Are testosterone patches available in the US?

Testosterone Patches in the United States

Yes, testosterone patches are available in the United States, specifically as Androderm (2 mg/24-hour patch), which can be applied to dry, intact skin of the back, abdomen, upper thighs, or upper arms. 1

Available Testosterone Formulations in the US

Testosterone replacement therapy in the US includes several delivery methods:

• Transdermal patches (Androderm): Applied once daily to dry skin, providing 2-6 mg/day of testosterone 1

  • Advantages: Easy application, no risk of transference to others 1
  • Disadvantages: Skin rash/irritation at application site (up to 66% of users), poor patch adherence 1

• Transdermal gels: Multiple options including AndroGel (1% and 1.62%), Axiron, Fortesta, and Testim 1

  • Advantages: Easy application, good skin tolerability 1
  • Disadvantages: Potential for transfer to partners or children through skin contact, generally more expensive than injections 1

• Injectable testosterone: Options include testosterone cypionate and enanthate 1

  • Advantages: Relatively inexpensive, flexible dosing, no risk of transference 1
  • Disadvantages: Requires intramuscular injection, fluctuating testosterone levels 1

• Other formulations:

  • Subcutaneous implants (Testopel) 1
  • Buccal tablets (Striant) 1

Important Considerations for Testosterone Patches

Efficacy and Monitoring

• Testosterone patches produce normal serum testosterone concentrations when used appropriately 1
• Peak testosterone values occur 6-8 hours after patch application 1
• Monitoring should occur 2-3 months after treatment initiation and after any dose change 1

Safety Considerations

• Transdermal testosterone preparations are associated with skin reactions, mainly erythema or pruritus 1
• Patches have higher rates of skin reactions (up to 66% of users) compared to gel preparations (5%) 1
• Unlike oral testosterone preparations (which are strongly discouraged in the US due to hepatotoxicity), transdermal patches do not appear to be associated with hepatic dysfunction 1

Clinical Pitfalls and Caveats

• Testosterone patches may have issues with adherence to skin, affecting consistent delivery 1
• The FDA required labeling changes in 2015 to inform about possible increased risk of heart attack and stroke with testosterone preparations 1
• Testosterone therapy may exacerbate sleep apnea, particularly in men with other risk factors 1
• Testosterone replacement therapy can compromise fertility due to down-regulation of gonadotropins 1

Comparative Considerations

• Transdermal patches minimize the issue of variable absorption seen with gels 1
• Patches generally cost more than injectable options 1
• Patches provide more stable testosterone levels compared to injections, which may reduce cardiovascular risk 1
• Patches restore normal circadian rhythm of testosterone levels when used daily, unlike periodic injections 2

When considering testosterone replacement therapy, patches offer a non-invasive option with relatively stable hormone levels, though skin irritation remains a significant limitation for many patients.