Any of the treatments will restore your testosterone to a normal or high level, but they have the side effect of reducing the amount of sperm your testicles produce which can result in infertility. The longer you are on the testosterone replacement the lower your sperm count will be, and prolonged treatment may result in permanent sterility. If you have not started or completed your childbearing it is important to discuss this issue with your provider before starting treatment. There are options such as freezing your sperm before starting testosterone replacement that will enable you to have healthy sperm for fertility options later. You may also consider using medications that stimulate your testicles to produce more testosterone, such as Clomid, which do not have the side effects of lowering your sperm count.
Potential risks and side effects
There is very little clinical research on treating pre-menopausal women. From the small amount of research available, it seems that the androgen levels achieved by treatment, as well as side effects, are the same as those in post-menopausal women. The main untoward effects are acne and facial hair. These occur if the level of testosterone is above normal. However, some sensitive women may have these effects with a level in the normal range. Occasionally fluid retention can occur. If testosterone rises above physiological levels, an abnormal lipid profile may occur. There are no side effects to DHEA itself because there are no receptors in the body for DHEA; all side effects are from the conversion product of DHEA, which is testosterone. Women with a history of breast cancer, severe liver disease, or severe deep vein phlebitis should not take androgens, as a certain amount of testosterone will be converted to estrogen. This treatment is also contraindicated during pregnancy, since testosterones, and even its precursor DHEA, cross the placenta and may cause changes in the genitals of the fetus. Special caution should be used when treating women of childbearing age. When prescribing testosterone treatment to a woman, be sure to prescribe adequate birth control and a warning that the androgen treatment should be stopped immediately if a pregnancy might be even remotely possible, or when considering pregnancy in the near future.