Abnormally high testosterone levels in women can lead to a variety of symptoms. Most often, women with high testosterone levels develop male pattern hair growth (hirsutism), especially on their faces and chests. More rarely and over time, some women may experience virilization, which is increased muscle mass, redistribution of body fat, enlargement of the clitoris, deepening of the voice, male pattern baldness , acne , and/or increased perspiration. It is important to note that some women develop hirsutism without having a high testosterone level.
• Evaluate formulation-specific adverse effects at each visit:
- Intramuscular injections of testosterone enanthate and cypionate: Ask about fluctuations in mood or libido.
- Testosterone patches: Look for skin reaction at the application site.
- Testosterone gels: Advise patients to cover the application sites with a shirt and to wash the skin with soap and water before having skin-to-skin contact because testosterone gel leaves a residue on the skin that can be transferred to a woman or child who comes in close contact. Serum testosterone levels are maintained when the site is washed 6 hours after applying the gel.
Androgens are responsible for the growth spurt of adolescence and for eventual termination of linear growth, brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates, but may cause disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of the growth process. Androgens have been reported to stimulate production of red blood cells by enhancing production of erythropoietic stimulation factor.