When testosterone levels drop below the healthy range, many men experience fatigue, low libido, brain fog, and other symptoms that affect their quality of life. Testosterone Replacement Therapy (TRT) is a proven treatment for restoring hormonal balance. But one common question is: How is testosterone actually delivered into the body?
There are several methods of administering TRT, and each has unique benefits, risks, and lifestyle considerations. In this guide, we’ll explore the five most common ways testosterone therapy is administered: injections, gels, patches, pellets, and oral treatments.
1. Injections (Intramuscular or Subcutaneous)
💉 Overview:
Testosterone injections are one of the most widely used and cost-effective forms of TRT. The hormone is delivered directly into the bloodstream via a needle, typically into the muscle (intramuscular) or fatty tissue (subcutaneous).
🔄 Frequency:
- Every 1 to 2 weeks for intramuscular (e.g., testosterone cypionate or enanthate)
- Some longer-acting versions (e.g., testosterone undecanoate) are injected every 10 to 12 weeks
✅ Pros:
- High effectiveness with predictable absorption
- Customizable dosing
- Lower cost compared to other methods
⚠️ Cons:
- Needle discomfort or injection anxiety
- Hormone levels may fluctuate, causing highs and lows (“rollercoaster effect”)
- Requires self-injection or clinic visits
Best For:
Men who want rapid symptom relief and are comfortable with injections.
2. Gels and Creams (Transdermal)
🧴 Overview:
Topical testosterone is applied daily to the skin, usually on the shoulders, upper arms, or abdomen. It absorbs into the bloodstream gradually.
💡 Brands:
AndroGel®, Testim®, Fortesta®, Axiron®, and compounded creams
✅ Pros:
- Easy to apply
- Maintains steady hormone levels
- Non-invasive
⚠️ Cons:
- Risk of transference to others through skin contact (especially women and children)
- Daily commitment
- May irritate the skin
Best For:
Men who prefer a non-invasive, needle-free method and are consistent with daily routines.
3. Patches (Transdermal Patches)
🩹 Overview:
Testosterone patches are adhesive strips worn on the skin, delivering the hormone through the skin over a 24-hour period.
💡 Brands:
Androderm®
✅ Pros:
- Steady hormone levels
- Convenient once-daily use
- Avoids peaks and troughs seen in injections
⚠️ Cons:
- Skin irritation at patch site is common
- Less effective for men with very low testosterone
- Patches can loosen with sweat or water
Best For:
Men looking for consistent hormone delivery and who don’t mind wearing a visible patch.
4. Pellets (Subcutaneous Implants)
💠 Overview:
Testosterone pellets are tiny cylinders implanted under the skin, usually in the hip or buttocks. They slowly release testosterone over several months.
🔄 Duration:
- Typically lasts 3–6 months before needing replacement
✅ Pros:
- Long-lasting and convenient (no daily or weekly dosing)
- Steady testosterone levels with minimal fluctuations
- No need to remember daily applications
⚠️ Cons:
- Requires minor surgical procedure (in-office)
- Risk of pellet extrusion or infection
- Not easily adjusted once implanted
Best For:
Busy men who want a “set it and forget it” method of TRT.
5. Oral and Buccal Tablets
💊 Overview:
Oral testosterone is either swallowed or placed inside the mouth (buccal tablets) where it’s absorbed through the gums.
💡 Forms:
- Testosterone undecanoate (oral capsule, such as Jatenzo®)
- Buccal tablets (e.g., Striant®)
✅ Pros:
- Convenient, needle-free
- No skin irritation or patch issues
⚠️ Cons:
- Can affect liver function (especially older oral formulations)
- Less consistent hormone levels
- May cause gum irritation with buccal tablets
Best For:
Men who cannot tolerate injections or transdermal options, and who need a non-invasive delivery method.
Choosing the Right Method
The best TRT method depends on a variety of factors, including:
- Your lifestyle and preferences
- Medical history
- Severity of testosterone deficiency
- Cost and insurance coverage
- Ability to commit to daily vs. long-term treatment cycles
Talk to your doctor about:
- Blood testosterone levels
- Response to past treatments (if any)
- Potential side effects
- Convenience and comfort with the method
Conclusion
Testosterone Replacement Therapy is not one-size-fits-all. From injections to implants to daily gels, there are multiple safe and effective ways to restore testosterone to optimal levels. Working closely with a knowledgeable provider ensures you get the right dose, delivery method, and ongoing monitoring to maximize benefits and minimize risks.
