GSRacer
Registered
- Joined
- Jun 18, 2012
- Messages
- 4,584
- Reaction score
- 219
- Points
- 63
- Location
- Anywhere it's cold and snowy
[h=2]I guess I had forgotten how many different delivery methods there are out there for the best things around, Testosterone. This article is from Hudson's FTM guide, which is actually a Female-to-Male resource board. Interestingly, it is one of the better, more thorough reviews I have seen. Enjoy!
....and no, I am not transgendered, I just came across this article while doing some ester research.
[/h][h=2]Testosterone delivery method
Injectable testosterone [/h]The dosage amount and timing for injectable testosterone will depend largely upon which ester is being used, as well as the individual's own response to the hormone. In general, dosages will vary between 50 mg and 300 mg per injection, depending on the ester and the dosing regimen. An average injectable dose is about 200-250 mg every two weeks, though many trans men inject 100 mg every week or every 10 days, or other variations depending on their own bodies' needs and sensitivities. Again, the exact dosage required will vary from person to person, and health and well-being should be carefully monitored while determining an individual's ideal dose.
Some doctors recommend decreasing the dosage of injectables to 100-150 mg every two weeks for those trans men whose ovaries are inactive, or who have had their ovaries removed. Again, this will vary from person to person.
There are a number of different types of injectable testosterone; those available may differ depending on the country in which you reside. The drug names for the same ester of testosterone may also differ depending on the company who produces it. This is not an exhaustive list, though it does cover the main injectable forms of T which are used by trans men for testosterone therapy.
Finally, testosterone esters are typically suspended in either cottonseed oil or sesame seed oil. Some people find that they may have an allergic or skin reaction to one of the oils. Certain brand-name testosterone esters are mass produced using one oil or the other (as noted below), but by using a compounding pharmacy, you can have any testosterone ester suspended in your choice of oil (with a proper prescription).
Injectable esters commonly used by trans men for testosterone therapy:
Transdermal testosterone
The term "transdermal" refers to topical delivery through the skin, by the use of a patch, gel, or cream.
Transdermal testosterone is usually applied to the skin daily in small doses in an effort to keep a steady level of testosterone in the system at all times. This approach avoids the "peaks and valleys" in T-levels sometimes associated with injectable testosterone. With injectables, T levels can reach a low-point a few days before the next shot is due, which can cause irritability, hot flashes, and low energy in some users. Daily transdermal application can help alleviate such problems. Indeed, some trans men who regularly use injectable testosterone sometimes supplement with a gel or patch during the last few days of their dosing cycle to maintain their T levels.
Transdermal application is also attractive to those individuals who are not comfortable with needles and injections.
However, there are some disadvantages to transdermal delivery. Some forms of daily transdermal testosterone application, particularly the patch, are substantially more expensive than injectable testosterone. Testosterone patches often cause skin irritation and/or allergic reactions to users. They can fall off with excessive sweating, and they must be fully protected with plastic when swimming. Testosterone cream and gel can be transferred by direct skin contact with a partner; special care must be taken with female partners who wish to avoid potential virilization.
Testosterone patches
There are currently two brand-name testosterone patches available in the United States: "Androderm" and "Testoderm." (Note that there are two forms of Testoderm available: a scrotal patch and a non-scrotal patch. The non-scrotal patch, "Testoderm TTS," is described herein). Generic testosterone patches are not yet available. Both Androderm and Testoderm TTS are very fast-acting once they have permeated the skin. The testosterone in the patches is suspended in an alcohol-based gel.
In order to deliver testosterone efficiently into the body, chemical enhancers are added to the patch to increase permeability of the skin. It is these enhancers that are often the cause of skin irritation in many users. Some individuals find Testoderm TTS to be less irritating to the skin than Androderm, but this will vary from person to person.
There are currently two brand-name versions of testosterone gel available in the United States: Androgel and Testim. There are no brand-name testosterone creams at this time. Both cream and gel formulations of testosterone can be made by compounding pharmacies. ) Gel formulations of testosterone are typically alcohol-based, whereas creams are typically safflower oil-based. The testosterone in creams and gels is typically very fast-acting once absorbed through the skin. Thus, it must be applied once or twice daily to maintain T levels.
Creams and gels are applied directly onto the skin. Care must be taken to avoid skin-to-skin contact with a partner on the site of application. Transfer of the testosterone from the site can be prevented by keeping the area covered.
Oral testosterone
Chemically unbound testosterone, if taken orally, is not effective for masculinization since it is immediately deactivated by the liver. However, two chemically-modified forms of testosterone have been successfully shown to induce masculine secondary sex characteristics when taken orally: methyltestosterone and testosterone undecanoate.
