Treatment

This is generally in the form of testosterone administered by gel or injection. Implants and tablets are less commonly used, as are patches.  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.

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.

Below is more information about the most usual methods of delivery of testosterone.

Sustanon Injection
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Sustanon has been used for many years and is administered monthly. Because it is relatively short acting preparation, some men feel that they are on an emotional roller coaster – levels are high following the injection and then gradually diminish with a low before the next injection is due. However many men find it satisfactory

Nebido injection
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Nebido is a newer preparation and is administered approximately every three months, although this may vary from person to person. Because the dosage interval is greater, the highs and lows occur less frequently. As the solution is quite thick, it should be warmed slightly before administration and should be injected slowly taking about 2 minutes using a white (large gauge needle).  Try leaning over a table or desk with legs apart, or sitting backwards on a chair or lying down while being injected in the buttock as these positions appears to limit the discomfort.

As Nebido is so long acting, it is usual initially to gauge the patient’s initial  reaction to testosterone using a gel or even Sustanon.

Our members often comment that they like Nebido because they can forget about KS for 3 months at a time.

Gels
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Currently there are 3 gels available in the UK. Testim is marketed in single dose sachet. Testogel® is now available in an easy to use pump, called Testogel® 16.2mg/g gel instead of a sachet. Tostran is available in a pump dispenser.

Gels generally give a very even dosage as they are administered daily.  However some men find them a nuisance as the gel must be allowed to dry before dressing and extreme care must be taken to avoid any transfer to females.

Patches
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Testosterone patches  are no longer routinely prescribed as they frequently caused skin irritation.

Implants
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Although some men found implants to be very successful they too are out of favour. It has been suggested that GPs do not have enough experience in inserting them and many implants popped out.

Tablets
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These are very rarely used as they are ineffective and can cause liver problems.

Next… Effects of Testosterone Replacement Therapy (TRT)