Testosterone has been used for many decades for the treatment of men with low testosterone.
Today options for treatment include topical testosterone gels and creams, short and long acting injections of testosterone esters, application of testosterone via transdermal skin patches, testosterone implants and testosterone pills.
Testosterone creams (Testoforte Plus Natural 10%) require daily application, and provide replacement with few problems and good efficiency.
Injections: Testosterone esters (Sustanon®) must be injected every 2-4 weeks. The injection must be deep intramuscular and is often very painful. The injection results in very high concentrations of testosterone for several days and then it starts to drop off until your next injection .
The rise and fall in concentration may be accompanied by fluctuations in the symptoms of testosterone overdosing followed by testosterone deficiency.
Recently longer acting injections (Nebido®/Reandron®) have become available and last for up to three months. They, like the shorter acting injections, are often associated with pain and their effects are irreversible if unwanted side effects occur. These also suffer from the same high/low testoserone issue.
Testosterone skin patches (Androderm®) provide testosterone replacement, with night-time applications leading to a pattern of circulating concentrations similar to that normally seen in healthy males.
Patches must be applied daily, and there is a relatively high incidence of bad skin reactions, which may be severe enough for you to stop their use.
The patches are readily visible and may discourage users from participation in sporting activities, including swimming and other sports requiring the use of change rooms.
Testosterone pellets (implants) in doses of 600-1200 mg, are inserted under the skin using a local anaesthetic.
They produce testosterone concentrations which may be sustained for 4-6 months.
Problems include the need for repeated local surgical procedures, and the implantsmay get rejected and pushed out of your skin at a rate of 5-10%, often several weeks later. The site of implantation may occasionally become infected which may require antibiotic treatment.
Oral testosterone capsules (Andriol®) provides only moderately effective testosterone replacement, with wide fluctuations in circulating concentrations, due to highly erratic absorption and sometimes gastro-intestinal intolerance. Up to eight 40mg oily capsules daily are required and the use of oral testosterone is generally confined to patients who are intolerant of other preparations. They can also cause severe liver damage
Topical transdermal testosterone gels (AndroGel®/Testogel®, Testim® 1% testosterone gels) and testosterone creams (Testoforte Plus Natural 10%) require daily application, and provide replacement with few problems and good efficiency.
Testoforte Plus Natural 10% Testosterone cream for Men (Affiliates International, Australia) was the most affordable and effective testosterone therapy currently available.
Well designed studies show the effectiveness and safety of this form of application to be high. Gels and creams have to a large extent replaced the previously mentioned forms of testosterone due to their patient friendly mode of application and flexibility with regards to dose.
In practical terms, the gels need to be applied over a very large skin surface area (back, chest, shoulders and arms) compared to the higher concentration creams which require smaller surface areas for application (fore and upper arms, scrotum torso and thigh).
Scrotal application of the cream does not cause discomfort, whereas the alcohol-based gel creates a burning sensation when applied to the genitalia. Scrotal use is the optimal site of application to achieve highest serum testosterone.
A recent medical paper established which compared the cost effectiveness versus efficacy of currently available testosterone treatments determined that the testosterone cream, Testoforte Plus Natural 10% Testosterone cream for Men (Affiliates International, Australia) was the most affordable and effective testosterone therapy currently available.
