Yes — many men use injections (weekly or bi-weekly) or pellets (every 3 — 6 months) for testosterone replacement therapy (TRT). Injections are flexible and adjustable but can cause peaks and troughs; pellets are low-maintenance but harder to fine-tune once placed. Some men also use gels/creams or patches. The best choice depends on symptoms, labs, lifestyle, fertility goals, and safety monitoring.
Key Points
- Common Options: Injections (e.g., cypionate/enanthate), pellets (3–6 months), gels/creams (daily), patches (daily), and select oral formulations.
- Adjustability vs Convenience: Injections allow easy dose changes; pellets offer set-and-forget convenience but can’t be adjusted mid-cycle.
- Safety Monitoring Matters: Expect checks of hematocrit/hemoglobin, PSA (per age/risk), estradiol, lipids, and blood pressure, plus symptom review.
- Fertility Considerations: Standard TRT can suppress sperm production; men planning future fertility should discuss alternatives (e.g., specialist-guided approaches) before starting.
- We personalize route and dose, coordinate labs, and offer telehealth where permitted.
How The Main Options Compare
Injections (Weekly Or Bi-Weekly)
- Pros: Widely available, precise titration, self-administered after teaching, cost-effective.
- Considerations: Potential peaks/troughs between doses (often improved with smaller, more frequent injections), injection logistics, site rotation.
Pellets (Every 3–6 Months)
- Pros: Low maintenance, steady release, no weekly dosing.
- Considerations: Dose not adjustable after insertion; if side effects occur (acne, irritability, high hematocrit), you typically wait it out. Office procedure and out-of-pocket cost.
Topicals: Gels/Creams (Daily) & Patches (Daily)
- Pros: Non-invasive; patches give steady delivery; gels allow simple daily routine.
- Considerations: Skin transfer risk with gels until fully dry; variable absorption for some; patches can irritate skin; adherence is key.
Oral Testosterone (Select Formulations)
- Pros: Pill form convenience.
- Considerations: Not for everyone, specific monitoring needed, cost/coverage vary.
How We Help You Choose
- Goals & Lifestyle: Travel schedule, comfort with self-injection, preference for set-and-forget vs adjustability.
- Medical History & Risks: Cardiometabolic profile, prostate risk discussions per guidelines/age, sleep apnea status, prior hematocrit trends.
- Fertility Planning: If you may want children, we’ll discuss options other than standard TRT before starting.
- Trial & Titrate: Many men start with injections to find the right dose, then decide whether to remain on injections or transition to pellets for convenience.
What Monitoring Looks Like
- Before Starting: Baseline total and free testosterone, LH/FSH (as indicated), hematocrit/hemoglobin, PSA per age/risk, lipids, A1C or fasting glucose, blood pressure.
- After Starting/Adjusting: Recheck labs typically at 6–12 weeks, then every 3–6 months until stable; assess symptoms, side effects, and blood pressure each visit.
- Red Flags To Address Promptly: Rising hematocrit, significant acne/irritability, breast tenderness, edema, or sleep apnea worsening.
Safety, Side Effects & When To Seek Care
Common effects can include acne, oily skin, fluid retention, mood changes, injection site irritation, or elevated hematocrit. Report side effects early — dose/route adjustments usually solve them.
Seek urgent care for chest pain, shortness of breath, severe headache/vision changes, one-sided weakness/numbness, or calf pain/swelling.
Next Steps
Wondering whether pellets or injections fit your life better — and how to optimize dose safely? Let’s map a plan that matches your goals, labs, and schedule.
Ready To Talk It Through? Book A Discovery Call




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