Comparison of Side Effects and Risks between Different Male Libido Treatments

Today, there is a range of different male libido treatments and low testosterone treatments available on the market.  Most require a prescription, though some don’t.  Some are intended specifically to treat low testosterone or boost libido, whereas, for other treatments, it’s an off-label use.  We’ve covered many of these treatments in separate articles on our site – how they work, what they offer, and other considerations.  But, we thought it would be useful to compare their side effects and risks, to help readers make a more educated decision about which treatment option might be right for them.

It’s important to stress that every individual is different and responds to medication differently.  The risks and side effects noted in this guide are based on published information from the treatment manufacturer(s), the FDA, and other health experts.  They are meant to inform and serve as a point of comparison among different male libido treatment options men may consider.  None of this information is a substitute for discussing side effects, your health history, current medications, and similar facts with your doctor or prescriber prior to starting a libido-enhancing or testosterone-boosting treatment.

Male Libido Treatment: Testosterone Replacement Therapy

The most well-known treatment, testosterone replacement therapy, has many risks, contraindications, and side effects associated with it.  This is true of many treatments that directly provide synthetic hormones into the body.  In the case of testosterone replacement therapy, there is also a range of risks that are specific to the method of therapy.  For example, testosterone replacement therapy gels should not be touched by other people. Other people should not touch the area to which it is applied for several hours following administration.  We’re going to side-step those kinds of risks or issues, however, to keep comparisons fairly direct between the different kinds of therapies featured here.

Contraindications and Risks

• If you have had breast cancer or prostate cancer, do not use testosterone replacement therapy.
• Obstructive sleep apnea may worsen while undergoing testosterone replacement therapy and may be a contraindication.
• Prostate-related symptoms, including enlargement or BPH, may be made worse by testosterone replacement therapy.  It can also cause related urinary symptoms, such as increased frequency or urgency.
• Do not use testosterone replacement therapy if you suffer or have suffered from congestive heart failure.
• If you have higher than normal red blood cell counts or other related blood disorders, you should not take testosterone replacement therapy (Osterberg et al., 2014; Grech et al., 2014)).

Side Effects

• Acne and oily skin.
• Enlarged breasts in men
• Excess hair growth
• Male pattern baldness
• Water retention
• Nausea
• Increased or decreased sex drive
• Headache
• Increased blood pressure
• Numbness or tingling
• Increased PSA
• Seizures
• Sleep apnea
• Changes in liver function
• Anxiety and depression (Cunha, 2016)

Male Libido Treatment: Human Chorionic Gonadotropin

Human chorionic gonadotopin is approved for use to treat low testosterone in men, but not when the cause of that low testosterone is solely due to aging.  While generally much safer than testosterone replacement therapy in absolute terms, much of the longer-term risk and side effect potential is not well established, as usage is not widespread.  There are also a significant number of known side effects.

Contraindications and Risks

• hCG is not suitable for those suffering from early-onset puberty.
• It is contraindicated in people with hormone-related cancer, such as prostate or breast cancer.
• Individuals with thyroid or adrenal dysfunction should not take hCG.
• If you have or have ever had, cancer or benign tumor of the hypothalamus or pituitary, then you should not take human chorionic gonadotropin.
• hCG may be contraindicated if you have heart disease or kidney disease, epilepsy, migraines, or asthma.

Side Effects

• Blood clots, which can manifest as pain, warmth, redness, numbness, or tingling, especially in the arms or legs, or confusion, severe headache, and extreme dizziness in the head.
• Growth of male breasts
• Pain, redness, and swelling at the injection site
• Stomach pain
• Nausea and vomiting
• Headache
• Swelling of the feet and ankles
• Mental or mood changes (Durbin, 2019)

Male Libido Treatment: Aromatase Inhibitors

Aromatase inhibitors are not approved for use for treatment of low testosterone, and are considered an off-label use.  Two of the most commonly-prescribed drugs in this class for low testosterone treatment are anastrozole and letrozole.  They are usually an oral medication, which is not typical of most hormone-related treatments.  They are primarily used for treatment of breast cancer, but a similar estrogen-related inhibitory pathway explains how they work to boost testosterone.  Like several other treatments on this list, long-term use for low testosterone and the associated side effects and risks have not been established.

Contraindications and Risks

• Use may be contraindicated if you have a history of heart disease.
• You need to be monitored closely and your doctor may consider this treatment as contraindicated if you have active osteoporosis, or a history of osteoporosis or bone loss.
• Liver disease may be a contraindication.
• Your doctor should use caution before prescribing if you have high blood pressure or a history of blood clots.
• Use with alcohol and/or marijuana may cause extreme dizziness and render you incapable of driving or using heavy machinery safely.

Side Effects

• Hot flashes.
• Headache.
• Dizziness.
• Insomnia or trouble sleeping.
• Upset stomach, nausea, and/or vomiting.
• Constipation or diarrhea.
• Loss of appetite.
• Weight gain.
• Tiredness or weakness.
• Sore throat or coughing.
• Bone pain and decreased bone density/mineralization.
• Joint stiffness or pain.
• Muscle pain or stiffness.
• Mental or behavioral changes.
• Numbness or tingling of the skin.
• Swelling of the ankles, feet, and/or hands.
• Shortness of breath.
• Vision changes.
• Signs of liver disease (Drugs.com, 2020).

