Can patients using topical testosterone (TT) therapy, such as AndroGel (testosterone gel) or Testim (testosterone gel), go swimming?

Swimming While Using Topical Testosterone Therapy

Patients using topical testosterone therapy should not go swimming until at least 2 hours after application to ensure proper absorption and minimize risk of medication washoff.

Rationale for Waiting Period

Topical testosterone products like AndroGel and Testim require adequate time for absorption to achieve therapeutic levels. The FDA-approved labeling for testosterone gel products specifically addresses this concern:

• The patient should avoid swimming or showering for a minimum of 2 hours after application 1, 2
• Research shows that showering even 15 or 30 minutes after application significantly reduces testosterone absorption, resulting in unacceptably low plasma testosterone levels 3

Proper Application and Absorption

For optimal absorption and effectiveness:

• Apply testosterone gel to clean, dry, intact skin of the upper arms and shoulders 2
• Do not apply to other parts of the body, including the abdomen, genitals, chest, armpits, or knees (unless specifically directed by product instructions) 2
• Allow the gel to dry completely before covering with clothing 1
• Wait at least 2 hours before swimming or showering 1, 2

Risks of Premature Swimming

Swimming too soon after application can:

1. Significantly reduce absorption, leading to subtherapeutic testosterone levels 3
2. Potentially transfer testosterone to the water, posing risk to others, particularly women and children 1
3. Compromise treatment effectiveness, as target testosterone levels should be maintained in the 450-600 ng/dL range 4, 5

Additional Precautions for Topical Testosterone Users

When using topical testosterone therapy, patients should also:

• Apply the medication at the same time each day, preferably in the morning 1
• Wash hands thoroughly with soap and water immediately after application 1, 2
• Cover application sites with clothing after the gel has dried 1, 2
• Be aware that alcohol-based testosterone gels are flammable until dry 1, 2
• Avoid transferring testosterone to others through skin contact, especially women and children 1, 2

Special Considerations for Swimmers

For patients who swim regularly:

• Consider timing application after swimming sessions rather than before
• Ensure the full 2-hour absorption period before entering water
• Monitor testosterone levels regularly if swimming frequently to ensure therapeutic levels are maintained
• Be aware that chlorinated pools may potentially have separate effects on endogenous testosterone production, though this is primarily a concern for developing adolescents 6

Conclusion

Following the 2-hour waiting period between topical testosterone application and swimming is essential for ensuring proper medication absorption and effectiveness. This recommendation is clearly supported by FDA labeling and research evidence demonstrating significant reduction in testosterone absorption when the skin is washed prematurely after application.