Safety of maternal testosterone therapy during breast feeding

This article is an adaptation of an abstract/poster presentaton made at the 13th International Congress on Steroidal Hormones and Hormones and Cancer, Quebec City, Canada (September 2008), concerning the topic of breast feeding as a contraindication to testosterone therapy. The purpose of the presentation and this article is to provide a summary of the findings of a study that was conducted to evaluate maternal absorption of testosterone and its excretion into breast milk by using three methods of delivery: sublingual drops, vaginal cream, and pellet implant. Testosterone was measurable in maternal blood by all three methods of delivery. No significanat increase of testosterone was seen in breast milk when testosterone was delivered by vaginal cream, sublingual drops, or subcutaneous pellet implant. Testosterone was very low in infant blood at baseline and during testosterone therapy by pellet implant. There was no adverse clinical affects in the infant after seven months of continuous testosterone therapy to the mother by subcutaneous pellet implant. Testosterone delivered by sublingual drops, vaginal cream, and pellet implant was absorbed but not measurably excreted into breast milk. Testosterone, delivered by a 100-mg subcutaneous pellet implant, was effective in relieving symptoms of testosterone deficiency and therapy is safe for the breast-fed infant. Testosterone by pellet implant may be a safer and more physiologic alternative to psychotropic medications.