What Types of Testosterone Replacement Therapy Are There?

The Aging-Self and Testosterone Replacement Therapy

Has your doctor diagnosed you with low testosterone (low T)? Or maybe you’re experiencing symptoms and simply educating yourself at this point. Regardless of where you are in the process, learning more about testosterone replacement therapy (TRT) may help you as you move forward.

You’re likely already aware that TRT is administered in different ways. These include patches, gels, and injections. Each administration method has its risks and benefits, and it is important to find the best option for you. The following information will help you better understand the differences and whether you should consider testosterone injections, patches, or gels.


What is Testosterone Replacement Therapy?

TRT is a method of returning testosterone within the body to normal, healthy levels. As men age, the level of testosterone in the bloodstream typically declines 0.4-2.6% per year. Almost one-quarter of men over 30 suffer from low T. The result is hypogonadal levels (that is, too little testosterone for normal body function) in millions of men. Besides aging, other causes of low T include obesity, alcoholism, and stress.


Symptoms Of Low T Include:

  • Decreased Muscle Mass
  • Increased Body Fat
  • Hair Loss
  • Moodiness And/Or Depression
  • Decreased Concentration And Trouble Learning New Things
  • Memory Issues
  • Fatigue, Decreasing Energy, And Daytime Sleepiness
  • Poor Sleep Habits
  • Erectile Dysfunction And/Or Reduced Sex Drive


If you experience these symptoms, you may want to have your testosterone levels tested.

In many cases, TRT can help you get back to feeling like yourself again. The goal of TRT is to supplement the body’s waning testosterone levels, easing or eliminating the related symptoms. TRT has been shown to improve sex drive, restore erectile function, improve mood, and increase bone density and muscle mass.


How is Testosterone Administered?

As you’ve probably learned, there are different ways to deliver supplemental testosterone. But do you know which form is most effective? What about the side effects of each form? These are important to understand before you begin your TRT so you can be sure you are receiving the ideal treatment for you.


Testosterone Gels

One method of administering testosterone therapy is a topical gel. This is the most commonly prescribed form of TRT in the United States, though not worldwide. The gel is applied daily, and it will diffuse through the skin into the bloodstream. But testosterone gel can also transfer to other people through contact. This can be particularly dangerous for women and children and should be taken into consideration. This also includes Nasal Gels; which can be applied by pump into each nostril 3x a day.


Testosterone Patches

Testosterone is also available in patch form, another transdermal (through the skin) delivery method. Patches are also applied daily, and you have to remember to apply them every single day. An unfortunate side effect of testosterone patches is rash and burning at the patch site. In one study, 56% of patients reported burning at the site of patches and 12-18% had burn-like blisters.



Testosterone Injections

Testosterone can be administered through injections. Some healthcare professionals give these injections in the office, but there are often take-home formulations available for your convenience. Low T injections have few side effects and are the most common form of TRT worldwide. This isn’t surprising, considering studies have found that total testosterone and free testosterone are higher in men following testosterone injections versus transdermal testosterone gel.


Sublingual Treatments

Sublingual testosterone is placed under the tongue and is usually in the form of a square or circle, depending on the strength of the troche. A sublingual dose is given twice a day, the same as the transdermal therapy. It by-passes the liver and takes about 2 to 3 minutes to melt. The taste is generally bitter, but the compounding pharmacies will flavor it to mask the bitterness somewhat. Testosterone levels will peak and drop on this therapy, and this is why it would be best to take it two or three times a day in smaller doses.


Pellet Therapy

Pellets contain a natural plant source of testosterone. Testosterone utilized in the pellets is compounded by hand and formed into a pellet shape. The pellets-which are smaller than a grain of rice-are then placed in the fatty tissue underneath the skin and act as if an ovary or testicle is present. The implantation procedure is easily performed in the office. Doctors recommend this method for those individuals who want a delivery system that is the most physiological approach and decreases the “roller-coaster” effect seen in some other methods.


Which Method is Right for You?

Your doctor will work with you to determine which form of TRT is best for your individual situation. However, understanding the pros and cons of each method can help you play a more active role in the decision-making process. Here are some things to keep in mind as you are making your decision.

1. Increasing the dosing schedule decreases compliance.

What does this mean? Put simply, the more times you have to remember to do something, the more likely you will be to forget it at some point. This decreased compliance means decreased effectiveness of treatment. Gels and patches must be applied daily, if not more frequently. By contrast, testosterone injections may be administered less frequently.

2. All methods can be administered conveniently at home.

Whether your doctor prescribes the testosterone patch, gel, or injections, there are options for each of these to be administered in the comfort and convenience of your own home.

3. Testosterone injections result in higher levels of free testosterone and total testosterone.

This makes sense when you think about it. Testosterone gel and patches are transdermal delivery methods. This means the testosterone has to cross through your skin, fat, muscle, and blood vessels before it gets into your system. Testosterone injections bypass some of these barriers.

4. Transdermal application methods put women and children at risk of exposure.

Caution must be used around women and children if you use testosterone gel or patches. This risk may be reduced with testosterone injections.


Making Your Decision

Clearly, there is a lot of information to consider before starting TRT. It’s important to work with an expert who understands the nuances of the different delivery methods and dosing to ensure that you receive the treatment that’s best for you.

At Integrative Telemedicine, the team works with patients through the convenience and security of telemedicine. Contact us to schedule a consultation to determine whether you can benefit from TRT.

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