Testosterone Gel: Androgel Side Effects & Dosage
Androgel is mainly used as a first line treatment for low testosterone in men, also described as male menopause, andropause, or hypogonadism.
One of testosterone gel's chief benefits is it's less invasive method of delivery as compared to the older but highly effective testosterone injections. There are a number of pros and cons of both delivery forms which we will delve in to later.
Testosterone gel usually dispenses in either packet or pump form in a hydroalcoholic base, and is generally clear and colorless, although there is distinct smell which some describe as off putting.
It can be acquired only through a prescription by a licenced medical doctor, and is produced either by a compounding pharmacist, (formulated to different prescribed dosages), or the two major brands currently on the market, Androgel and Testim.
The various gels provide a steady transdermal delivery of testosterone over an approximate 24 hour period. It is administered as a single application to clean and dry skin (usually in the morning after showering), to the shoulders and/or upper arms.
Androgel by Abbott
Developed by Abbott Laboratories, AndroGel® is arguably the most widely recognized brand of testosterone gel on the market today. It comes in both 1% and 1.62% formulations via packets or a multi-dose pump.
AndroGel® (testosterone gel) 1% is a clear, colorless hydroalcoholic gel containing 1% testosterone.
Testim Gel by Auxilium
Developed by Auxilium Pharmaceuticals, a 1% formulation testosterone gel is administered from a squeeze tube, not unlike a small toothpaste container. Application areas are the same as Androgel (shoulders and upper arms) for the same reason as to prevent accidental transference to women or children.
A daily application of testosterone gel (5g, 7.5g, or 10g) contains (50mg, 75mg, or 100mg) of testosterone respectively, to be applied daily to the skin's surface. Approximately 10% of the applied testosterone dose is absorbed across skin of average permeability during a 24-hour period.
Therefore from a 1%, 5g testosterone gel formulation, approximately 5mg would be absorbed in the average male. Since this is an average, some men will be "super responders" with higher than normal testosterone levels, while with others the gel may barely register an effect.
With these "non-responders" either a higher dose may be warranted (7.5g or 10g) or a change to a different testosterone delivery method may be needed, in accordance with your doctor's recommendations. The most common and likely to succeed treatment thereafter would be treatment via testosterone injections.
Androgel Side Effects
Most testosterone gel side effects are common to all testosterone preparations. The more unique side effects relating to the gels are mainly skin irritation due to allergy or rashes.
Many of the side effects of testosterone don't have to do with the testosterone itself but it's metabolites estrogen and DHT (dihydrotestosterone). They can be mitigated for the most part through the use of anti-estrogen medications like Arimidex (anastrozole) and Aromasin (exemestane), or a DHT inhibitor Proscar/Propecia (finasteride).
Cosmetic Side Effects
Acne (mainly back, chest, and/or shoulders)
Water retention (bloating)
Gynecomastia/gyno (enlarged breast tissue)
Hair loss/baldness (top of head)
Hair growth (chest, back, face)
Mental/Emotional Side Effects
Sex drive/libido changes (increased or decreased)
Mood changes (depression or mania)
Physical Health Side Effects
Prostate enlargement (Benign Prostatic Hyperplasia)
Infertility (reduction in sperm count and motility)
Polycythemia (increased red blood cell count)
Hypertension (increased blood pressure)
Prescriptions and Buying Androgel
The price of the different testosterone gels can vary considerably. The pharmacy compounded gels are generally much less expensive than the branded Androgel and Testim products.
Alternatively, testosterone injections usually cost less than the gels due to it's their more efficient method of delivery. Close to 100% of the testosterone from injections gets absorbed whereas only 10% is usually absorbed from testosterone gel.