Testosterone therapy transdermal

Siddique H, Smith JC, Corrall RJM. Reversal of poly-cythaemia induced by intramuscular androgen replacement using transdermal testosterone therapy. Clin Endocrinol 2004 60 143-5. 

Middle-aged women with somatic and mood symptoms shonld undergo evaluation for perimenopansal depression. Transdermal 17/3-estradiol replacement can rednce vasomotor symptoms significantly improve mood, sleep, and cognition and decrease the risk of osteoporosis. " Transdermal testosterone therapy has been shown to improve mood, well-being, and sexnal fnnctioning in perimenopansal women. ... 

Goldstat R, Briganti E, Tran J, et al. Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women. Menopause 2003 10 390-398. 

The goal of testosterone therapy in hypogonadal men is to mimic as closely as possible the normal serum concentration therefore, serum testosterone concentration must be monitored. With transdermal patches, the serum testosterone concentration fluctuates during the 24-hour period, with a peak value 6—9 hours after application and a nadir (about 50% of the peak) just before the next patch is applied (Figure 58-6). With testosterone gels, the mean serum testosterone concentration is relatively constant from one application to the next. Occasional random fluctuations can occur, so measurements should be repeated for any dose. When the enanthate or cypionate esters of testosterone are administered once every 2 weeks (typically in a dose of200 mg), the serum testosterone concentration measured midway between doses should be normal if not, the dose should be adjusted accordingly. 

Current androgenic formulations for TRT largely are restricted to injectable formulations of testosterone esters, transdermal delivery formulations (scrotal or nonscrotal patches or gel), or buccal testosterone. Marketed injectable forms of testosterone esters (e.g., testosterone enanthate, propionate, or cypionate) produce undesirable fluctuations in testosterone blood levels, with supraphysiological concentrations early and subphysiological levels toward the end of the period before the next injection. These fluctuations provide an unsatisfactory benefits profile and, in some cases, undesired side effects. Skin patches provide a better blood level profile of testosterone, but skin irritation and daily application limit the usefulness and acceptability of this form of therapy. Oral... 

Androderm, anotiier transdermal system, is applied nightly to clean, dry skin on the abdomen, tiiigh, back, or upper arm. This system is not applied to die scrotum. Sites are rotated, witii 7 days between application to any specific site The system is applied immediately after opening the pouch and removing die protective covering. If the patient has not exhibited a therapeutic response after 8 weeks of tiierapy, another form of testosterone replacement therapy should be considered. 

Testosterone transdermal system—Apply according to the directions supplied witii die product. (See Promoting an Optimal Response to Therapy .) Be sure the skin is clean and dry and die placement area is free of hair. Do not store outside die pouch or use damped systems. Discard systems in household trash in a safe manner to prevent ingestion by children or pets. 

Testosterone Transdermal Spray For replacement therapy in males with testosterone deficiency. 

Testosterone is available as oral testosterone undecano-ate, buccal testosterone, intramuscular testosterone esters, testosterone implants, and testosterone transdermal patches and gel. Proponents of transdermal testosterone products, such as gels and scrotal or non-scrotal dermal patches, claim that they have a good safety profile (101). Transdermal testosterone replacement certainly improves bone mass and lean body mass, reduces fat mass, and improves mood and sexual function. There are said to be no harmful effects on the prostate and lipids. Acne, polycythemia, and gynecomastia are stated to be less common with this form of therapy than with the intramuscular esters. To date these claims must be regarded with some reservations it is not at all clear that in equieffective doses the local or topical forms of administration dissociate wanted and unwanted effects. 

Ebert T, Jockenhovel F, Morales A, Shabsigh R. The current status of therapy for symptomatic late-onset hypogonadism with transdermal testosterone gel. Eur Urol 2005 47 137-46. 

Parker S, Armitage M. Experience with transdermal testosterone replacement therapy for hypogonadal men. Clin Endocrinol (Oxf) 1999 50(l) 57-62. 

Advances in transdermal delivery systems (TDSs) and the technology involved have been rapid because of the sophistication of polymer science, which now allows incorporation of polymeric additives in TDSs in adequate quantity. Drugs with which transdermal therapy was pioneered include scopolamine, nitroglycerine, iso-sorbide dinitrite, clonidine, estradiol, nicotine, and testosterone [74],... 

The use of transdermal patches for administering testosterone to hypogonadal men ( Andropatch ) seems logical and convenient, but a British study in 50 treated patients showed that patient acceptance was surprisingly poor (70). There were adverse effects in 84%, mostly skin problems 72% requested a return to depot injections, and 5% returned to oral therapy. The reservoir patches, 6 cm in diameter, were, to quote the report hteraUy, judged to be too large. 

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