Difference Between Injection and Topical Testosterone Replacement Therapy

Testosterone deficiency is more common than many realize and its symptoms can be incredibly frustrating for the men that experience them.  Symptoms include weight gain, erectile dysfunction, reduced sex drive, sexual dysfunction, decreased muscle mass, osteoporosis, changes in cholesterol levels, decrease in hemoglobin, fatigue, mood problems, increased irritability, and more.  So, just how common is low testosterone?

The BCMJ (British Columbia Medical Journal) reports the startling prevalence of low testosterone (hypogonadism) in men, “Hypogonadism affects ap­proximately 40% of men aged 45 or older, although less than 5% of these men are actually diagnosed and treated for the condition. Despite some controversy, testosterone therapy has been established as a safe and effective principal treatment for hypogonadism for nearly 70 years.

Studies have shown that testosterone replacement therapy for hypogonadal men improves their sense of well-being, sexual function, mood, libido, bone density, muscle bulk, and muscle strength. It also may decrease visceral and peripheral body fat and can reduce insulin resistance and blood sugar.

Treatment of hypogonadism can be provided through injectable testosterone esters, transdermal testosterone (gels or patches), or oral testosterone in the form of testosterone undecanoate.

As the BCMJ notes, you can treat low testosterone through by injection, topically, or orally, we will be looking more closely at injection and topical treatments.  While both methods are valid treatment options, they each have their advantages and disadvantages.  Below are the pros and cons of both injection and topical testosterone replacement therapy.Rear view of healthy muscular young man

Injection Testosterone Replacement Therapy Dosage

  • Pro: Lower Maintenance –  Once the patient receives their testosterone replacement therapy injection that is all they need to do until their next injection which can be anywhere from 1 to 3 weeks later.  This is unlike topical creams which may need to be applied multiple times each day.
  • Pro:  Better Absorption – Injectable testosterone is better absorbed by the body than topical testosterone.  Topical absorption is harder to control and can vary from individual to individual while the absorption level of injections are consistent and superior.
  • Pro:  Easy to Monitor and Adjust – With injections, the doctor knows exactly how much is being administered/absorbed and can adjust dosage as needed depending on symptoms.
  • Pro:  Fast Symptom Relief – With testosterone injections, patients begin feeling the effects of increased testosterone almost immediately unlike creams or gels that have to gradually build up in the body to be felt.
  • Con:  Needles – If you are not a fan of needles, injectable testosterone may not appeal to you.
  • Con:  Soreness – Some patients experience injection site soreness for a few days after receiving their injection.
  • Con: Testosterone Decline – Injections provide an initial high dose of testosterone that gradually declines before the patient receives another injection.

Topical Testosterone Replacement Therapy

  • Pro:  No Needles – If you do not like needles or just prefer to avoid them then testosterone cream may be more appealing.
  • Pro:  Convenient – Creams can be administered in the comfort of your home without any appointment necessary so they are more convenient for certain individuals.
  • Con:  Daily Administration – Creams or gels must be administered twice daily, once in the morning and once in the evening.  This can be difficult to remember or annoying for many patients.
  • Con:  Variable Absorption – Variable absorption among patients using testosterone cream has been seen which can be problematic when fast and effective results are needed for a patient.  Not everyone absorbs topical creams or gels the same so the dose for one person may not work as well for a very similar person and it can be hard to track and determine what is best with topical cream.
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