Testosterone implant

How does it work?

Testosterone implants contain the active ingredient testosterone, which is the same as the naturally occurring male hormone testosterone.

Testosterone is known as an androgen. It is produced by the testicles and is the main hormone essential for normal growth and development of the male sex organs and male sexual characteristics.

The natural production of testosterone is controlled by another set of hormones called gonadotrophins, which are released from the pituitary gland in the brain.

During adult life, testosterone is essential for the production of sperm, the maintenance of sex drive, erectile potency, and the functioning of the prostate gland and other reproductive structures. It also has functions in the skin, muscles, skeleton, kidney, liver, bone marrow and central nervous system.

Low levels of testosterone can cause decreased sex drive, impotence, infertility due to decreased sperm production, decreased mental and physical activity, fatigue and weakening of bones.

Testosterone is given as replacement therapy when natural testosterone levels fall too low, causing symptoms such as those above. Natural testosterone levels fall with age and following surgical removal of the testicles (castration). They may also fall due to decreased functioning of the testicles (hypogonadism or eunuchoidism) caused by testicular disease, or by decreased gonadotrophin production by the pituitary gland, as a result of pituitary disease.

Testosterone replacement allows natural testosterone levels to return to normal, thus relieving the symptoms of the deficiency.

Testosterone implants are also sometimes given to women who are going through the menopause and are taking oestrogen replacement therapy (HRT). Women's ovaries naturally produce testosterone as well as oestrogen, but levels of both hormones fall as a woman goes through the menopause. HRT with oestrogen relieves the oestrogen-related symptoms of the menopause, while replacement of testosterone can be used to relieve testosterone-related symptoms, such as reduced sex drive or loss of energy.

The implant is inserted under the skin of the abdomen or buttock under local anaesthetic. From here it releases testosterone into the bloodstream continuously over a period of a few months.

What is it used for?

Replacement therapy of low testosterone levels in men.

Osteoporosis due to low testosterone levels in men.

Male menopause symptoms such as decreased sex drive.

Female menopause symptoms such as decreased sex drive (used in combination with oestrogen hormone replacement therapy).

Warning!

Men being treated for low testosterone levels will need to have blood tests to measure your blood level of testosterone before starting and regularly throughout treatment with this medicine.

Tell your doctor if you experience symptoms such as frequent or persistent erections, irritability, nervousness or weight gain after starting treatment with this medicine, as these suggest your testosterone levels are too high and your dose may need adjusting.

Men being treated for low testosterone levels will also need to have regular blood tests to monitor their red blood cells, liver function and prostate specific antigen (PSA) levels.

Testosterone can increase the growth of prostate cancers and benign enlargement of the prostate in men. Your doctor will perform various examinations to make sure you don't have prostate cancer before you start treatment with this medicine. Your doctor may need to perform a digital rectal exam to check your prostate gland at least once a year while you are receiving testosterone replacement (more frequently than this if you are elderly or have risk factors for prostate cancer).

Women should report to their doctor without delay any deepening or hoarsening of their voice after the implant has been inserted.

Use with caution in

Boys who have not yet reached puberty.

Women.

Elderly people.

Decreased kidney function.

Decreased liver function.

Heart failure.

Heart disease caused by inadequate blood flow to the heart.

High blood pressure .

Epilepsy.

History of migraines.

Diabetes.

Cancer that has spread from its original site to the bones (skeletal metastases).

Not to be used in

Men with breast cancer.

Prostate cancer.

A syndrome caused by kidney inflammation, characterised by a large amount of protein in the urine, swelling, weight gain and high blood pressure (nephrotic syndrome).

High level of calcium in the blood (hypercalcaemia).

Pregnancy.

Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine must not be used during pregnancy or breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache.

Depression.

Acne.

Hair loss.

Enlargement of the breasts in men.

Salt and water retention.

Swelling caused by fluid retention (oedema).

Excessive frequency and duration of erections.

Persistent painful erection of the penis (priapism).

Decreased sperm count.

Reduced volume of ejaculation.

Prostate problems.

Increased levels of red blood cells and haemoglobin in the blood.

Change in sex drive.

Jaundice.

Liver tumours in rare cases.

Premature closure of the ends of bones, causing stunted growth when used to treat delayed puberty in boys.

Acne, excessive hair growth and voice changes in women (virilism).

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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