Summary of Use during Lactation

Limited data indicate that a low-dose (100 mg) subcutaneous testosterone pellet given to a nursing mother appears not to increase milk testosterone levels markedly. Testosterone has low oral bioavailability because of extensive first-pass metabolism, so it is unlikely to affect the breastfed infant. One breastfed infant seemed not to be adversely affected by low-dose maternal testosterone therapy.

Drug Levels

Maternal Levels. A woman received testosterone for depressive symptoms sublingually (drops, dose unspecified), vaginally (cream, dose unspecified), and subcutaneously (pellet, 100 mg). Foremilk samples were obtained at various times over the first 24 hours after administration of the sublingual and vaginal administration and on days 2, 3 and 7 after the implanting of the testosterone pellet. The highest milk level recorded following the pellet implantation was 101 ng/L on day 7. Testosterone levels in breastmilk were not increased above baseline with any of these preparations.[1]

Infant Levels. After implantation of a 100 mg pellet of testosterone subcutaneously in a postpartum woman, serum levels of testosterone in her breastfed infant (extent and age not stated) were <100 mcg/L on days 2, 3 and 7, and at 5 months after the implanting of the testosterone pellet.[1]

Effects in Breastfed Infants

An infant (age not stated) was breastfed (extent not stated) after implantation of 100 mg of testosterone subcutaneously. No adverse effects were noted in the infant over a 5-month period.[1]

Effects on Lactation and Breastmilk

Supraphysiologic serum levels of testosterone, either from a tumor[2][3] or from exogenously administered testosterone,[4] reduces milk production in postpartum women. Testosterone alone reduces serum prolactin;[4] however, when given in combination with estrogen and progestin, serum prolactin levels are not markedly reduced.[5] Testosterone was previously used therapeutically to suppress lactation, usually in combination with an estrogen.[4][5][6][7][8][9][10]

References

1.

Glaser RL, Newman M, Parsons M et al. Safety of maternal testosterone therapy during breast feeding. Int J Pharm Compound. 2009;13:314-7. [PubMed: 23966521]

2.

Betzold CM, Hoover KL, Snyder. Delayed lactogenesis II: a comparison of four cases. J Midwifery Womens Health. 2004;49:132-7. [PubMed: 15010666]

3.

Hoover KL, Barbalinardo LH, Platia MP. Delayed lactogenesis II secondary to gestational ovarian theca lutein cysts in two normal singleton pregnancies. J Hum Lact. 2002;18:264-8. [PubMed: 12192962]

4.

Weinstein D, Ben-David M, Polishuk WZ. Serum prolactin and the suppression of lactation. Br J Obstet Gynaecol. 1976;83:679-82. [PubMed: 788774]

5.

Welti H, Paiva F, Felber JP. Prevention and interruption of postpartum lactation with bromocriptine (Parlodel) and effect on plasma prolactin, compared with a hormonal preparation (Ablacton). Eur J Obstet Gynecol Reprod Biol. 1979;9:35-9. [PubMed: 570523]

6.

Schwartz DJ, Evans PC, Garcia CR et al. A clinical study of lactation suppression. Obstet Gynecol. 1973;42:599-606. [PubMed: 4582587]

7.

Ng KH, Lee KH. Inhibition of postpartum lactation with single-dose drugs. Aust N Z J Obstet Gynaecol. 1972;12:59-61. [PubMed: 4502478]

8.

McNicol E, Struthers JO. A combined/oestrogen/progestogen/testosterone agent for the inhibition of lactation. Br J Clin Pract. 1972;26:567-8. [PubMed: 4567863]

9.

Morris JA, Creasy RK, Hohe PT. Inhibition of puerperal lactation. Double-blind comparison of chlorotrianesene, testosterone enanthate with estradiol valerate and placebo. Obstet Gynecol. 1970;36:107-14. [PubMed: 4912251]

10.

Iliya FA, Safon L, O'Leary JA. Testosterone enanthate (180 mg.) and estradiol valerate (8 mg.) for suppression of lactation: a double-blind evaluation. Obstet Gynecol. 1966;27:643-5. [PubMed: 5949195]

Substance Name

Testosterone

CAS Registry Number

58-22-0

Drug Class

• Breast Feeding
• Lactation
• Androgens
• Hormones