Types of Testosterone Replacement: Gels, Injections and Implants

Testosterone Replacement Therapy (TRT) is an effective treatment for men with hormone deficiency, but its success largely depends on the chosen form of administration. There is no single “best” option, as each type has its own advantages, disadvantages and is best suited to a different lifestyle. Next, the main types of testosterone replacement will be described in detail.

Topical Gels and Creams

Testosterone gels and creams are a popular and convenient form of TRT. They are applied daily to the skin, which allows for a gradual and sustained absorption of the hormone.

How it works: The gel or cream is applied to areas of clean and dry skin, such as the shoulders, the upper part of the arms or the abdomen. Testosterone is absorbed through the skin and passes into the blood stream, maintaining relatively stable levels throughout the day.

Advantages:

Daily and controlled dosage: Allows the doctor to easily adjust the dosage to find the optimal level.

Non-invasive: Avoids the discomfort of injections.

Stable levels: Keep testosterone at a more constant level, which can reduce peaks and valleys in other forms of administration.

Disadvantages:

Transfer risk: Testosterone can be transferred to other people, such as children or couples, through direct contact with the skin. Therefore, it is recommended to cover the application area with clothes and wash your hands thoroughly.

Variable absorption: The amount of testosterone absorbed can vary depending on the person, the area of application and the quality of the skin.

Daily care: Requires daily application, which may be an inconvenience for some.

Testosterone Injections

Intramuscular injections are one of the oldest and most effective forms of TRT. They allow you to administer a large dose of testosterone periodically, which results in a gradual release into the body.

How it works: A specialist administers the injection into a large muscle, such as the gluteal or muscle, from where the medicine is slowly released into the bloodstream. The injections can be applied every week, depending on the type of testosterone ester used.

Advantages:

Efficacy and low cost: It is a very effective way to raise testosterone levels and is more economical than other options.

Less frequency: Injections are administered less frequently than the daily application of gels, which may be more convenient.

No risk of transfer: Although it is administered intramuscularly, there is no risk of transferring the hormone to other people.

Disadvantages:

Hormonal peaks and valleys: Testosterone reaches a high peak just after injection and decreases gradually until the next dose. These changes can cause fluctuations in the state of mind, energy or libido.

Invasive: Some men may feel discomfort or anxiety at the idea of these waters.

Subcutaneous Implants (Pellets)

Subcutaneous implants, known as “pellets”, are small granules of testosterone that are inserted beneath the skin. It's a long-term and low-maintenance option.

How it works: The doctor surgically inserts the testosterone granules into the gluteal skin or thigh through a small incision. The pellets release the hormone constantly and sustainably for 3 to 6 months.

Advantages:

Maximum convenience: Once inserted, you don't need to think about treatment for several months.

Stable levels: Provide a constant and controlled release of testosterone, avoiding peaks and valleys of injections.

No risk of transfer: There is no risk of transferring the hormone to other people.

Disadvantages:

Surgical procedure: Require a minor procedure at the doctor's office for its insertion.

Initial cost: The initial cost may be higher than other forms of TRT.

Less flexibility: The dose cannot be easily adjusted once the pellets are inserted, which makes it more difficult to find the optimal dose at first.

Choosing the type of TRT is a personal decision that must be made together with a specialist, such as a urologist or an endocrinologist. The doctor will evaluate your lifestyle, your preferences and your clinical history to recommend the form of administration that best suits you. Would you like to know more about how treatment is followed with each of these options?