Men who use transdermal testosterone gel (AndroGel) should be advised to avoid:
• Washing their hands after applying the gel
• Wearing occlusive clothing while using the gel
• Exposure to estrogens while using the
...
Men who use transdermal testosterone gel (AndroGel) should be advised to avoid:
• Washing their hands after applying the gel
• Wearing occlusive clothing while using the gel
• Exposure to estrogens while using the gel
• Skin-to-skin contact with pregnant women while using the gel
Education when prescribing androgens to male patients includes advising that:
• Short-term use places the patient at risk for hepatocellular carcinoma.
• Cholestatic hepatitis and jaundice may occur with low doses of androgens.
• Gynecomastia is a rare occurrence with the use of androgens.
• Low sperm levels only occur with long-term use of androgens.
Patients who are prescribed exogenous androgens need to be warned that decreased libido:
• Is an unusual side effect of androgens and should be reported to the provider
• Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems
• May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam
• May occur with androgen therapy
The U.S. Food and Drug Administration warns that androgens may cause:
• Peliosis hepatis
• Orthostatic hypotension
• Menstrual irregularities
• Acne
Monitoring for a patient who is using androgens includes evaluation of:
• Complete blood count and C-reactive protein levels
• Lipid levels and liver function tests
• Serum potassium and magnesium levels
• Urine protein and potassium levels
Male patients require before and during androgen therapy.
• A digital prostate exam
• A Doppler exam of testicular blood flow
• Urine analysis for proteinuria
• Serial orthostatic blood pressures
Absolute contraindications to estrogen therapy include:
• History of any type of cancer
• Clotting disorders
• History of tension headaches
• Orthostatic hypotension
Postmenopausal women with an intact uterus should not be prescribed:
• Estrogen/progesterone combination
• IM medroxyprogesterone (Depo Provera)
• Estrogen alone
• Androgens
Women who have migraines with an aura should not be prescribed estrogen because of:
• The interaction between triptans and estrogen, limiting migraine therapy choices
• An increased incidence of migraines with the use of estrogen
• An increased risk of stroke occurring with estrogen use
• Patients with migraines may be prescribed estrogen without any concerns
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