by Anthony Roberts - Testosterone is a hormone produced predominantly in the testes of males. It is the hormone responsible in giving males their specific sexual traits. Transdermal testosterone mimics the body's natural rhythmic release of testosterone through a time-release patch. Medically, this form of testosterone is used to improve testosterone deficiencies such as hypogonadism and sexual dysfunction with limited side effects.

Background

Transdermal Testosterone is a fairly newer version of the hormone, sold in patch form. Two forms of transdermal testosterone are available; one has to be applied to the scrotum while the other is applied to other areas such as the thigh or back. Brand names: Androderm, AndroGel, Testim, Testoderm, Testoderm TTS. Transdermal testosterone is not currently available in Australia, Canada, Denmark, France and The Netherlands.

Steroid Action

Testosterone is responsible for promoting health and well-being through enhanced libido, energy, immunity, increased fat loss, gaining and maintaining lean muscle mass, preventing Osteoporosis (loss of bone density) and possible protection against heart disease. Testosterone is also responsible for normal growth and development of male sex organs and maintenance of secondary sex characteristics. Secondary sex characteristics are specific traits that separate the two sexes, but are not directly part of the reproductive system, for example: chest and facial hair, a distinguished jaw line, broad shoulders and increased muscle mass. Testosterone binds to the Androgen Receptors (AR), which thus causes accelerated muscle gain, fat loss, and muscle repair and growth. These mechanisms are stimulated by activation of the Androgen Receptors (either directly or as DHT).

Technical Data

One study was done on 26 transdermal recipients and 32 intramuscular testosterone recipients to compare effects (1). According to the Watts questionnaire, which is used to determine normal sexual function in males, the average amount of nightly erections per week were significantly improved in all subjects who used a patch supplying a constant source of Testosterone in comparison to those who used the time-release version. Their nightly erections were limited during the period where testosterone was not released from the patch(2). The increase in sexual function and nocturnal erection were comparable to those using injectable versions of testosterone.(3)

Skin reactions are the most frequently reported adverse effects associated with transdermal testosterone (4). Skin reactions were the most commonly reported side effect and seen in almost half of the subjects using the permeation-enhanced variety. 10% of patients found it intolerable and withdrew from the study (5) (6). It was eventually discovered that treating the skin with 0.1% triamcinolone cream eliminated skin discomfort with out hindering the effects of the testosterone. (7) Other side effects of permeation-enhanced transdermal testosterone reported were an increase in prostate weight (although they all still were in normal weight range) (8). There were no prostate problems in men treated over the course of a year. In a 4 year study of 122 men, 5% reported abnormalities (9).

Testosterone's effect on fat loss was far greater in those injecting the hormone. The same effects on cholesterol (HDL decrease) were similar in those using both types (10). There have only been very few studies on the use of the newer version, permeation-enhanced transdermal testosterone, patches that are placed on non-scrotal skin. There were great results in a study done on 34 males suffering from hypogonadism who applied 5mg each night for 12 months (11). Morning and evening peaks of the hormone were found to be correlated to healthy young men (peak testosterone concentrations were 25.7 and 7.4 nmol/L).(12) Subjects using transdermal testosterone showed serum testosterone concentration profiles that were the same as normal circadian release by the endocrine system (13)(14)(15).

User Notes

Most of the information I have about testosterone patches and such comes from countless e-mail interactions with people who have switched to an injectable form and were much happier with their results (anabolic-wise), when they switched.

Really, as an anabolic, transdermal testosterone isn’t too great…it’s primary advantage is to help patients who need testosterone avoid injections and doctors visits.

The only real advantage I can see for an athlete using this kind of product is to do it during a “cruising” phase, or as a part of a very non-aggressive type of hormone replacement therapy, when the constant injections of a (real) anabolic cycle become tiresome.

Testosterone is the chemical name of active ingredient in AndroGel and Androderm. AndroGel is a registered trademark of Unimed Pharmaceuticals. Androderm is a registered trademark of Watson Pharmaceuticals, Inc.

Transdermal Testosterone Resources

Download AndroGel Package Insert
Download Androderm Package Insert

Trivial name	Testosterone [USAN:INN] (base)
Chemical name	17ß-hydroxyandrost-4-en-3-one
Systematic Name	(8S,9S,10R,13S,14S,17S)-17-hydroxy-10,13-dimethyl-1,2,6,7,8,9,11,12,14,15,16,17-dodecahydrocyclopenta[a]phenanthren-3-one
Index name	Androst-4-en-17beta-ol-3-one
CAS number	58-22-0
Empirical formula	C19-H28-O2
Merck Index Number	Merck 11, 9109
Molecular weight	288.424 g/mol
Pregnancy category	X
Legal status	Prescription only (US); DEA Schedule III (US)
Routes of administration	Transdermal

References

1. Arver S, Meikle AW, Dobs AS, et al. Hypogonadal men treated with the Androderm Æ testosterone transdermal system had fewer abnormal hematocrit elevations than those treated with testosterone enanthate injections [abstract]. 79th Annual Meeting of the Endocrine Society; 1997 Jun 11-14; Minneapolis: 327
2. Drury PL. Endocrinology: reproduction and sex. In: Clinical Medicine. 2nd ed. Kumar PJ & Clark MI, editors. Bailliere Tindall 1990; 785-6
3. Arver S, Dobs AS, Meikle AW, et al. Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 1996 May; 155: 1604-8
4. Cofrancesco J, Dobs AS. Transdermal testosterone delivery systems. Endocrinologist 1996 May; 6: 207-13
5. Arver S, Dobs AS, Meikle AW, et al. Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 1996 May; 155: 1604-8
6. PDR Generics. 4th ed. Montvale NJ: Medical Economics, 1998: 2609-13
7. McClellan KJ, Goa KL. Transdermal testosterone. Drugs 1998 Feb; 55 (2): 253-8
8. McClellan KJ, Goa KL. Transdermal testosterone. Drugs 1998 Feb; 55 (2): 253-8
9. Prescribing information: Androderm Æ testosterone transdermal controlled-delivery for once-daily application. Available from: URL: http://www.androderm.com/prescribe.htm1#-prescribe [Accessed 1997 Jul 24]
10. Arver S, Dobs AS, Meikle AW, et al. Long-term efficacy and safety of a permeation-enhanced testosterone transdermal system in hypogonadal men. Clin Endrocrinol Oxf 1997 Dec; 47 (6): 727-37
11. Mazer NA, Heiber WE, Moellmer JF, et al. Enhanced transdermal delivery of testosterone: a new physiological approach for androgen replacement in hypogonadal men. J Control Release 1992; 19 (1-3): 347-61
12. Arver S, Dobs AS, Meikle AW, et al. Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 1996 May; 155: 1604-8
13. McClellan KJ, Goa KL. Transdermal testosterone. Drugs 1998 Feb; 55 (2): 253-8
14. Cofrancesco J, Dobs AS. Transdermal testosterone delivery systems. Endocrinologist 1996 May; 6: 207
15. PDR Generics. 4th ed. Montvale NJ: Medical Economics, 1998: 2609-

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