Testosterone Replacement Therapy: Which Type Is Best?
I’ve been treating testosterone-deficiency syndrome as a urologist for more than a decade. I’ve used every form of therapy available in the United States: Clomid, human chorionic gonadotropin, various gels, several types of testosterone patches, implantable testosterone pellets and injections. I’ve found that all these options are effective for some men if used correctly — but short-acting injections have become my go-to treatment over the past several years.
Short-acting injections entail administering testosterone cypionate or enanthate intramuscularly every seven to 14 days. This is often done by a medical practitioner, though patients can self-administer after proper training. The bottom line: These injections work extremely well. Dosing is easy to determine, and the results are far superior to every other kind of testosterone-replacement therapy I’ve prescribed.
Other therapies can be effective, of course, but their results often lag. Topical gels, for example, sometimes fail to raise a man’s testosterone level as well as injections. Patches can cause skin irritation and suffer the same testosterone inadequacy. Pellets require surgery. Fertility-sparing treatments such as Clomid and human chorionic gonadotropin can work for men who wish to preserve their fertility but fail to provide symptom control after the fact when compared to injections.
Perhaps the best thing about injectable testosterone is its cost, which is significantly less than the alternatives. Gels, patches and pellets, by contrast, can run several hundred dollars a month. It’s rare in medicine, believe me, that a superior treatment costs less than its inferior alternatives. Take advantage!
Bear in mind that any testosterone-replacement therapy should be prescribed only to men who have been correctly diagnosed with a deficiency. All forms of low-T therapy carry risks, and injectable testosterone’s risk profile — acceleration of sleep apnea, increased red-blood-cell production and a higher chance of clotting, breast-tissue growth, among a few others — is no different than any of the others I’ve mentioned here. Low-T treatment entails, essentially, a lifetime of hormone-replacement therapy; be sure to discuss your questions and concerns with your physician before you make a decision.
Posted on Tue, December 23, 2014
by Marc Richman, M.D. filed under