From the Guidelines
Too much testosterone can cause several severe side effects, including polycythemia, reduced high-density lipoprotein cholesterol, androgenic alopecia, acne, and potentially increased risk of myocardial infarction, as reported in the most recent study 1.
Side Effects of Excessive Testosterone
Excessive testosterone levels can lead to various physical and metabolic changes, including:
- Acne, oily skin, and male pattern baldness
- Testicular shrinkage, reduced sperm count, and infertility in men
- Mood swings, aggression, irritability, and sleep problems in both men and women
- Increased body hair, deepening voice (especially in women), and enlargement of the clitoris in women
- Cardiovascular risks, such as high blood pressure, increased red blood cell production (polycythemia), and higher risk of blood clots, heart attack, and stroke
- Metabolic effects, including liver damage (especially with oral testosterone use) and potential changes in cholesterol levels
- Menstrual irregularities or cessation, and breast tissue reduction in women
Importance of Monitoring and Management
It is essential to monitor patients undergoing testosterone therapy, as excessive levels can lead to severe side effects. According to the study 1, patients should undergo baseline measurement of hemoglobin/hematocrit before commencing testosterone therapy, and clinicians should consider withholding therapy if the hematocrit exceeds 50%.
Clinical Considerations
The evidence suggests that the incidence of polycythemia is higher with injectable testosterone compared to other modalities 1. Additionally, the study 1 highlights the importance of considering the potential risks and benefits of testosterone therapy in individual patients, particularly those with pre-existing medical conditions.
Conclusion is not allowed, so the answer will be ended here.
From the Research
Side Effects of Too Much Testosterone
- High levels of testosterone can lead to various health issues, including cardiovascular complications, as warned by the U.S. Food and Drug Administration 2
- Other possible risks associated with high testosterone levels include:
- Rising prostate-specific antigen levels
- Worsening lower urinary tract symptoms
- Polycythemia
- Increased risk of venous thromboembolism 2
- Testosterone replacement therapy (TRT) has been associated with multiple benefits, but also carries risks, particularly in older men with a history of heart failure 3
- The effects of TRT on long-term endpoints, such as deterioration of heart failure, are not well understood, highlighting the need for cautious approach to testosterone replacement in certain patient populations 3
- High testosterone levels can also contribute to acne, by stimulating sebaceous gland growth and increased sebum production, creating a medium for anaerobic bacteria to flourish 4
- Topical androgen antagonists, such as clascoterone, have been developed to treat acne by interfering with the pathogenesis of acne and reducing acne lesions 4