 3 weeks respectively In patients with veno-occlusive dysfunction, testosterone undecanoate restored erectile function after a minimum of 3 months and a maximum of The International Index of Erectile Function is a reliable, self-administered measure of erectile function that is cross-culturally valid and psychometrically sound, with the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction.
It has five domains: erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Increases in the IIEF erectile function have been noted after 3 months 35, 40 but increases in IIEF sexual desire, intercourse satisfaction, and overall satisfaction appear already after 6 weeks Maximal effects are usually achieved after 3—6 months 72 but may take even up to 1 year in individual cases An improvement was noted after 1 month of testosterone treatment The Aging Males' Symptom AMS questionnaire is a item scale assessing health-related quality of life and symptoms in aging men e.
Improvements on scores on the AMS have been noted after 1 month 38 , 6 weeks 40 to 3 months on treatment with parenteral testosterone undecanoate 35 or after 9 months on testosterone gel 74 continuing over a total of 18 months Several studies report an improvement in depression after 3 weeks 68 or 1 month Increase in good mood and a decrease in bad mood were noted after 3 weeks 68 or after 30 days There was also an increase in motivation after 30 days which was maintained thereafter Two studies using the Hamilton Depression Rating Scale found an improvement in depression after 6 weeks 75 or 8 weeks A number of psychological variables increase in sociability, decrease in anxiety, increase in concentration, and self-confidence were apparent after 3 weeks A decrease in fatigue and listlessness was found after 1 month 31 or 6 weeks The effect was not consistent within the whole group of patients.
It is likely that, in severe clinical depression, the receptiveness for testosterone effects depends on the overall pattern of disturbed neurotransmitters, especially noradrenaline and serotonin, and also baseline testosterone concentrations It is very likely that the positive effects of testosterone on depressive symptoms start as early as after 3—6 weeks, but will most likely take 18—30 weeks to find the patient with a significant improvement.
A recent study in hypogonadal men receiving i. It is remarkable that effects were more pronounced in men with the lowest baseline testosterone levels Similarly, effects of testosterone administration in hypogonadal men on the ability to process spatial data of visual content were observed within 2 weeks of treatment These effects are obviously directly related to testosterone and not its aromatization product E 2 , as it was later confirmed in a placebo-controlled trial involving an aromatase inhibitor combined with testosterone administration in hypogonadal men.
These patients exhibited a markedly improved spatial working memory within 3 weeks, improving further until week six The effects of testosterone on red blood cell formation hemoglobin and hematocrit are dose dependent 14, 82, 83 while higher age is also a factor The effects are apparent after 3 months 14, 35, 40 and a maximum is reached after 9—12 months In hypogonadal men treated with testosterone, levels of PSA rise usually up to levels of eugonadal men Upon judging the time-course of effects of testosterone on the prostate, it is of note that aging itself is a factor in the rise of both prostate volume and PSA 84 , and there is no endpoint in the effects of testosterone on the prostate.
A rise in PSA levels was noticed after 6 months, whereafter over the following 24 months there was no significant further increase Other studies have found a rise of PSA levels after 3 months 40 , some only after 12 months An increase in prostate volume was noted after 3 months 86 and after 12 months One study over 24 months found no significant increase in both PSA and prostate volume.
In a study of subjects over 42 months of testosterone gel application, there was significant increase in serum PSA over the first 6 months and then no further significant increases with continued testosterone treatment was found In a study of 81 hypogonadal men mean age This is a systematic analysis of the time-course of the spectrum of biological effects of testosterone on the various target systems. The authors view this as a worthwhile endeavor for a number of reasons.
Attending physicians can prepare their patients for the intervening time periods before effects of testosterone can be experienced. Studies investigating the effects of testosterone have to take this time-course into consideration to design the duration of studies to be able to have quantifiable measurements. It is of note that almost none of the quoted studies had been specifically designed to assess the time-course of effects.
Some studies measure effects of testosterone only after 3 months 31 , and, particularly, effects on libido and erections have occurred well before this time span 14, We noticed considerable differences in the occurrence of effects of testosterone.
