Transdermal testosterone gel should only be used when there are clear indications and no contraindications.
Indications for therapy with a transdermal testosterone gel – all of the following:
(1) one of the following:
(1a) congenital or acquired hypogonadism
(1b) congenital or acquired hypogonadotropic hypogonadism
(2) low serum testosterone concentration (< 300 ng/dL)
(3) significant clinical findings ascribable to hypogonadism (Therapy may not be necessary if the person is asymptomatic.)
Hypogonadism secondary to testicular failure may be caused by:
(1) cryptorchidism
(2) bilateral torsion
(3) bilateral orchitis
(4) vanishing testis syndrome
(5) bilateral orchiectomy
(6) Klinefelter’s syndrome
(7) chemotherapy
(8) toxic injury to the testis
Hypogonadotropic hypogonadism may be caused by:
(1) gonadotropin or luteinizing hormone-releasing hormone deficiency
(2) pituitary-hypothalamic damage
(3) inherited defects in gonadotropin receptors
Contraindications for therapy with a transdermal testosterone gel:
(1) prostate cancer
(2) breast cancer
(3) other serious side effects (abnormal lipids, thrombosis, etc) not corrected by dose reductions
Women who are pregnant or breastfeeding should avoid active or passive exposure.
