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Testosterone Therapy and Pregnancy: What Women Need to Know

An In-Depth Look at the Safety, Risks, and Precautions for Women Using Testosterone Therapy

Testosterone therapy is not typically recommended for women during pregnancy due to potential risks to the developing fetus. It’s crucial to consult healthcare professionals for safe and appropriate treatment options during pregnancy.

Testosterone therapy has become a popular treatment option for women seeking to correct low testosterone levels and improve symptoms like low libido, fatigue, and decreased bone density. 

However, testosterone use during pregnancy raises important safety concerns. Any woman using testosterone replacement therapy (TRT) who becomes pregnant needs to understand the potential risks involved.

Understanding the effects of testosterone on pregnancy and fetal development will help inform the choices you make regarding your hormone therapy and reproductive health.

What is Testosterone Therapy?

Testosterone therapy, also known as testosterone replacement therapy (TRT), is a treatment used to address low testosterone levels, a condition called hypogonadism. The key points about testosterone therapy are:

  • It is used to treat abnormally low production of testosterone, which can cause symptoms like low sex drive, fatigue, and muscle loss.
  • Testosterone therapy aims to restore normal testosterone levels and reverse the effects of hypogonadism.
  • Common forms of testosterone therapy include injections, gels, patches, and pellets that are administered to raise the body’s testosterone levels.
  • While testosterone therapy can provide benefits like increased muscle mass and libido, it also carries potential risks such as sleep apnea, prostate issues, and cardiovascular problems.
  • The long-term safety and benefits of testosterone therapy are still being studied, and it’s important for women to discuss the potential risks and benefits with their healthcare provider.

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Why Do Women Take Testosterone Replacement Therapy?

While testosterone therapy is often associated with men’s health, an increasing number of women are turning to testosterone replacement for its benefits. Women take testosterone replacement therapy for reasons such as:

Boosting Libido and Sexual Well-being

Testosterone is essential for a woman’s sexual health by helping to boost libido and supporting reproductive health.

Improving Mood, Concentration, and Energy

Many women notice improved mood, concentration, motivation, and energy levels from testosterone therapy.

Preventing Fatigue and Muscle Weakness

Without enough testosterone, women may experience fatigue, muscle weakness, and mood changes. Testosterone replacement can help address these issues.

Supporting Blood Cell Development

Testosterone is necessary for the development of new blood cells in women.

Preventing Osteoporosis: There is growing evidence that physiologic doses of testosterone can help prevent osteoporosis in women.

Protecting Brain Function

Testosterone therapy may also help protect cognitive function in women.

Addressing Low Testosterone Levels

Women may have low testosterone due to menopause, surgery, or other reasons, and testosterone replacement can help correct this deficiency.

Is Testosterone Therapy Safe During Pregnancy?

Testosterone therapy is not recommended for women during pregnancy, as it carries significant risks. Testosterone is considered teratogenic, meaning it may cause birth defects if a pregnant woman is exposed to it. Taking testosterone while pregnant can negatively impact the baby’s development. For this reason, use of testosterone is contraindicated (not recommended) during pregnancy. If a woman becomes pregnant while undergoing testosterone therapy, the treatment should be immediately discontinued.

Research has shown that elevated testosterone levels during pregnancy are associated with low birth weight in both humans and animals. While testosterone is sometimes prescribed off-label to treat low libido and other symptoms in women, it is not FDA-approved for this use. 

The potential to harm the developing fetus makes testosterone therapy unsafe for use during pregnancy. The risks outweigh any potential benefits.

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Can Women Get Pregnant While on Testosterone Therapy?

It is possible, although difficult, for women to get pregnant while on testosterone therapy. Testosterone does not act as a contraceptive, so it does not completely prevent pregnancy. 

To carry a pregnancy to full term while continuing testosterone therapy would be risky and is not advised. In order to safely continue a pregnancy, a woman on testosterone would need to stop hormone therapy altogether. 

More research is still needed on the exact effects of testosterone on fertility and pregnancy. However, current evidence indicates that while pregnancy is possible for women on testosterone replacement therapy, the chances of conception may be reduced compared to not being on the treatment. 

It is important to note though that testosterone does not act as a reliable birth control method. Any women taking testosterone who wants to avoid becoming pregnant should use additional forms of contraception, since no hormonal therapy completely eliminates the risk of pregnancy.

What Are the Risks of Testosterone Therapy During Pregnancy?

Using testosterone therapy while pregnant carries significant health risks. Pregnant women considering this treatment must fully understand the profound hazards which include:

Birth DefectsTestosterone is teratogenic and can cause serious developmental issues in a female fetus, including genital abnormalities.
Low Birth WeightElevated testosterone exposure is linked to lower birth weight in babies.
Reduced FertilityTestosterone therapy may impair a woman’s ability to conceive and have children.
Harm From AbsorptionPregnant women should avoid skin contact with testosterone creams/gels as absorption could impact the fetus.
Developmental ImpactContinued testosterone use during pregnancy may affect the baby’s growth and organ development.

Given these serious risks, testosterone therapy is contraindicated during pregnancy. If you become pregnant on testosterone, stopping treatment is strongly recommended.

What to Do If You Become Pregnant on Testosterone

If you become pregnant while taking testosterone, it is important to stop hormone therapy right away. Testosterone can cause serious risks to fetal development if exposure continues during pregnancy. Here are some recommended steps:

  1. Immediately cease taking testosterone as soon as you realize you are pregnant. Do not continue therapy, as this can harm the baby’s growth and increase the chances of birth defects. Stop all forms of testosterone, including injections, gels, patches, and pills.
  2. Contact your doctor and inform them you are pregnant and have been taking testosterone. They can provide guidance on safely transitioning off hormone treatment and can monitor you and the baby more closely throughout the pregnancy. Be ready to disclose the dose, frequency, and duration of testosterone use.
  3. Consider your options carefully. You will need to decide whether to continue the pregnancy or opt for termination. Make this personal choice based on your circumstances, beliefs, and after consulting your healthcare providers. If continuing the pregnancy, promptly quitting testosterone is critical.
  4. Discuss alternatives with your doctor, like pausing hormone therapy until after you give birth and breastfeed. Understand the risks and benefits of various options. Your doctor can explain what’s safest for you and the baby.
  5. Expect to undergo additional prenatal testing and monitoring. Your provider may recommend more frequent ultrasounds, growth scans, non-stress tests, and other screenings to check for potential developmental issues and be sure the fetus is growing appropriately.
  6. Watch closely for any side effects or symptoms as your body adjusts to stopping testosterone. Hormone changes could trigger issues like hot flashes, menstrual bleeding returning, mood swings, and depression. Report any worrisome effects to your OB-GYN.

By promptly ceasing testosterone therapy and working closely with your medical team, you can reduce the risks involved with testosterone exposure during pregnancy.

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In Conclusion

For women using testosterone replacement therapy who become pregnant, stopping treatment immediately is strongly recommended to avoid potential developmental harms to the baby. Work closely with your medical team, consider all options, and take steps to safely transition off testosterone therapy during your pregnancy.

At Physician’s Rejuvenation Centers, our experienced doctors specialize in hormone therapies and balancing treatments. If you’re currently taking testosterone and want to discuss your options for hormonal health, fertility, and a future pregnancy, schedule a consultation with one of our caring providers. 

We’ll listen to your unique needs and help you develop an individualized plan to look and feel your best, now and in the years ahead.