Sublingual/buccal testosterone
Sublingual and buccal testosterone delivery works by either placing a dissolving tablet under your tongue (sublingual) or by placing a tablet against the surface of the gums (buccal). It is different from oral delivery in that very little of the substance is swallowed, avoiding potential liver toxicity.
Subcutaneous testosterone pellet
Another relatively new form of testosterone delivery is via a pellet of pure, crystalline testosterone implanted beneath the skin. The pellets are about the size of a grain of rice, and are typically placed in the buttocks or abdomen. The insertion of the pellets is a quick procedure, usually done under local anesthesia. Pellets are typically replaced after 3-4 months. "Testopel" is a brand name for testosterone pellets in the United States.
A 200 mg testosterone pellet releases testosterone at a steady rate of 1-3 mg per day. Several pellets can be inserted at the same time to increase dosage.
Some users have reported problems with the pellets working their way out from under the skin.
....and no, I am not transgendered, I just came across this article while doing some ester research.
[/h][h=2]Testosterone delivery methodInjectable testosterone [/h]The dosage amount and timing for injectable testosterone will depend largely upon which ester is being used, as well as the individual's own response to the hormone. In general, dosages will vary between 50 mg and 300 mg per injection, depending on the ester and the dosing regimen. An average injectable dose is about 200-250 mg every two weeks, though many trans men inject 100 mg every week or every 10 days, or other variations depending on their own bodies' needs and sensitivities. Again, the exact dosage required will vary from person to person, and health and well-being should be carefully monitored while determining an individual's ideal dose.
Some doctors recommend decreasing the dosage of injectables to 100-150 mg every two weeks for those trans men whose ovaries are inactive, or who have had their ovaries removed. Again, this will vary from person to person.
There are a number of different types of injectable testosterone; those available may differ depending on the country in which you reside. The drug names for the same ester of testosterone may also differ depending on the company who produces it. This is not an exhaustive list, though it does cover the main injectable forms of T which are used by trans men for testosterone therapy.
Finally, testosterone esters are typically suspended in either cottonseed oil or sesame seed oil. Some people find that they may have an allergic or skin reaction to one of the oils. Certain brand-name testosterone esters are mass produced using one oil or the other (as noted below), but by using a compounding pharmacy, you can have any testosterone ester suspended in your choice of oil (with a proper prescription).
Injectable esters commonly used by trans men for testosterone therapy:
Testosterone enanthate: Chemical formula C[SUB]26[/SUB]H[SUB]40[/SUB]O[SUB]3[/SUB]
Testosterone enanthate is one of the main forms of testosterone prescribed to trans men in the United States. It is a slow-acting ester with a release time between 8-10 days. The name-brand of T-enanthate available in the United States is called "Delatestryl," which is suspended in sesame oil. Testosterone enanthate is typically injected anywhere between once every week to once every three weeks. Generic testosterone enanthate can also be obtained through a compounding pharmacy; such pharmacies can mix T-enanthate in sesame, cotton seed, or any other appropriate oil.
Testosterone cypionate: Chemical formula C[SUB]27[/SUB]H[SUB]40[/SUB]O[SUB]3[/SUB]
Testosterone cypionate is the other main injectable form of testosterone prescribed to trans men in the United States. It is a slow-acting ester with a release time between 8-10 days, similar to that of enanthate. The name-brand of T-cypionate available in the United States is called "Depo-Testosterone," which is suspended in cottonseed oil. Testosterone cypionate is typically injected anywhere between once every week to once every three weeks. Generic testosterone cypionate can also be obtained through a compounding pharmacy; such pharmacies can mix T-cypionate in sesame, cotton seed, or any other appropriate oil.)
Sustanon
"Sustanon" is the brand name for two formulas of injectable testosterone that contain a blend of esters. "Sustanon 100" contains three testosterone esters: testosterone propionate (C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]), testosterone phenylpropionate (C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]), and testosterone isocaproate (C[SUB]25[/SUB]H[SUB]38[/SUB]0[SUB]3[/SUB]). "Sustanon 250" contains four testosterone esters: testosterone propionate (C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]), testosterone phenylpropionate (C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]), testosterone isocaproate (C[SUB]25[/SUB]H[SUB]38[/SUB]0[SUB]3[/SUB]), and testosterone decanoate (C[SUB]29[/SUB]H[SUB]46[/SUB]0[SUB]3[/SUB]). Both formulas feature fast-acting and slow-acting esters, and can be injected anywhere from once every week to once every four weeks. Sustanon is prescribed outside of the United States.
