Testosterone Side Effects

Danger of secondary exposure to testosterone therapy

Testosterone replacement therapy products such as the prescription topical treatments Androgel, Testim and Axiron are used to help boost testosterone levels in men who have a deficiency of the male hormone. Low testosterone symptoms include decreased libido and low energy.

Testim and Androgel are gels that are applied to the skin of the shoulders and upper arms. Androgel may also be applied to the abdomen. Axiron is applied to the underarm. The area where the gel is applied should be covered, and patients are warned that others should not come into contact with the skin where the gel was applied.

Secondary exposure to testosterone in children and women can occur with the use of testosterone gel in men. Reported cases involved children ranging in age from 9 months to 7 years old.

Physicians should advise patients of the reported signs and symptoms of secondary exposure, which may include the following:

  • In children: unexpected sexual development including inappropriate enlargement of the penis or clitoris, premature development of pubic hair, increased erections, aggressive behavior and advanced bone age
  • In women: changes in hair distribution, increase in acne, or other signs of testosterone effects

The possibility of secondary exposure to testosterone gel should be brought to the attention of a health care provider.

In at least one reported case of secondary exposure to testosterone in children, the reporter considered the possibility of secondary exposure from items such as the testosterone gel user’s shirt and other fabrics such as towels and sheets.

In most cases, signs and symptoms of testosterone exposure regressed with the removal of the testosterone gel exposure. However, there were cases where enlarged genitalia did not fully return to age appropriate normal size, and bone age remained modestly greater than chronological age.