Male Libido Treatment: Selective Estrogen Receptor Modulators

Selective estrogen receptor modulators, or SERMs, are also considered off-label when used for treating low testosterone.  Generally, they are not prescribed for the treatment of age-related testosterone loss, but that caused by other medical conditions or pathologies.  The most common SERM that can be used off-label to treat low testosterone or libido is clomiphene, usually an oral pill.  As with aromatase inhibitors, long-term risks and side effects have not been well-established.  However, it is known that higher dosages than recommended, even in the short-term, can lead to lower sperm counts or infertility.

Contraindications and Risks

• May be contraindicated if you have a history of thyroid or adrenal gland problems, especially if those problems are active/current and uncontrolled.
• Pituitary tumors, even benign, may be a contraindication.
• High levels of triglycerides in the blood may be a contraindication for use.
• Extreme dizziness may result from use of the medication along with alcohol and/or marijuana.  This can also exacerbate the blurred vision or visual changes side effect listed below.

Side Effects

• Tenderness or swelling of the breast tissue.
• Headache.
• Nausea or vomiting.
• Diarrhea.
• Flushing of the skin.
• Blurred vision or visual disturbances.
• Shortness of breath.
• Seizures.
• Stroke.
• Chest pain.
• Weight gain.
• Decreased urination.
• Bloating.
• Rapid heart rate (RX List, n.d.)

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Male Libido Treatment: Testosterone-Boosting Supplements and Pills

There are many testosterone-boosting supplement products and pills on the market, none of which are regulated as medicines by the FDA.  These are the kinds of pills and supplements you see at nutrition stores or for purchase online.  They often contain a range of “natural” ingredients, which may produce some results or no results at all – ginger, boron, chrysin, horny goat weed, fenugreek, basella alba, hibiscus macranthus, and many others.  Depending on the exact makeup of these pills or supplements, they may have a range of side effects.  Since they are not put through drug trials like regulated medications, these side effects often only come to light after consumer complaints, often resulting in the supplement being pulled if side effects are sufficient enough.  Therefore, we cannot recommend this as a safe or suitable way to supplement low testosterone or boost your libido.

Male Libido Treatment: Growth Hormone Releasing Peptide CJC-1295

CJC-1295, often compounded with Ipamorelin, is an amino acid peptide, rather than a hormone itself.  It triggers production of human growth hormone in the patient’s pituitary gland.  Because it is not a synthetic hormone being introduced to the body, it is generally well-tolerate, with more mild side effects and fewer risks than any other treatment for low testosterone or decreased libido included on our list.

Contraindications and Risks

• May be contraindicated if you have had a pituitary tumor, including benign tumors.
• May be contraindicated if you have adrenal dysfunction, especially if that dysfunction is uncontrolled.
• High blood pressure, liver, or kidney problems may contraindicate use.
• Those with active cancers should not use this medication.  A history of cancer may or may not contraindicate use.

Side Effects

• Swelling, redness, sensitivity, or pain at the injection site.
• Flu-like symptoms.
• Headache.
• Dizziness.
• Diarrhea.
• Nausea.
• Tiredness.
• Flushing of the skin or hives.
• Hyperactivity.
• Difficulty swallowing (Teichman et al., 2006).

Concluding Thoughts

As is clear, there is a range of options for treating low testosterone and other age-related sexual health changes in adult men.  Some are exclusively reserved for treating low testosterone or libido problems resulting from other medical conditions or diseases.  Others can be used off-label to treat low libido and testosterone, whereas others have unrestricted, multi-purpose uses.  In each case, there are pros and cons associated with the product you may choose for your own libido treatment or other health and anti-aging benefits.  We hope this comparison of side effects, risks, and contraindications has provided a foundation for you to talk to your doctor, healthcare provider, or prescriber so that you can determine which option is right for you.

DISCLAIMER

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider.  You should always consult a practicing professional who can diagnose your specific case.  The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References:

• Osterberg, E. C., Bernie, A. M., & Ramasamy, R. (2014). Risks of testosterone replacement therapy in men. Indian journal of urology : IJU : journal of the Urological Society of India, 30(1), 2–7. https://doi.org/10.4103/0970-1591.124197 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/
• Lo, E., Rodrguez, K., Pastuszak, A., & Khera, M. (2017). Alternatives to Testosterone Therapy: A Review. Sex Med Rev 2018;6:106e113 https://doi.org/10.1016/j.sxmr.2017.09.004
• Grech, A., Breck, J., & Heidelbaugh, J. (2014). Adverse effects of testosterone replacement therapy: an update on the evidence and controversy. Therapeutic advances in drug safety, 5(5), 190–200. https://doi.org/10.1177/2042098614548680
• Cunha, J. (2016). What is depo-testosterone? Retrieved from https://www.rxlist.com/depo-testosterone-drug.htm
• Durbin, K. (2019). Human Chorionic gonadotropin. Drugs. com Retrieved from https://www.drugs.com/hcg.html
• Drugs.com. (2020). Anastrozole side effects. Retrieved from https://www.drugs.com/sfx/anastrozole-side-effects.html
• Rxlist.cin. (n.s.) Clomid patient information. Retrieved from https://www.rxlist.com/clomid-drug/patient-images-side-effects.htm#info
• Teichman, S., Neale, N., Lawrence, B., Gagnon, C., Castaigne, J.P., & Frohman, L.A. Prolonged Stimulation of Growth Hormone (GH) and Insulin-Like Growth Factor I Secretion by CJC-1295, a Long-Acting Analog of GH-Releasing Hormone, in Healthy Adults, The Journal of Clinical Endocrinology & Metabolism, Volume 91, Issue 3, 1 March 2006, Pages 799–805, https://doi.org/10.1210/jc.2005-1536