From the Guidelines
Initiating topical testosterone replacement therapy may lead to increased urinary output in some individuals, primarily due to fluid retention and potential effects on the prostate and kidney function, as suggested by various studies 1. The relationship between testosterone therapy and urinary output is complex and influenced by multiple factors, including the formulation of testosterone used, individual patient characteristics, and the presence of pre-existing medical conditions.
- Key factors to consider include:
- Fluid retention: Testosterone therapy can cause initial fluid retention, which may trigger compensatory mechanisms leading to increased urination 1.
- Prostate effects: Testosterone can affect the prostate, potentially causing enlargement (benign prostatic hyperplasia) over time, leading to urinary symptoms including increased frequency and volume of urination 1.
- Kidney function and renin-angiotensin-aldosterone system influence: Testosterone may influence kidney function and the system regulating fluid balance in the body, potentially impacting urinary output 1. It is essential for patients to discuss any significant changes in urinary patterns with their healthcare provider, as adjustments in dosage or evaluation for other causes may be necessary.
- The effects of testosterone therapy on urinary output can vary considerably between individuals, with some experiencing no changes and others noticing differences within weeks of starting therapy 1. Given the potential for increased urinary output and other effects on the urinary system, monitoring and open communication with a healthcare provider are crucial when initiating topical testosterone replacement therapy.
From the FDA Drug Label
Patients should be informed that treatment with androgens may lead to adverse reactions which include: Changes in urinary habits such as increased urination at night, trouble starting the urine stream, passing urine many times during the day, having an urge to go to the bathroom right away, having a urine accident, being unable to pass urine and weak urine flow.
- Initiating topical testosterone replacement therapy may lead to changes in urinary habits, including increased urination.
- Specifically, polyuria (increased urination) is a possible adverse reaction to androgen treatment, as stated in the drug label 2.
- Additionally, frequent urination is reported as an adverse reaction in less than or equal to 2% of testosterone gel 1.62%-treated patients, and more frequently than placebo 2.
From the Research
Testosterone Replacement Therapy and Urinary Output
- The provided studies do not directly address the question of whether initiating topical testosterone replacement therapy leads to increased urinary output, specifically polyuria 3, 4, 5, 6, 7.
- However, some studies mention the safety and efficacy of testosterone replacement therapy in patients with renal failure or chronic kidney disease, which may be related to urinary output 4, 5, 6, 7.
- One study notes that four patients (14.8%) reported fluid retention after receiving depot testosterone 5, which could be related to increased urinary output.
- Another study mentions that the safety of testosterone replacement therapy was monitored by measuring overhydration, but does not report any significant changes 6.
- Overall, there is limited evidence to suggest a direct link between topical testosterone replacement therapy and increased urinary output, specifically polyuria.