World Journal of Urology

, Volume 21, Issue 5, pp 316–319 | Cite as

Transdermal testosterone delivery: testosterone patch and gel

Topic Paper

Abstract

Testosterone replacement treatment is usually life-long. Fortunately, testosterone administration is relatively safe and until the age of 50 years few side effects are noted with normal doses of testosterone. After the age of 50 years when prostate disease becomes more prevalent, shorter-acting testosterone preparations, allowing a fast reduction of circulating testosterone levels, may be an advantage. Testosterone has an impact on sexual and non-sexual behaviour and short-acting testosterone preparations may be better suited for the initiation of long-term administration allowing the monitoring of behavioural effects. Testosterone can be delivered to the circulation through the intact skin, both genital and non-genital. Transdermal administration delivers testosterone at a controlled rate into the systemic circulation, avoiding hepatic first pass and reproducing the diurnal rhythm of testosterone secretion and without the peak and trough levels observed with the use of the traditional long-acting testosterone injections. In conclusion, both the testosterone patch and testosterone gel are valuable contributions to androgen replacement treatment meeting the requirements specified for testosterone replacement treatment.

Keywords

Androgen replacement therapy Testosterone patch Testosterone gel Hypogonadism 

References

  1. 1.
    Arver S, Dobs AS, Meikle AW, Allen RP, Sanders SW, Mazer NA (1996) Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 155:1604–1608PubMedGoogle Scholar
  2. 2.
    Atkinson LE, Chang YL, Snyder PJ (1998) Long/term testosterone replacement through scrotal skin. In: Nieschlag E, Behre HM (eds) Testosterone: action, deficiency, substitution. Springer, Berlin New York Heidelberg, pp 365–388Google Scholar
  3. 3.
    Behre HM, von Eckardstein S, Kliesch S, Nieschlag E (1999) Long-term substitution therapy of hypogonadal men with transscrotal testosterone over 7–10 years. Clin Endocrinol (Oxf) 50:629–635Google Scholar
  4. 4.
    Bhasin S, Bagatell CJ, Bremner WJ, Plymate SR, Tenover JL, Korenman SG, Nieschlag E (1998) Issues in testosterone replacement in older men. J Clin Endocrinol Metab 83:3435–3448PubMedGoogle Scholar
  5. 5.
    De Lignieres B (1993) Transdermal dihydrotestosterone treatment of ‘andropause.’ Ann Med 25:235–241Google Scholar
  6. 6.
    Marbury T, Hamill E, Bachand R, Sebree T, Smith T (2003) Evaluation of the pharmacokinetic profiles of the new testosterone topical gel formulation, Testim trade mark, compared to AndroGel(R). Biopharm Drug Dispos 24:115–120CrossRefPubMedGoogle Scholar
  7. 7.
    McClellan KJ, Goa KL (1998) Transdermal testosterone. Drugs 55:253–258PubMedGoogle Scholar
  8. 8.
    McNicholas TA, Dean JD, Mulder H, Carnegie C, Jones NA (2003) A novel testosterone gel formulation normalizes androgen levels in hypogonadal men, with improvements in body composition and sexual function. BJU Int 91:69–74CrossRefPubMedGoogle Scholar
  9. 9.
    Meikle AW (1998) A permeation enhanced non-scrotal testosterone transdermal system for the treatment of male hypogonadism. In: Nieschlag E, Behre HM (eds) Testosterone: action, deficiency, substitution. Springer, Berlin, New York Heidelberg, pp 389–422Google Scholar
  10. 10.
    Meikle AW, Mazer NA, Moellmer JF, Stringham JD, Tolman KG, Sanders SW, Odell WD (1992) Enhanced transdermal delivery of testosterone across nonscrotal skin produces physiological concentrations of testosterone and its metabolites in hypogonadal men. J Clin Endocrinol Metab 74:623–628PubMedGoogle Scholar
  11. 11.
    Nieschlag E, Wang C, Handelsman DJ, Swerdloff RS, Wu FC, Einer-Jensen N, Waites G (1992) Guidelines for the use of androgens. Special Programme of Research, Development and Research Training in Human Reproduction of the World Health Organisation. World Health Organisation, GenevaGoogle Scholar
  12. 12.
    Rolf C, Knie U, Lemmnitz G, Nieschlag E (2002) Interpersonal testosterone transfer after topical application of a newly developed testosterone gel preparation. Clin Endocrinol (Oxf) 56:637–641Google Scholar
  13. 13.
    Schaison G, Couzinet B (1998) Percutaneous dihydrotestosterone treatment. In: Nieschlag E, Behre HM (eds) Testosterone: action, deficiency, substitution. Springer, Berlin New York Heidelberg, pp 423–436Google Scholar
  14. 14.
    Steidle C, Schwartz S, Jacoby K, Sebree T, Smith T, Bachand R (2003) AA2500 Testosterone gel normalizes androgen levels in aging males with improvements in body composition and sexual function. J Clin Endocrinol Metab 88:2673–2681CrossRefPubMedGoogle Scholar
  15. 15.
    Swerdloff RS, Wang C, Cunningham G, Dobs A, Iranmanesh A, Matsumoto AM, Snyder PJ, Weber T, Longstreth J, Berman N (2000) Long-term pharmacokinetics of transdermal testosterone gel in hypogonadal men. J Clin Endocrinol Metab 85:4500–4510PubMedGoogle Scholar
  16. 16.
    Wang C, Berman N, Longstreth JA, Chuapoco B, Hull L, Steiner B, Faulkner S, Dudley RE, Swerdloff RS (2000) Pharmacokinetics of transdermal testosterone gel in hypogonadal men: application of gel at one site versus four sites: a general clinical research center study. J Clin Endocrinol Metab 85:964–969PubMedGoogle Scholar
  17. 17.
    Wang C, Swedloff RS, Iranmanesh A, Dobs A, Snyder PJ, Cunningham G, Matsumoto AM, Weber T, Berman N (2000) Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. Testosterone Gel Study Group. J Clin Endocrinol Metab 85:2839–2853Google Scholar
  18. 18.
    Wang C, Swerdloff RS, Iranmanesh A, Dobs A, Snyder PJ, Cunningham G, Matsumoto AM, Weber T, Berman N (2001) Effects of transdermal testosterone gel on bone turnover markers and bone mineral density in hypogonadal men. Clin Endocrinol (Oxf) 54:739–750Google Scholar
  19. 19.
    Wilson DE, Kaidbey K, Boike SC, Jorkasky DK (1998) Use of topical corticosteroid pretreatment to reduce the incidence and severity of skin reactions associated with testosterone transdermal therapy. Clin Ther 20:299–306CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Section of Andrology of the Department of EndocrinologyVU University Medical CenterAmsterdamThe Netherlands

Personalised recommendations