For HRT...which form of testosterone is best? “Should I use a cream, gel, pellets or injection?” The answer is that it depends. Each has its own advantages and disadvantages.
TOPICAL CREAM: Advantage is you can use very high doses vs gels. In a standard lipoderm cream we can use up to 200mg/gram. Compare that to androgel which only has 10mg/gram or 20mg/gram. Creams will also provide very stable levels daily. Creams tend to have a more positive effect on cholesterol profile (specifically increasing HDL) than do the injections. a
A downside to creams is that we see variable absorption. Some patients get excellent levels but others do not. It is difficult to predict who will absorb them better so it can be frustrating for a patient who is applying the cream daily and not feeling the effects. The other downside with the creams is that they are dosed twice daily making compliance difficult at times.IN
INJECTABLE: Testosterone can be injected once per week, twice per week or daily. Most commonly is an injection 1ml of 200mg/ml every week. The advantage is that individuals will get great levels and there really is no problem with absorption like you have with the creams. You avoid having to think about it daily and there is no chance of transferring it to your spouse/girlfriend.
TESTOSTERONE PATCHES: Patches deliver a slow, steady amount of testosterone to your system, and they don’t require follow-up office visits every 7–10 days since you can apply them yourself. They need to be applied around the same time every day for them to be effective. The drawback with patches is you have to apply them every day. That means there’s a risk of forgetting an application. If you do skip a dosage, it’s not detrimental, but these methods are most effective when consistently applied every day. The second main drawback is the risk of transference.
The bottom line is Testosterone replacement therapy isn’t a "one-size-fits-all". Talk with your doctor and figure out which method works best for you and your lifestyle.
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