If you’ve done any research on low testosterone treatment options, you’ve probably come across a wide variety of recommendations. Some will tell you that pellets are the best form of treatment. Others people will swear by topicals.
We have specific practices that we follow based on recommendations by the Endocrine Society and our own experience. We’ve found certain practices to be the most effective, and we’ve also found other practices to be ineffective.
Let’s start with what works.
All of Your Low Testosterone Treatment Options
At Testosterone Centers of Texas, one of the low testosterone treatment options that we primarily recommend is a testosterone injection regimen. This regimen consists of weekly in-clinic injections of testosterone cypionate.
We recommend weekly injections of testosterone to keep your levels optimal—not too high, and not too low. These weekly injections also allow for the use of the lowest effective dose, which decreases the potential for side effects. These intramuscular injections go deep into the muscle and dissolve over time.
The amount of time it takes for the injection to dissolve depends on the half-life of the testosterone cypionate, which is about 8 days. We’ve found that injections cause your numbers to go up in the first 48 hours, but within 8 days the amount of medicine in your body reduces by half.
That’s why we do weekly injections—an injection on day 7 gets your numbers back up where they need to be. Your levels will still fluctuate with testosterone injections, but the fluctuations will be much less than other low testosterone treatment options.
Topicals (Creams, Gels, and Patches)
While we recognize that men respond most favorably to injection therapy, some patients are not candidates for traditional testosterone replacement and may benefit from topical (AndroGel, Testim, Axiron, Fortesta) testosterone gel preparations.
Applying a topical is simple, and all topicals must be applied daily. This is the only one of the low testosterone treatment options that requires a daily dosage. However, a few side effects of topicals exist that you should be aware of. Even though topicals seem like a great solution because you don’t have to come in to the clinic each week, they have some issues.
First, topicals can come off of your skin and on to other people, like your wife or your kids. You don’t want to be transmitting this hormone to people who don’t need it.
Second, topicals can be very expensive because insurance usually doesn’t cover them.
Third, some men find that topicals irritate their skin—if you already have skin problems, topicals might not be a great solution for you.
Finally, (and this is the biggest issue) topicals tend to have a high failure rate—somewhere between 30-40% of men cannot absorb enough of the topicals through their skin to improve their testosterone levels.
This is why, of all the low testosterone treatment options out there, we recommend injections. Not only do they have a higher success rate, but they have fewer drawbacks compared to to topicals.
Another one of the popular low testosterone treatment options available to you is testosterone pellets. Pellets are compounded testosterone medications that are surgically implanted under your skin. They then release the medication over a period of months.
We recommend against pellets, mostly because pellets don’t live up to their promises. They’re usually created by a local compounding pharmacy, so there is little standardization. The pellets made don’t have any sort of time-release mechanism. Because there’s no time gradient—no extended release or immediate release pellets—all the pellets begin dissolving in your body at once.
This practice leads to a spike in testosterone levels for the first month, usually well above what your body needs. Then, you have a 3-4 month window where your levels plummet, while you are only briefly in the target range. Finally, you drop below the normal range until you get another implantation of pellets, which just puts you back on the roller coaster.
You’re also not being monitored appropriately during the time that you are at the highest risk for development of side effects.
Finally, they’re not FDA approved, which means you’re paying out of pocket. Once again, injections seem to be the best of the low testosterone treatment options out there.
More Information About Low Testosterone Treatment Options
If you’re looking to get some more information about your low testosterone treatment options, I’ve got a few great resources for you.
Next, watch our video summarizing all these different options and why you need to choose injectable testosterone over other options (just click the video below to start watching).
Finally, if you’re ready to learn more about your specific situation, click here to set up your free consultation today. It won’t cost you anything, and you’ll be able to talk to a medical care provider about your unique situation and what options might work best for you.