Hormone replacement therapy

This is generally in the form of testosterone administered by gel or injection. There is no ideal method of testosterone delivery – it is often down to individual choice. The best method for any patient will depend on their own personal circumstances.

However testosterone is a controlled drug and all forms are available only by prescription.

Gel products

Many like the gel preparations because they give a very even delivery of testosterone. They are short-acting and can be discontinued immediately if the patient is uncomfortable with the effects.
There are several products on the market. If you don’t like one, ask to try an alternative one.

daily dosage gives an even delivery without highs and lows.
easy to discontinue if patient unhappy with effect

have to be applied every day
should be applied after a shower
take a few minutes to dry (time varies between products)
accidental transference to others must be avoided

Long acting injection injection

Nebido is commonly prescribed and must be administered by a nurse or doctor.


needs to be administered only 3 to 5 times per year
no special precautions required

injection can be painful
some patients dislike the initial high level of testosterone
some patients find that they run out of steam before the next injection is due
some patients forget to book their appointment

Using a gel

Read the instructions carefully!
Do nor rub the gel in – spread it on the areas of your body recommended in the instructions.
Wash your hands thoroughly.
Allow the gel to dry before putting on clothing – perhaps clean your teeth or have a shave while you are waiting.

Administering Nebido - important!

Many medical professionals have little or no experience of administering a Nebido injection so make sure they have read the instructions – and make sure you know how it should be done so that you can check!

Nebido must not be cold when it is administered. Hold the ampule in you hand for a few minutes.

A small needle is used to ectract the liquid from the ampule but a large needle must be used to inject it

You should be comfortable and relaxed, lying face down

The injection should be given in the buttock

Ihe injection should not take less than 2 minutes

Sometimes no medication will be required if natural testosterone levels are sufficiently high.

Some adults may not wish to have hormone treatment. Occasionally the use of oestrogen may be preferred.

KS/XXY is not on the list of conditions which qualify for free prescriptions – although the KSA is working with the Prescription Coalition to get the list extended.

If you are on a low income you may qualify for help.

You might be able to get help to pay these NHS charges:
• NHS prescriptions
• NHS dental treatment
• sight tests, glasses and contact lenses
• travel to receive NHS treatment
• NHS wigs and fabric supports
You can check what help you could get and what to do next.
It usually takes 3 minutes to check.
To do this, visit the NHS Business Services Authority website.

Next… Effects of Testosterone Replacement Therapy (TRT)