Metabolic syndrome, breast cancer, cardiovascular disease: the risks are theoretical based on the known increased risk of these conditions with high endogenous testosterone levels.[157]Zhao D, Guallar E, Ouyang P, et al. Endogenous sex hormones and incident cardiovascular disease in post-menopausal women. J Am Coll Cardiol. 2018 Jun 5;71(22):2555-66.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986086
http://www.ncbi.nlm.nih.gov/pubmed/29852978?tool=bestpractice.com
[161]Ruth KS, Day FR, Tyrrell J, et al. Using human genetics to understand the disease impacts of testosterone in men and women. Nat Med. 2020 Feb;26(2):252-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025895
http://www.ncbi.nlm.nih.gov/pubmed/32042192?tool=bestpractice.com
Testosterone should be discontinued.
Hirsutism, acne: known effects of testosterone.[158]Davis SR, Baber R, Panay N, et al. Global consensus position statement on the use of testosterone therapy for women. J Clin Endocrinol Metab. 2019 Oct 1;104(10):4660-66.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821450
http://www.ncbi.nlm.nih.gov/pubmed/31498871?tool=bestpractice.com
If these effects are more than what was experienced pre-menopause from endogenous androgens, then dose should be reduced or discontinued.
Clitoromegaly, voice change: not expected with doses that approximate premenopausal physiological testosterone concentrations.[158]Davis SR, Baber R, Panay N, et al. Global consensus position statement on the use of testosterone therapy for women. J Clin Endocrinol Metab. 2019 Oct 1;104(10):4660-66.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821450
http://www.ncbi.nlm.nih.gov/pubmed/31498871?tool=bestpractice.com
Testosterone should be discontinued.