Table 1.
Route | Formulation | Advantages | Disadvantages |
---|---|---|---|
IM | T enanthate or cypionate | Relatively inexpensive, self-administered; predictable levels | Requires IM injection; peaks and valleys in serum T concentrations that may be associated with fluctuations in symptoms |
T undecanoate | Infrequent administration | Requires IM injection of a large volume (3 or 4 mL); coughing episodes after injection in some men | |
Transdermal | Gels (1%, 1.62%, or 2%) | Ease of application, good skin tolerability | Potential of transfer by skin contact; T concentrations may be variable from application to application; skin irritation in some men; moderately high DHT concentrations (of unknown significance) |
Patch | Ease of application, predictable levels | High rate of skin irritation at application site; reduced adherence with sweating | |
T axillary solution | Good skin tolerability | Potential transfer to others by contact; T concentrations may be variable from application to application; skin irritation in a small proportion of patients; moderately high DHT concentrations (of unknown significance) | |
Transmucosal | Buccal tablets | Convenient | Gum irritation; dysgeusia; twice-daily dosing |
Nasal gel | Rapid absorption; avoidance of first-pass metabolism | Multiple daily dosing; cannot be used in men with nasal disorders | |
SC implant | Pellets | Infrequent administration | Requires surgical insertion; pellets may extrude spontaneously; risk of hematoma and infection |
Oral | T undecanoate | Ease of administration | Requires twice-daily dosing; unfavorable effect on lipids and blood pressure |
Adapted from (1).
Abbreviations: DHT, 5-dihydrotestosterone; IM, intramuscular; SC, subcutaneous; T, testosterone.