Risks of Testosterone Therapy in Elderly Females

Critical Safety Concerns

• Acne and hirsutism are the most common adverse effects, occurring with increased frequency in women receiving testosterone therapy, according to the New England Journal of Medicine 1
• Erythrocytosis (elevated hematocrit) is a serious concern, particularly in elderly patients who may have underlying vascular disease, with a risk varying by formulation: intramuscular preparations carry up to 43.8% risk versus 15.4% with transdermal patches, as reported by Praxis Medical Insights 2
• Elevated hematocrit increases blood viscosity and can aggravate coronary, cerebrovascular, or peripheral vascular disease—especially dangerous in elderly populations, as noted by Praxis Medical Insights 2

Monitoring Requirements

• Hematocrit or hemoglobin must be monitored regularly to detect erythrocytosis early, as recommended by the New England Journal of Medicine and Praxis Medical Insights 1, 2
• If hematocrit exceeds 54%, withhold treatment and consider therapeutic phlebotomy, according to Praxis Medical Insights 3

Contraindications and Precautions

• Elderly women are more likely to have comorbidities such as breast or uterine cancer, cardiovascular disease, liver disease, and thromboembolic disorders, making them poor candidates for therapy, as noted by Praxis Medical Insights 2