Effects on libido and other psychological variables and effects on vasculature occur rather rapidly. It may well be that these effects are not mediated via the classical androgen receptor but through other mechanisms like effects on membranes 6, 7.
Also effects on erection occur rather rapidly and may be partially explained by non-genomic effects on vascular penile erectile tissue The effects of testosterone on glycemic control and variables clustered in the metabolic syndrome occur somewhat slower, but there is evidence that acute testosterone fall during deprivation therapy is directly related to a worsening in insulin sensitivity This may also apply to other factors of the metabolic syndrome.
Testosterone inhibits the expression of the activity of lipoprotein lipase, the main enzymatic regulator of triglyceride uptake in the fat cell, preferentially in abdominal fat 28, Several studies have indeed confirmed that testosterone treatment reduces waist circumference which, in its simplicity, appears to be a valid parameter of the degree of visceral obesity In our own studies, signs and symptoms of the metabolic syndrome improved substantially following administration of long-acting testosterone undecanoate 32, 35, 92 and improvements in glycemic control and lipids parallel improvements in body composition.
The effects of testosterone on muscle and bone involve protein synthesis and are a result of genomic actions of testosterone and, therefore, rather slow. Apart from reviewing the onset of effects of testosterone treatment in hypogonadal men, it would also be possible to look at the onset of symptoms of testosterone deficiency in patients on androgen deprivation therapy ADT , standard treatment for men with advanced prostate cancer.
ADT causes unfavorable changes in body composition, insulin resistance and other risk factors for cardiometabolic diseases leading to an increased incidence of cardiovascular diseases and type 2 diabetes for review 93, However, deprivation of testosterone and the time-dependent effects thereof might be totally different from the onset of testosterone action in testosterone treatment, even in the same parameter.
Therefore, it was decided to restrict this paper to aspects of testosterone treatment. It is obvious that sub-optimal therapeutic regimens or, alternatively, inappropriate patient selection eugonadal or men with biochemical but not clinical hypogonadism may show different time-course of effects. In conclusion, this analysis tries to chart the differences in time periods after which biological effects of testosterone administration in hypogonadal men occur. This may add to a better understanding of the physiology of androgen action.
Earlier studies have shown that there are thresholds for the various actions testosterone: in other words signs and symptoms of testosterone deficiency appear at different threshold values of circulating testosterone. The above results call for a well-designed study that charts the time required to restore an androgen-dependent function with the optimal circulating testosterone for that specific androgen-dependent function. These studies are not easy to perform.
Ideally, they should measure at what serum levels of testosterone, all androgen-dependent biological functions are restored. Some biological functions, like erectile functions are composite in nature, and next to testosterone, endothelial function and psychological factors are equally relevant 2. A major problem is the so-called late onset hypogonadism: the decline in serum testosterone with aging. It is still hotly debated whether this is a true form of hypogonadism, or a decline of serum testosterone associated with the progressive accumulation of health problems with aging 95, 96 , but rather independently of the process of aging itself.
Though small-scale studies show benefits and acceptable risks of treating elderly men with lower than normal testosterone levels 46, 97 , a verdict can only be reached with large-scale studies including men over 5 years 95 , for which presently the funding is not available.
There is a degree of consensus that elderly men with serum testosterone clearly below the reference ranges and persistent clear clinical signs of hypogonadism may justifiably be treated 98, 99 , but there remains a large degree of dissent.
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported. No financial or other support was received for the preparation of this manuscript. L Gooren received compensation for lecturing from Bayer Pharma. National Center for Biotechnology Information , U. European Journal of Endocrinology. Eur J Endocrinol. Author information Article notes Copyright and License information Disclaimer.
Correspondence should be addressed to F Saad; Email: moc. This is an Open Access article distributed under the terms of the European Journal of Endocrinology's Re-use Licence which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Objective Testosterone has a spectrum of effects on the male organism.
Design Literature data on testosterone replacement. Results Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Conclusion The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Introduction Treatment of hypogonadal men with testosterone is rewarding, for the patients as well as the physician.
Methodological search Data to compile a time-course for the diverse actions of testosterone are not easily available.
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