• Evaluate formulation-specific adverse effects at each visit:
- Intramuscular injections of testosterone enanthate and cypionate: Ask about fluctuations in mood or libido.
- Testosterone patches: Look for skin reaction at the application site.
- Testosterone gels: Advise patients to cover the application sites with a shirt and to wash the skin with soap and water before having skin-to-skin contact because testosterone gel leaves a residue on the skin that can be transferred to a woman or child who comes in close contact. Serum testosterone levels are maintained when the site is washed 6 hours after applying the gel.
One study using MCF-7 breast cancer cells (a cell line responsive to estrogen) noted that Maca at -100ug/mL was able to induce proliferation and induced notable estrogenicity at 100-200ug/mL concentration, but was less potent than physiological concentrations of estrogen;  the potency was comparable to that of Silymarin from Milk Thistle .  Estrogenic effects have been seen in vivo when ovariectomized rats were given /kg ethanolic extract of Maca (equivalent to /kg root extract), where the measured uterine weight after 28 weeks was % of ovariectomized control but % that of non-menopausal control.  Another study using a lower dose of three variants of Maca for 4 weeks failed to establish estrogenic effects,  and estrogenic effects have also failed to be observed in other in vitro assays.