From the Guidelines
Night sweats are a potential side effect of testosterone therapy, and patients experiencing this symptom should consult their healthcare provider for guidance on managing symptoms and adjusting treatment as needed. According to a 2020 study published in the Annals of Internal Medicine 1, testosterone therapy may provide small improvements in sexual functioning and quality of life in older men with low testosterone levels, but its long-term efficacy and safety are unknown.
Some key points to consider when evaluating the relationship between night sweats and testosterone therapy include:
- The study found that testosterone treatment is approved by the U.S. Food and Drug Administration (FDA) for replacement therapy for men with primary or secondary hypogonadism caused by disorders of the hypothalamus, pituitary gland, or testes 1.
- Testosterone use in the United States has tripled in recent years, with much of the increase in men with nonspecific symptoms, such as decreased energy, sexual function, and mobility, who have serum testosterone concentrations below the normal range or in the low-normal range for healthy young men for no apparent reason other than older age or comorbid conditions, such as obesity 1.
- The level of baseline testosterone that prompts initiation of such therapy varies widely, and substantial proportions of U.S. men who receive testosterone therapy do not have testosterone levels tested before initiation of therapy 1.
To manage night sweats associated with testosterone therapy, patients can try using moisture-wicking bedding, keeping their bedroom cool, wearing lightweight sleepwear, and staying hydrated. Healthcare providers may need to adjust the testosterone dosage or administration method to minimize side effects, such as switching from weekly to more frequent smaller injections to maintain steadier hormone levels. If night sweats persist beyond several weeks or are severe enough to disrupt sleep, patients should be evaluated for other potential causes or complications, as persistent night sweats could indicate a need for dosage adjustment or underlying health issues requiring attention.
From the Research
Night Sweats and Testosterone Therapy
- There is limited research directly linking night sweats and testosterone therapy, however, some studies provide insight into the effects of testosterone on the body.
- A study on night sweats found that the symptom is nonspecific and can be caused by various factors, including hormonal changes 2.
- Testosterone replacement therapy (TRT) has been shown to increase serum testosterone levels, which can lead to various physical and emotional changes, but its direct effect on night sweats is not well understood.
Effects of Testosterone Therapy
- TRT can cause significant increases in hematocrit, estradiol, and prostate-specific antigen (PSA) levels, particularly with intramuscular testosterone cypionate 3, 4.
- Different formulations of testosterone, such as gel, patch, oral, and injectable, can have varying effects on the body, but all can increase hematocrit levels 3.
- Subcutaneous testosterone enanthate autoinjector (SCTE-AI) has been shown to have a lower testosterone peak-to-trough ratio, which may mitigate some of the adverse effects associated with TRT 4.
Testosterone Replacement Therapy
- The primary goal of TRT is to improve symptoms and signs of testosterone deficiency, including decreased libido, erectile dysfunction, and depressed mood 5.
- Various preparations and formulations of testosterone are available, each with its own pharmacokinetics and potential adverse effects 5.
- Clinicians must consider individual patient characteristics and adjust treatment accordingly to provide the safest and most beneficial results 5.