Topical Testosterone Therapy :

Topical administration avoids first pass metabolism by the liver, however other issues arise.  Besides having to apply to the skin on a daily basis, topical administration can be messy and problematic.  In the instance of topical testosterone application, an enzyme exists in the skin that can metabolize it into 5-DHT.  This can lead to undesirable side effects.  In women, it can lead to undesirable hair growth.  Common commercial gels include  Androgel  ® , Fortessa ®,  Testim ®.  Topical testosterone can also be compounded in various topical vehicles. 

Injectable Testosterone :

Injections of testosterone can be given.  The recommendation is to give deep intramuscularly.  The injection is given every 7-14 days.  For those faint of heart, the injection route may not be palatable. Typical form is Testosterone Cypionate, which is either in cottonseed oil or sesame seed oil.  The injection technique may also give a "peak-and-valley" of testosterone levels, with the peak coming immediately 24 hrs after the injection with a slow progression towards the "valley" over the course of the week.  This method doesn't keep a static level and may result in symptoms returning towards the end of the week. Testosterone Replacement in Seattle mens clinic Testosterone Replacement in Federal Way

Testosterone Pellets :

This method has a smoother delivery of hormone, hormone pellets. These very small heat fused hormone pellets are placed under the skin in the fatty tissue. Men typically need pellets inserted every six months.  Women need pellets every 4-6 months. Hormone level testing is done before therapy to determine necessity, and every 6 weeks for the first 6 months, then every 6 months thereafter if levels remain therapeutic. 

Inserted under the skin in the buttocks. The area is numbed, a small incision is placed and a special customized trocar is used to insert the hormone pellets.    However, not all pellets are  created equal.  Testosterone Pellets are processed utilizing a "heat-fusion" method that makes them more uniform and more predictable in their hormone release pattern.  The favorable thing about pellet therapy is the smooth stable release of hormone, and the need to only place them 2-3 times a year. No messy creams or gels, and no irregular hormone levels from oral or injectable administration. 

Note:  Testosterone replacement is not for those seeking to become parents, male or female.  Testosterone decreases sperm count in men.  It also is ill advised for women who may be pregnant as it can affect the sexual differentiation of the developing fetus.  

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