From the Guidelines
Too much testosterone can cause a range of side effects, including acne, oily skin, increased body and facial hair growth, male pattern baldness, and mood changes, and can increase the risk of cardiovascular events, such as heart attack and stroke, as well as reproductive changes, like reduced sperm production and infertility in men, and deepening voice and clitoral enlargement in women. The potential risks associated with testosterone-replacement therapy are well-documented, and include cardiovascular disease, lipid alterations, erythrocytosis, fluid retention, benign prostatic hyperplasia, prostate cancer, hepatotoxicity, sleep apnea, gynecomastia, skin reactions, acne or oily skin, and testicular atrophy or infertility 1. Some of the key side effects of excessive testosterone levels include:
- Cardiovascular risks, such as elevated blood pressure, higher cholesterol levels, and increased risk of blood clots, heart attack, and stroke
- Reproductive changes, such as reduced sperm production and infertility in men, and deepening voice and clitoral enlargement in women
- Physical effects, such as fluid retention, increased muscle mass, decreased testicle size in men, and irregular menstrual cycles in women
- Mood changes, such as aggression, irritability, and depression
- Sleep apnea may worsen, and liver damage is possible, especially with oral testosterone supplements It is essential to carefully monitor patients receiving testosterone therapy, particularly with regards to hemoglobin/hematocrit levels, as excessive levels can lead to polycythemia 1. Additionally, clinicians should be aware of the potential risks of testosterone therapy, including the transfer of testosterone to others, particularly women and children, who may experience adverse events such as virilization, precocious puberty, and hyperandrogenism 1. Overall, the management of testosterone deficiency requires careful consideration of the potential benefits and risks of testosterone therapy, as well as alternative therapies, such as aromatase inhibitors, human chorionic gonadotropin, and selective estrogen receptor modulators, which may be used to promote endogenous production of testosterone while minimizing the risks associated with exogenous testosterone administration 1.
From the Research
Side Effects of Too Much Testosterone
- The provided studies do not directly address the side effects of too much testosterone, but rather focus on the benefits and risks of testosterone replacement therapy (TRT) for men with hypogonadism 2, 3, 4, 5, 6.
- However, it can be inferred that excessive testosterone levels may lead to adverse effects, as TRT is associated with risks such as negative feedback mechanisms on the hypothalamic-pituitary-gonadal (HPG) axis, which can affect fertility 3.
- Additionally, studies suggest that TRT should be used cautiously in older men with a history of heart failure, as there is limited evidence on the long-term safety of TRT in this population 2.
- The potential side effects of TRT are also mentioned, including formulation-specific adverse effects, which should be considered when selecting a treatment method 6.
- It is essential to monitor men receiving TRT for symptom improvement, potential adverse effects, and adherence, as well as measure serum testosterone, hematocrit, and prostate-specific antigen levels at baseline and at least annually in men 40 years or older receiving TRT 6.