Key Takeaways
- Testosterone replacement therapy (TRT) is available in multiple forms, including oral pills, injections, topical gels, creams, and nasal sprays. Each has different benefits and drawbacks, depending on various factors.
- While many forms of TRT can negatively affect fertility, some newer options, like Maximus Oral TRT+ offer a more fertility-friendly alternative.
- Each form of TRT comes with specific side effects and risks. Before taking TRT, it’s extremely important to consult with a doctor to find the right therapy and learn about any potential side effects.
Have you started to notice that your energy is lagging or your sex drive is a bit sluggish? Maybe you’re feeling a little heavier since the last time you stepped on a scale? These symptoms can arise for many reasons, including if your testosterone production is slowing down. Many men experience a 1 to 2% drop in testosterone levels each year after hitting their 30s and 40s, but you can experience symptoms of low testosterone at any time. In many cases, testosterone replacement therapy, or TRT, can help.
Whether you’ve been diagnosed with hypogonadism or are experiencing symptoms of low testosterone, like low libido, fewer spontaneous erections, sexual dysfunction, shrinking testes, and patchy or sparse beard hair growth, TRT may be an option for you. When you’re on TRT, you may see improvements in libido, erectile function, sexual satisfaction, energy levels, muscle mass, memory, concentration, and more.
If you’re interested in testosterone replacement therapy, you’ll want to speak with a doctor to learn more about whether it’s right for you. Keep reading to learn more about the different forms of TRT, including how each works and what to expect.
What are the different types of testosterone replacement therapy?
Many different kinds of TRT are available in the U.S. today, such as oral TRT, TRT injections, transdermal gels, creams, and more. Here’s some more information on each:
Oral TRT
Oral TRT is a prescription medication that is prescribed to treat the symptoms of hypogonadism, or low testosterone. Research shows that some forms of oral testosterone are among the least suppressive forms of TRT. In fact, some forms of oral testosterone maintain LH and FSH (which are markers of fertility) within normal limits, despite a decrease from baseline, research shows, with the researchers suggesting that this could result in less suppression of spermatogenesis. Other forms have maintained FSH and LH within range for 40% and 41% of men, respectively.
Oral TRT pills are typically taken daily with a high-fat meal to to help with lymphatic absorption. Lymphatic absorption takes place in the GI tract before the medication hits the liver, allowing for the oral testosterone to be liver friendly.
Maximus’ Oral TRT+ Protocol contains native testosterone, enclomiphene, and pregnenolone. The benefit of combining oral testosterone with enclomiphene is that it helps men maintain fertility markers and testicular function while benefiting from exogenous testosterone.
Potential side effects and safety concerns:
Early forms of oral TRT were discontinued due to a risk of liver damage, but newer versions of oral TRT bypass the liver and are instead absorbed by the lymphatic system.
The side effects of oral TRT are generally mild and may include things like headaches, stomach upset, and increased blood pressure. As with other forms of TRT, oral TRT may lower your fertility. As mentioned, Maximus’ Oral TRT+ Protocol combines oral testosterone with enclomiphene to offer a more fertility-friendly option.
TRT injections
For a long time, testosterone injections were seen as the gold standard treatment for low testosterone. Though they can boost T levels significantly, there are some drawbacks, like potentially annoying injections, increased blood viscosity through elevated hematocrit, and the risk of harming fertility.
These intramuscular testosterone injections are typically done once or twice weekly, often beginning with 50-100mg doses. The dosing has to be adjusted individually to avoid increases in downstream hormones like estrogen and DHT, which can cause gynecomastia, mood swings, and hair loss. . After taking TRT injections, subjects in studies noticed increases in muscle mass, decreased fat, as well as improved sexual function.
With testosterone injections, testosterone levels stay elevated for long periods of time and then slowly decrease before the next injection. This is different than the natural increase of testosterone production early in the day, peaking around 10 am to 12 pm, and then slowly decreasing by the time you head to sleep.
Potential side effects and safety concerns:
Some injectable testosterone therapies have been associated with libido, energy, and mood fluctuations. Other potential side effects include swelling and muscle scarring at the injection site, and allergic reactions. Additionally, research shows that long-term testosterone injections can have a negative impact on fertility and sperm quality.
Topical TRT gels and creams
Testosterone gels and creams are a common form of TRT prescribed to help men maintain serum testosterone concentrations, whether to treat symptoms of low testosterone or diagnosed hypogonadism. When you apply testosterone gels to your skin’s surface, the product is absorbed through your skin, where it then enters the bloodstream to help your body increase your testosterone levels. These products come in many forms and should be applied as directed. Most commonly, they’re applied at least once per day to clean, dry, thick skin on places like the upper arms and shoulders, and sometimes on the scrotal region. Each brand has different instructions, so you’ll want to follow your doctor’s recommendations for where to apply your testosterone gel.
Potential side effects and safety concerns:
One concern with TRT gels is that the medication can easily be transferred to someone else if it comes in contact with their skin. Some studies found that when men’s skin came in contact with their young children, the testosterone gel transferred to their children’s skin and led to early onset puberty. Now, testosterone gel products include warnings to avoid this potential health risk.
To avoid accidental transfer, It’s important to wash your hands before and after applying TRT gel and to wear clothing or wash the area where you applied the product before coming in contact with someone else’s skin.
Nasal testosterone replacement therapy
Nasal testosterone gels are used to treat the symptoms of low testosterone. You take this medication by spraying it into each nostril three times a day after swabbing your nose clean. It’s important not to blow your nose or sniff for an hour after spraying the medication into your nasal cavities.
Potential side effects and safety concerns:
Nasal testosterone gels carry side effects like a possible increased risk of nasal problems like a runny nose and congestion, cough, and sinus infections. Nasal testosterone gels can also interact with other medications, like other nasal sprays, diabetes medications, and steroids. So it’s important to tell your doctor about all the medications you take.
How to choose between the different forms of TRT
Chat with your doctor or a health professional at Maximus to learn more about whether testosterone replacement therapy is recommended for you and will help with your symptoms as well as your goals.
You can discuss the different forms of TRT with your physician, including the pros and cons of each, and they might make certain recommendations based on your health history, symptoms, lifestyle preferences, as well as specific concerns, like fertility.
Learn more about Maximus’ Testosterone Protocol and Oral TRT+ Protocol.
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