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Different Types of Testosterone Therapy

Once an individual has been diagnosed with Low T (hypogonadism, low testosterone), the doctor will most likely prescribe some form of testosterone replacement therapy. TRT is available in a number of different methods, and not all are going to be the best option for each person.

Types of Testosterone Therapy

Different types of testosterone therapy are prescribed by doctors who specialize in hormone replacement therapy. The first thing the physician will look at when making this decision is if the individual in question is male or female. The best options based on gender will be discussed in the sections below.

In general, the varied types of testosterone therapy include:

  • Intramuscular Injections:
    • Testosterone Cypionate
    • Testosterone Enanthate
    • Testosterone Propionate
  • Topical Testosterone:
    • Testosterone Skin Patches
    • Testosterone Gels
    • Testosterone Cream
  • Intranasal Testosterone:
    • Nasal Gel
  • Oral Testosterone:
    • Adhesive Tablet for the Gums
    • Testosterone Pills
  • Implantable Testosterone:
    • Testosterone Pellets

Doctors rarely prescribe the testosterone pills due to their high incidence of liver toxicity. Testosterone pellets have also had numerous concerns including an inherent difficulty to remove them if there is a problem, and pellets working their way out of the body. Continue reading to find out which types of testosterone therapy are most prescribed for men and women, and why.

Intranasal Testosterone Therapy

As of approximately four year ago, intranasal testosterone therapy was being called the newest thing in testosterone replacement. This is nasal gel. Natesto, sources say is the first nasal gel to be approved for use with testosterone replacement therapy in the United States.

Natesto is a gel that is applied inside of the nostril and experts say that one advantage is the small chance that it can come into contact with others. Natesto is a metered pump applicator that can give just the correctly prescribed dosage of testosterone to a patient.

Experts also say that a disadvantage of the intranasal testosterone therapy route is that it needs to be dosed several times per day. It can get more costly than the traditional injection way of delivering testosterone and it does not seem very convenient.

More than a fair share of experts say that this nasal spray is not a first choice delivery method for TRT patients. Specialists in the medical field say that more research needs to be done to determine how effective intranasal testosterone therapy is for low T patients.

Side effects can be nasal and sinus problems such as a runny nose, sore throat, sneezing and sinusitis. Those who have allergies may not prefer this method of testosterone delivery. The average recommended dose of nasal testosterone is two pumps (5.5 mg each) for a total of 11 mg in alternating nostrils per day.

Experts say to apply their testosterone nasal dispenser pump at the same times each day to help with remembering to use it. They say to take the dosages approximately six to eight hours apart, but your doctor will give you your exact dosage and frequency to take it. Never use more medication than is prescribed and always follow the directions given to you exactly as they are written.

Oral Testosterone Therapy

Oral testosterone therapy can be done using pills, drops or sprays. These ways are never highly recommended and will never be prescribed by a licensed doctor. They do not contain enough medication to get to the blood stream before being metabolized by the stomach when they are ingested.

Some experts believe that any oral testosterone that bypasses the stomach can have negative effects on the liver. They will suggest using other methods of testosterone delivery that do not go to the liver, but right into the blood stream. Examples of these methods can be patches, gels, tablets that disintegrate in the mouth or injections.

Since licensed doctors do not prescribe oral testosterone for testosterone replacement therapy, people may tend to turn to unsafe measures to get it. They will buy from the online black market or overseas. Sellers who are not qualified to sell testosterone may also take money for often fake testosterone pills, sprays or drops. Some doctors may warn that this can be very harmful to the body, especially to the liver and other doctors may say that oral testosterone has no effect at all.

The problem with oral testosterone is that you never know what you are getting. You can legally purchase oral testosterone over the counter, but again, you will not be getting enough testosterone in those pills, sprays or drops to have any impact on your low testosterone levels.

Implantable Testosterone

Implantable testosterone is one of the types of testosterone replacement that uses small pellets that are implanted under the skin in the upper hip or buttocks (in many cases) by a physician. The procedure is done in the doctor’s office and is short (taking about 10 minutes) and simple.

These testosterone pellets are approximately 3 mm to 9 mm in length. They contain crystalline testosterone and slowly release the medication into the body over the course of three to six months.

Implantable testosterone is considered to be a very convenient form of testosterone replacement therapy because it is long acting and the patient does not have to do anything while the pellets are still active under the skin.

Each dose of testosterone should be released into the body in a steady and stable fashion. A patient will need to work with their doctor to find the correct dosage that will give them the right benefits with no side effects. At times, this can be a small challenge.

The procedure for the implantation of the testosterone pellet is done with local anesthesia to the implantation area. Firstly, the area is cleaned well, numbed and a small incision is made in the skin. Approximately 10 to 12 tiny pellets will be placed under the skin. They are put there by an instrument called a trocar.

The pellets will all gradually dissolve into the fat tissue over the course of a few months. Men who choose this method have the flexibility to live their lives without the daily administration of injections (or other chosen methods) of testosterone.

In general, the cost of implantable testosterone therapy can range from $150 to $300 just for the pellets, depending on how many the patient gets implanted. Pellets range around $75 each and that does not include the cost of doctor’s fees.

Understanding The Types Of Testosterone Therapy: A Comparison Chart

Below is a comparison chart of the four different types of bioidentical testosterone therapies. Here you can compare them side by side.

Topical Intranasal Oral Implantable
Most popular form Least popular form Most non-effective form Most convenient form
Taken once per day Taken 3 times per day Taken once per day Implanted for 3 to 6 months
Highly effective Effective Non-effective Highly effective
Cream, gels, jellies Gel pump dispenser Pills, sprays, drops Pellets
Easy to apply Easy to use pump Taken by mouth Surgically implanted
Easy to avoid contact with others Must keep pump away from others Keep vials capped and out of reach of others Cannot be transmitted to another

For more information about the different types of testosterone therapy, please reach out and contact us. Use our simple to follow online contact form to have an expert clinical advisor call you at your convenience. We would love to share all the information you will need about testosterone therapies in order to help you make the best informed decision for your health.

Medically reviewed by   Reviewers National HRT Staff - Updated on March 23, 2018

Please note that the information provided in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.