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Understanding Your Options: Types of Testosterone Replacement Therapy (TRT) and Why We Often Recommend Testosterone for Both Men and Women
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Testosterone is essential to both men’s and women’s overall health, influencing everything from energy and muscle mass to mood, libido, and bone strength. But as people age—or due to certain medical conditions or even high risk occupations—testosterone levels can decline, leading to symptoms like fatigue, low sex drive, weight gain, and mental fog. That’s where testosterone replacement therapy (TRT) comes in.
At Age Management Center, we tailor TRT plans to meet each individual’s needs and goals, backed by expert medical providers that have extensive experience in both hormone replacement as well as traditional medicine. Why does that matter? Because you *shouldn’t* approach TRT or HRT in a silo – you should consider the individual’s whole health picture.
So when people are only offered one form of testosterone and given no explanation, we see that as a red flag. Here’s a breakdown of the most common forms of testosterone therapy—and why we often recommend injectable testosterone as a preferred option.
Types of Testosterone Replacement Therapy
Topical Gels and Creams
These are applied to the skin daily so testosterone is absorbed through the skin.
Pros:
- Easy to apply
- Steady hormone absorption throughout the day
Cons:
- Must be applied at the same time daily and sometimes twice daily to gain optimal levels.
- Risk of transferring testosterone to others through skin contact (partners, kids, pets)
- Absorption can vary depending on skin type and lifestyle factors
- Can cause skin irritation
- Because of the presence of the enzyme 5 Alpha Reductase in the skin, topicals have a greater risk of elevating dihydrotestosterone [DHT] which can be toxic to hair cells.
Oral Testosterone (Capsules or Tablets)
Oral testosterone, including newer formulations like testosterone undecanoate, is taken by mouth and absorbed through the gastrointestinal system.
Pros:
- Convenient and familiar method
- Non-invasive
Cons:
- May have variable absorption
- Can be harder on the liver
- May require multiple doses per day
- Often less effective in maintaining optimal levels compared to other methods
Injectable Testosterone
Injectables are administered via intramuscular injection, typically once or twice per week, depending on the individual plan.
Pros:
- Consistent and reliable testosterone levels
- More customizable dosing
- Fewer daily compliance concerns
- Avoids liver metabolism
- Often more cost-effective over time
- A 2015 article in the National Library of Medicine states that: “Injection of testosterone may be safer and more effective than transdermal administration for combating loss of muscle and bone in older men”
Cons:
- Requires self-injection or clinic visits
- Some individuals may experience hormonal fluctuations between doses (though this can be managed with proper scheduling)
Pellets
Pellets require a simple and very minor surgical office visit where a local anesthesia is administered, an incision is made in the hip, a narrow insertion tube is placed and the pellets are pushed through the injection tube.
Pros:
- “Set it and forget it”. Once your provider has inserted the pellets, you don’t have to do anything nothing until the pellets need replacement. This is convenient for those that are prone to forgetting to take their meds, or whose job requires extensive travel and they prefer not to bring materials with them.
- For women testosterone can be combined with estrogen in a pellet so both hormones are available.
Cons:
- Requires a minor surgical procedure every 14-16 weeks
- Once implanted the dose cannot be adjusted
- For some, there is variable absorption and blood levels drop as the replacement date approaches
Why We Often Recommend Injectable Testosterone for Both Men and Women
While we are comfortable with any and all of the ways to administer testosterone based on individual choices, at Age Management Center, we frequently recommend injectable testosterone for several key reasons:
- Consistency and Control: Injections allow for precise dosing and consistent testosterone levels, reducing the peaks and valleys that some experience with other forms.
- Customization: Injectable TRT can be easily adjusted to meet each patient’s exact hormonal needs, and we monitor levels through regular lab work to ensure optimal results.
- Ease: We help individuals learn how to self-inject so this can be done safely and easily at home—or on the road for our many patients who travel regularly. Or for those that still prefer to come into the office to have our team administer the injection, we have flexible hours and priority scheduling for those coming in for their testosterone.
- Effectiveness: Many patients report feeling stronger benefits from injectables—more energy, improved mood, better body composition, and enhanced libido—compared to topical or oral options.
- Safety: Because it bypasses the liver, injectable testosterone has fewer risks of hepatotoxicity than oral formulations.
- Predictable Dosing:Injectable formulations provide more consistent serum testosterone levels, especially when dosing intervals and amounts are tailored to the patient’s needs.
- Higher Patient Satisfaction:Studies have shown higher reported satisfaction with injectable testosterone in men who prefer the efficiency of less frequent dosing and more pronounced results.
- Ease of Monitoring:Because injectable testosterone delivers a known dose with predictable absorption, we can more accurately monitor and adjust levels based on lab results and clinical response.
- Minimal Risk of Transference or Irritation:Unlike topicals, there’s no risk of contact exposure to others and no concerns about skin sensitivity.
- Cardiometabolic Support:When properly managed and monitored, testosterone replacement may improve insulin sensitivity, lower visceral fat, and support cardiovascular health (Mayo Clinic Proceedings, Saad et al., 2017).
While each individual’s needs are different, we find that many patients experience better outcomes and greater satisfaction with injectable TRT. That said, our providers always take the time to evaluate your symptoms, lifestyle, medical history, and lab results before recommending the best therapy option for you.
Ready to Feel Like Yourself Again?
Whether you’re just starting to explore hormone replacement or looking to optimize your current plan, our expert providers are here to guide you. Contact Age Management Center to schedule a free screening and take the first step toward feeling your best.