TRT for low testosterone: Options, cost, and side effects

There are several ways to administer testosterone:

Injectable

Injectable testosterone is an inexpensive and common form of TRT. A person can receive short-acting treatment, which involves a shot every 1 or 2 weeks, or long-acting treatment, in which the second shot is 4 weeks after the first, and all others are 10 weeks apart. The dosage and frequency of the treatment may vary depending on the person.

Doctors inject short-acting testosterone under the skin or into the muscle, while long-acting shots go in the gluteal muscles.

TRT can cause fluctuations in testosterone levels, which can affect energy levels, libido, mood, and the presence of symptoms such as breast tenderness.

Topical (transdermal)

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People usually apply gels and creams on a daily basis. Gradual absorption causes more stable testosterone levels in the blood.

However, people using topical treatments must be careful to avoid skin-on-skin contact with other people for at least 6 hours after application. It is important to prevent the risk of transferring the medication onto other people’s skin because it may be dangerous for pregnant people and children.

Topical patches stick to the skin and stay in place for 24 hours until the next dose. They typically come in doses of between 2 milligrams (mg) and 5 mg. The downsides to patches are that they are not cosmetically appealing and often cause skin irritations. In comparison with oral medications, topical patches may prove less toxic to the liver.

Topical gel dosage is usually between 40-100 mg per day but this will vary between products. A person should start at the lowest recommended dose and increase gradually, if necessary.

Cheek or buccal patches

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A person places a buccal patch above the upper teeth, and it releases testosterone over 12 hours. These patches usually contain 30 mg. A person should apply them twice each day, around 12 hours apart. However, they can cause headaches and gum and mouth irritation.

Testosterone implants or pellets

Testosterone pellets are small plastic pellets that doctors implant under the skin. The implant goes into a person’s upper hip or buttock. The pellets dissolve slowly and can deliver TRT for 3-6 months. The dosage varies between individuals and a person should discuss this with their doctor prior to the first implantation.

Inserting implants is a minor inpatient surgical procedure. A doctor makes a small incision in the fatty tissue below the skin to insert the pellets. They perform the procedure under local anesthesia.

Learn more about testosterone pellets here.

Oral testosterone

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Oral testosterone is a less common type of TRT that is more expensive and less practical. Its long-term use can potentially cause liver damage.

Most tablets also come with warnings about the drug causing hypertension and stroke. As a result, only individuals who cannot use other forms of TRT resort to taking testosterone by mouth.

A doctor will recommend a Dosage ranging from 225-396 mg, and a person will typically take oral testosterone tablets twice daily.

Intranasal

A person applies nasal testosterone gel to the inside of the nose. They will need to do this three times a day at intervals of 6-8 hours, preferably at the same times every day. Dosage is usually 11 mg per application across both nostrils, resulting in a total dosage of 33 mg daily.

Some common reactions to this treatment include headaches, nosebleeds, a runny nose, and nasal discomfort.