contraindications to testosterone therapy
Last edited 05/2018 and last reviewed 06/2023
Contraindications to testosterone therapy
The main contraindications to testosterone therapy (T therapy) are:1
- Prostate cancer (locally advanced or metastatic)
- Male breast cancer
- An active desire to father children
- Haematocrit >54%
- Severe chronic heart failure (NYHA class IV)
An unevaluated prostate nodule or induration, or raised prostate specific antigen (PSA), should be fully investigated prior to starting T therapy.
Untreated sleep apnoea and severe LUTS have previously been considered contraindications to T Therapy, but more recent evidence suggests this may no longer be the case.2 These conditions should however, be fully investigated and optimally manged before starting treatment with testosterone.
References
- 1. Dohle GH, Arver S, Bettochi C et al. Guidelines on Male Hypogonadism. European Association of Urology 2017. Available at: http://uroweb.org/guideline/male-hypogonadism/ (Accessed May 2018).
- 2. Seftel AD, Kathrins M, Niederberger C. Critical update of the 2010 Endocrine Society clinical practice guidelines for male hypogonadism: a systematic analysis. Mayo Clin Proc 2015;90:1104-1115