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Brand
name Primoteston
Brand
name Sustanon
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Product
Injection
(deep intramuscular)
Testosterone
esters or enanthate (100 mg in 1 mL or 250
mg in 1 mL) in oil
Dose
Approx.
250 mg every 2 weeks — 3
weeks.
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Advantages
- Widely
available;
- Cheapest;
- Suits
most clinical situations for many men
requiring treatment;
- Released
slowly and a very effective way of
keeping a healthy level of testosterone
in your body;
- Usually
ensures the maximum change is effected;
- The
liver does not process testosterone
received via intramuscular injection
and this acts to minimise any liver
damage. Injections can be useful if you
have had liver damage in the past;
- If
you do not inject your own hormones,
you will need to make fortnightly
visits to your doctor and this is a
useful way to ensure you get regular
medical access for blood tests, general
health, and the best possible
maintenance of your health over this
time;
- If
you learn to inject your own
testosterone, remember to never share
needles or syringes. Have an
safe,effective disposal container for
your needles.
Disadvantages
- Injections
can be painful or uncomfortable.
Changing the needle size before
injecting can overcome this discomfort;
- Can
be difficult to self-inject;
- Contraindicated
in bleeding disorders;
- Can
produce wide mood or energy swings, as
blood testosterone level fluctuates
rapidly;
- If
you do not inject your own hormones,
you will need to make fortnightly
visits to your doctor and you may feel
more dependent on their
services.
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Brand
name Androderm
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Product
Testosterone
patch
(2.5 mg or 5.0 mg)
Dose
5.0
mg daily (may start with 2.5 mg daily; can
be up to 7.5 mg)
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Advantages
- These
can be suitable for men who have had
full hysterectomy or removal of the
ovaries and require maintainance dose;
- This
method can deliver a continuous steady
dose of the hormone;
- Suitable
in bleeding disorders;
- Convenience.
Disadvantages
- Patches
tend to cause a high rate of skin
irritation due to absorption enhancers;
- Patches
deliver very low levels of testosterone
and is usually insufficient to effect
an acceptable masculine transition for
most men in the early years of
transition (<3-5 years).
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Brand
name Testogel
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Product
Cream
(5%)
or Gel (1%)
Dose
Daily
delivery
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Advantages
- Gel
can be suitable for men who have had
full hysterectomy or removal of the
ovaries and require maintainance dose;
- Convenience;
- Can
maintain effective continuous level of
testosterone;
- Suitable
in bleeding disorders.
Disadvantages
- Gel
has been known to be transferred
through close skin to skin contact with
female partners, causing unwanted
effects;
- Efficacy
of cream not yet established and not
yet available in Australia.
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Implants
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Product
Testosterone
implant (100 mg or 200 mg)
Dose
approx.
800 mg 6-monthly
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Advantages
- Once
in place, implants can last several
months;
- They
provide an effective continuous dose;
- They
are especially suitable for men who
have had full hysterectomy or removal
of the ovaries and require maintainance
dose;
- Convenience.
Disadvantages
- Pellets
do not tend to deliver the large doses
of the hormone usually required in the
early stages of treatment, for most men
identified female at birth;
- It
involves a minor surgical procedure
under local anesthetic to insert the
small implant/s (requires minor office
surgery);
- Extrusions
after about 10% of
implantations.
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Brand
name Andriol
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Product
Oral
Testosterone
Dose
160–240
mg in 2–3 divided doses
daily
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Advantages
- Andriol
(in Australia) is the only safe oral
androgen;
- Oral
androgens (tablets) is suitable in
bleeding disorders;
- Tablets
are a painless form of
delivery.
Disadvantages
- Tablets
require frequent administration (2-3
times daily);
- Tablets
will maintain your testosterone at a
safe and effective level only if you
take them completely regularly - same
time every day without fail;
- Tablets
have an erratic absorption, metabolism
and distribution rate;
- Tablets
can be very hard on your liver and can
cause extra problems through this form
of absorption. This method has caused
high blood pressure for many
individuals, as well as liver
complications such as tumors;
- Tablets,
which bypass your liver, remains in
your body for only a very short period
of time and is passed from your body in
urine within a matter of hours;
- Some
individuals develop gastrointestinal
intolerance;
- Andriol
does not suppress menstruation in 50%
of men identified female at
birth;
- Tablets
tend to be too weak for the induction
of virilization in men identified
female at birth;
- It may
be inconvenient to have hormone tablets
in your home where they might present
unwanted questions from relatives or
friends.
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Other
forms Troche
Dragee or Ointment.
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Formulated
by a compounding pharmacist on a
prescription; sale allowed in Australia
under extemporaneous preparation
provisions of State pharmacist
registration.
Disadvantages
- Troches
tend to be too weak for the induction
of virilization in men identified
female at birth;
- No
available evidence of pharmacological
or clinical efficacy;
- Expensive.
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So, what's best?
The best product for you will depend on
your own physical health and personal situation.
Always consult with your medical healthcare
provider to determine your best option.
Oral testosterone (tablets) pass
rapidly out of the body (within hours) and this
form of testosterone tends to be ineffective for
men who seek an effective transition with male
secondary sexual characteristics including
cessation of the menstrual cycle. Oral
testosterone form is strongly discouraged for
long-term use due to evidence of liver damage
and increased levels of blood pressure sustained
by men over years of use.
Implants are highly effective for men
who have had their ovaries removed. However,
implants are associated with extrusions and
infections in about 10% of men. Patches
can also be useful in some cases, however the
adhesive causes skin irritations and sometimes
blistering skin reactions in about 10% of
men.
Intramuscular injections of
testosterone currently represent the standard
form of testosterone therapy. Injectable
testosterone is either tesosterone
enanthate, tesosterone cypionate,
testosterone propionate, testosterone
undecanoate or a mixture.
- Testosterone enanthate has a wide
margin of safety - however 24-48 hours after
the injection there is a high peak in the
concentration of testosterone in the body,
followed by a significant drop before the
next injection. In some men these
fluctuations negatively affect well-being and
mood;
- Testosterone cypionate is
comparable to the testosterone
enanthate;
- Testosterone propionate has an
even shorter duration of action than
testosterone enanthate;
- Testosterone undecanoate overcomes
the shortcomings of conventional testosterone
injections - however it is a newly developed
long-acting injectable testosterone ester and
expensive if not accessible on the
Pharmaceutical Benefits Scheme. Testosterone
undecanoate is believed to become the
standard preparation for long-term
treatment.
- Injectable forms of testosterone
deliver a high level of hormone in the early
stages of transition for the beginning of
virilization in men identified female
at birth. During the early years of
treatment, monthly to fortnightly visits to
your doctor for injections provide an ideal
opportunity for your medical practitioner to
carry out the necessary blood, lipid and
hormone level tests to monitor your
emotional, physical and hormonal health. It
is advisable that in the early years of
transition, you undergo regular blood tests
every three months in the first year and
every six months thereafter. Your
testosterone levels should be monitored
using the male range.
Further reading
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Testosterone Products Summary
