The good news is that the risk of heart disease, heart attacks and strokes is reduced by testosterone therapy. The bad news is there are many different kinds of testosterone therapy and not all have been studied.
Testosterone therapy has been used for nearly 50 years to treat men with low or no testosterone levels. Since then, more than a million men around the world have taken it.
The main types of testosterone replacement therapy include injectable testosterone, which lasts up to six months, and patch therapy, which lasts four to 12 weeks depending on how much testosterone you need. There are also topical treatments, like gel patches and sprays, oral testosterone tablets, as well as intranasal gels and injections.
The most commonly prescribed form of testosterone therapy is the injection. It’s called intramuscular testosterone undecanoate (TU), and it comes in two strengths — 100 mg/ml and 200 mg/ml. Both work the same way, but the higher-strength version lasts longer.
Injections last about three months, although some men may take them for up to six months. Injections can be painful, so before getting one, your doctor will give you an injection of lidocaine (Lidoderm) cream. Lidocaine stops the pain from the needle. You might experience soreness at the injection site after treatment, but this usually goes away within 24 hours.
If you’re taking TU, your doctor will likely prescribe you a “loading dose,” which is a series of injections given a few days apart to bring your testosterone levels back up to where they should be. This helps get rid of any side effects — such as fatigue, muscle weakness, sleepiness or mood swings — and makes sure you start feeling better right away.
There are a couple of other ways to administer testosterone, including subcutaneous implants, which replace testosterone in fat cells; pellets implanted under the skin, which can last anywhere from five to 10 years; and transdermal patches, which release testosterone into the bloodstream through the skin. Find the best testoprime review online.
Subcutaneous implantation of testosterone pellets
A small device, called an Invega Transplant, is inserted under the skin between your hip bones. Once inside the body, the device releases testosterone slowly over time, and the amount you get changes based on your weight and height. The first year is a gradual process, so don’t expect results overnight.
Benefits and risks
One benefit of subcutaneous implants is that they are reversible. They come out easily when you stop using them. One study found that after 10 years, only 4 percent of people had their implants removed.
However, the downside is that the pellets are made of polyethylene glycol (PEG), a synthetic polymer. Over time, PEG can cause the body to reject it. If your body does find the pellets, they can cause inflammation, swelling, redness and tenderness at the injection site. These symptoms go away once the pellets are removed.
Intramuscular injection of testosterone
An intramuscular injection of testosterone, called IM T, is similar to the subcutaneous implant. But instead of releasing testosterone slowly into the blood stream, the medication is injected directly into the muscle tissue surrounding the spine where the spinal cord ends. A syringe with a long needle is used, and the treatment lasts about three months.
Benefits and risks
When using IM T, you go through a loading phase during which you receive testosterone injections every seven to 14 days until you reach your target level. Your doctor may change the schedule if necessary.
The benefits of IM T are that it doesn’t have the side effects associated with implants, such as inflammation and rejection. However, the downside is that the treatment takes longer to achieve its full effect. Most studies show that you’ll feel more satisfied with the results after six to nine months, compared to a few weeks with implants.
Topical gel
Transdermal testosterone patches, which release testosterone through the skin, are another alternative. One brand, Testim, has been approved by the FDA for use in the U.S. It can last up to 90 days and works best if you’re overweight or obese. Studies show that it can reduce cholesterol levels and help build muscle mass in the upper body. Like other testosterone products, it’s not suitable for everyone.
Benefits and risks
Unlike injectables, transdermal gel is absorbed through the skin rather than being injected directly into the muscle. This means that it’s less invasive and easier to administer.
One drawback is that the gel isn’t absorbed very quickly. Because it takes a while for the testosterone to enter the bloodstream, you’ll feel the effects gradually over the course of several days. For example, if you were hoping to lose weight, you could get better results from a transdermal gel than from a testosterone pill.
Oral testosterone
For decades, doctors have prescribed testosterone pills to treat low testosterone levels. Unfortunately, these pills aren’t very effective. And because they contain synthetic forms of testosterone, they raise your risk of prostate cancer, which is the leading male cancer.
Benefits and risks
Another downside to these pills is that they’re absorbed too fast. They get into your system almost immediately, causing your body to respond too strongly. That means you’ll feel the effects of testosterone almost immediately, even though you haven’t taken the pill yet. Also, in order to get the desired effects, you’ll need to take the pills daily.
Some doctors recommend shortening the duration of treatment or combining it with other testosterone therapies to make it more effective. For instance, you can increase your dosage gradually over weeks or months or take a combination of testosterone pills and testosterone injections.
Intranasal spray
Like the oral testosterone pills, intranasal sprays are more effective when you combine them with other therapies. For instance, you can spray testosterone into your nose, wait for the testosterone to dissolve, and then swallow it. This is called transnasal absorption.
Benefits and risks
This type of therapy was developed as a way to bypass the liver, which can metabolize testosterone. As a result, it’s very potent and can produce rapid results.
But there are other downsides. For starters, it’s expensive. It typically costs $150 per month. Plus, it requires training, which means you have to visit your doctor regularly to get your shots. Side effects can include nausea, headache and nasal congestion.
