Types of testosterone: What to know

Testosterone is a vital hormone in various body functions, such as it helps maintain muscle mass, bone density, and a healthy sex drive. This hormone has an association with male characteristics. Everyone produces testosterone in different amounts.  

Healthcare professionals may prescribe testosterone to treat conditions like hypogonadism (where the body doesn’t produce enough testosterone naturally), delayed puberty, or certain types of breast cancer. 

Sometimes, athletes may misuse testosterone to enhance their performance, but this is illegal and can cause serious health problems. Researchers can explore testosterone for its potential in transgender hormone therapy, helping people to transition. 

It would be best if you administer or apply testosterone under the guidance of a healthcare professional to ensure safe and effective outcomes.

Sex and gender exist on spectrums. This article uses the terms “women,” “men,” or both when discussing people assigned female or male at birth to reflect language that appears in source materials. 

While gender is solely about how you identify yourself, independent of your physical body, you may need to consider how your personal circumstances will affect diagnosis, symptoms, and treatment. Learn more about the difference between sex and gender here.

Injections

Testosterone therapy commonly involves testosterone injections. You can self-administer them either subcutaneously (SC) into the skin or intramuscularly (IM) into the muscles. Doctors usually prescribe testosterone cypionate (Depo-Testosterone) and testosterone enanthate (Xyosted).

Benefits of testosterone injections include: 

• Cost effectiveness (inexpensive): Testosterone injections are usually more cost effective than other alternative forms of testosterone therapy. Generic versions of testosterone cypionate and testosterone enanthate are available and are cost effective for people who require testosterone supplementation.
• Self-administration: The design of the SC injections makes it easy to self-administer testosterone into the fatty tissue just beneath the skin. It is a convenient option if you prefer the flexibility to administer injections at home. 
• Predictable hormone levels: Testosterone injections produce more stable and predictable hormone levels than other administration methods. The injections aid in a controlled and gradual release of testosterone into the bloodstream. A stable hormone supply results in more consistent effects and better symptom management.
• Infrequent administration: Testosterone injections generally have a longer duration of action. You will need to administer these less frequently than some other forms of testosterone replacement therapy. The frequency may vary depending on the formulation. You may receive injections every 1–2 weeks. This schedule is convenient and can help you adhere to the treatment.

Possible risks and side effects include:

• acne and skin reactions
• emotional changes
• pain or swelling at the injection site 
• coughing episodes in some people after injection 
• cardiovascular risks with long-term use

Gels 

Testosterone gels are another form of hormone replacement therapy, and research has found them to be effective in treating hypogonadism. A typical example is testosterone gel 1% (Androgel). 

Benefits of testosterone gels include:

• Ease of use: Testosterone gels are convenient to apply and user-friendly. Apply the gel on clean and dry skin. The skin absorbs the gel that goes into the bloodstream. This method doesn’t need injections, making it more comfortable for you if you’re averse to needles or medical procedures.
• Flexibility: Applying testosterone gel every day is easy. You apply the gel to specific areas, such as the shoulders, upper arms, or abdomen, allowing you to include applying the gel in your morning routine easily.
• Minimized skin irritation: Testosterone gels are usually well-tolerated by the skin. The gels dry quickly, reducing the likelihood of residue and minimum risk of irritation.
• Localized absorption: The skin acts as a natural barrier, and testosterone gels allow absorption of testosterone through the skin. This localized absorption helps maintain steady hormone levels and avoid the peaks that you may experience with some other forms of testosterone therapy.

Possible risks and side effects include:

• skin discoloration, itching, or irritation at the application site
• risk of accidental transfer to others, especially women and children, through close skin contact
• misuse or overuse may lead to hormonal imbalances
• cardiovascular risks with long-term use

Patches 

You apply testosterone patches such as Androderm to clean dry skin. The patch provides a steady release of testosterone over a specific duration. 

Benefits of testosterone patches include:

• Ease of use: Testosterone patches are straightforward and convenient to apply. You apply the patch to a clean and dry skin area. This simplicity makes it user-friendly, and you apply it once per day.
• Stable adherence: Patches adhere well to the skin, providing a secure and consistent delivery of testosterone. This adherence contributes to the convenience of patches, as you do not need to worry about reapplication throughout the day.
• Less residue: Unlike gels, which may leave a residue on the skin, the design of the patch doesn’t leave a residue once applied. This can be particularly beneficial for people with sensitive skin.
• Steady hormone release: Testosterone patches provide a constant and regulated hormone release over a specified period. This consistency helps maintain stable testosterone levels in the bloodstream, avoiding the fluctuations that occur with some other forms of testosterone therapy.

Possible risks and side effects include:

• high risk of skin irritation at the application site
• similar to gels, there’s a risk of accidental transfer to others through close skin contact
• hormonal imbalance with overuse or misuse 

Choosing the right kind for you

Selecting the appropriate testosterone therapy to boost your testosterone levels requires understanding your needs and preferences. This may include:

• Medical evaluation: Speak with a healthcare professional to discuss your symptoms, medical history, and overall health. They may order hormone level tests to determine your current hormone levels and identify any underlying health issues.
• Lifestyle considerations: Speak with your doctor, this will help you assess the practicality of each form, whether injections, gels, or patches, based on your daily routine. You need to check how well each aligns with your ability to adhere to the prescribed treatment plan.
• Treatment goals: A healthcare professional can help define your needs for testosterone therapy, whether you want to manage fatigue, muscle mass, mood, or other symptoms. They can help evaluate whether you need short-term relief or long-term treatment.
• Administration preferences: Gauge your comfort with the administration method, whether you prefer injections, topical gels, or patches. Choose the form that is simple and practical for you to use daily.
• Potential side effects: Understand each form’s risks and side effects and assess your comfort level in managing them. Note any known allergies or sensitivities that may influence your choice.
• Cost and insurance coverage: Explore the cost of each form and whether it aligns with your budget and insurance coverage. Please make sure the form you choose is easily available and covered by your insurance plan.
• Regular monitoring: Try to book regular follow-up appointments with a healthcare professional to monitor the effectiveness and adjustment of the treatment plan. Please discuss any changes, concerns, or side effects with your healthcare team.

Summary

There are various types of testosterone, including injections, gels, and patches. Choosing the right testosterone therapy begins with a thorough medical evaluation and testing your hormone levels. 

Lifestyle choices, treatment, and administration preferences may also help you choose the right type. Weighing in potential side effects, cost, and insurance coverage while committing to regular monitoring can help you make informed choices to manage your condition and improve your overall well-being.