Testosterone replacement therapy (TRT) is used to treat low testosterone levels in men. The goal of TRT is to return testosterone levels to a normal range and alleviate symptoms of low testosterone. There are several different forms of testosterone that can be used:
- Testosterone cypionate - An injectable esterified form of testosterone. Considered one of the most common testosterone preparations used in TRT. Injections are typically administered every 7-14 days.
- Testosterone enanthate - Another injectable esterified form very similar to cypionate. Also commonly used and injected on a similar schedule.
- Testosterone undecanoate - An injectable testosterone ester with a much longer half-life, allowing for injections every 10-14 weeks.
- Transdermal testosterone - Testosterone preparations designed to absorb through the skin, such as gels (Androgel, Testim), creams and patches (Androderm). Applied daily.
- Sublingual testosterone - Tablets that are placed under the tongue and absorbed sublingually, such as Testosterone pellet implants - Pellets implanted under the skin that release testosterone over 3-6 months.
Factors that determine which formulation is best for TRT:
- Mode and frequency of administration - Some patients may prefer less frequent injections over gels/creams applied daily.
- Cost and insurance coverage - Insurance may cover some preparations over others, affecting out-of-pocket costs.
- Side effects - Skin reactions more common with gels/creams. Some formulations have higher peaks/troughs.
- Convenience - Daily gels may be inconvenient for some patients versus 2 week injection intervals.
When determining the optimal form of testosterone,
your doctor will work with you to balance these factors and fit your goals, lifestyle and preferences.
Some general guidelines on choosing testosterone formulation:
- Patients who want injectable testosterone have several excellent options in cypionate, enanthate or undecanoate. These allow for longer intervals between doses.
- Patients who want to avoid injections may prefer transdermal or sublingual preparations. Skin reactions are the main side effect to monitor.
- Pellet implants offer the least frequent dosing, but require a minor procedure for placement and removal.
- Most patients do well starting with testosterone cypionate or enanthate injections every 2 weeks. This allows easy adjustment of doses as needed.
Monitoring and adjustments are critical to achieve symptom relief and avoid side effects. Your physician will order regular lab tests of hormone levels and symptoms to guide dosage adjustments. The goal is to maintain testosterone levels in the normal healthy range with the minimal effective dose.
When administered properly under medical supervision,
testosterone replacement can successfully relieve symptoms of low testosterone and improve one's sense of well-being. TRT has risks that need to be monitored, but quality of life often improves substantially for patients who need it.
If you are experiencing potential symptoms of low testosterone, consult a physician who specializes in hormone therapy and replacement. The physicians at Hormone Harmony Clinic specialize in testosterone replacement therapy as well as hormone therapy for women, growth hormone deficiencies, thyroid disorders and other conditions. We individualize treatment plans with a variety of hormone preparations to help you achieve your wellness goals. Visit www.Hormone Harmony Clinic.