Other injectable esters of testosterone:Testosterone enanthate is one of the main forms of testosterone prescribed to trans men in the United States. It is a slow-acting ester with a release time between 8-10 days. The name-brand of T-enanthate available in the United States is called "Delatestryl," which is suspended in sesame oil. Testosterone enanthate is typically injected anywhere between once every week to once every three weeks. Generic testosterone enanthate can also be obtained through a compounding pharmacy; such pharmacies can mix T-enanthate in sesame, cotton seed, or any other appropriate oil.
Testosterone cypionate: Chemical formula C[SUB]27[/SUB]H[SUB]40[/SUB]O[SUB]3[/SUB]
Testosterone cypionate is the other main injectable form of testosterone prescribed to trans men in the United States. It is a slow-acting ester with a release time between 8-10 days, similar to that of enanthate. The name-brand of T-cypionate available in the United States is called "Depo-Testosterone," which is suspended in cottonseed oil. Testosterone cypionate is typically injected anywhere between once every week to once every three weeks. Generic testosterone cypionate can also be obtained through a compounding pharmacy; such pharmacies can mix T-cypionate in sesame, cotton seed, or any other appropriate oil.)
Sustanon
"Sustanon" is the brand name for two formulas of injectable testosterone that contain a blend of esters. "Sustanon 100" contains three testosterone esters: testosterone propionate (C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]), testosterone phenylpropionate (C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]), and testosterone isocaproate (C[SUB]25[/SUB]H[SUB]38[/SUB]0[SUB]3[/SUB]). "Sustanon 250" contains four testosterone esters: testosterone propionate (C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]), testosterone phenylpropionate (C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]), testosterone isocaproate (C[SUB]25[/SUB]H[SUB]38[/SUB]0[SUB]3[/SUB]), and testosterone decanoate (C[SUB]29[/SUB]H[SUB]46[/SUB]0[SUB]3[/SUB]). Both formulas feature fast-acting and slow-acting esters, and can be injected anywhere from once every week to once every four weeks. Sustanon is prescribed outside of the United States.
Testosterone propionate: Chemical formula C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]
Testosterone propionate is a fast-acting ester with a release time of 3-4 days. To keep blood levels from fluctuating greatly, propionate is usually injected between one to three times a week. It is for this reason that it is not usually prescribed for FTM hormone therapy. Some users also report that propionate is a more painful injection, with swelling and noticeable pain around the injection site. Brand names of testosterone propionate include "Testovis" and "Virormone."
Testosterone phenylpropionate: Chemical formula C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]
Testosterone phenylpropionate is a slow-acting ester, with a release time of 1-3 weeks. A popular name brand for T-phenylpropionate is "Testolent." Testosterone phenylpropionate is also one of the components of Sustanon and Omnadren.
Omnadren
"Omnadren" is the brand name for a blend of four testosterone esters: testosterone propionate (C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]), testosterone phenylpropionate (C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]), testosterone isocaproate (C[SUB]25[/SUB]H[SUB]38[/SUB]0[SUB]3[/SUB]), and testosterone decanoate (C[SUB]29[/SUB]H[SUB]46[/SUB]0[SUB]3[/SUB]). In the past, Omnadren consisted of a blend of different esters, but now is essentially the same formula as Sustanon, mentioned above. It features both fast-acting and slow-acting esters, and can be injected anywhere from once every week to once every four weeks. It is sometimes prescribed in parts of Europe.
Aqueous testosterone suspension
In the United States, injectable aqueous (non-esterified) testosterone is available, but it is very short-acting (it is completely released in the system within a matter of hours). Therefore, it is not typically used for men in transition, as it would require constant re-injection to maintain regular blood levels. The brand name for aqueous testosterone suspension is "Aquaviron."
Testosterone propionate is a fast-acting ester with a release time of 3-4 days. To keep blood levels from fluctuating greatly, propionate is usually injected between one to three times a week. It is for this reason that it is not usually prescribed for FTM hormone therapy. Some users also report that propionate is a more painful injection, with swelling and noticeable pain around the injection site. Brand names of testosterone propionate include "Testovis" and "Virormone."
Testosterone phenylpropionate: Chemical formula C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]
Testosterone phenylpropionate is a slow-acting ester, with a release time of 1-3 weeks. A popular name brand for T-phenylpropionate is "Testolent." Testosterone phenylpropionate is also one of the components of Sustanon and Omnadren.
Omnadren
"Omnadren" is the brand name for a blend of four testosterone esters: testosterone propionate (C[SUB]22[/SUB]H[SUB]32[/SUB]O[SUB]3[/SUB]), testosterone phenylpropionate (C[SUB]28[/SUB]H[SUB]36[/SUB]O[SUB]3[/SUB]), testosterone isocaproate (C[SUB]25[/SUB]H[SUB]38[/SUB]0[SUB]3[/SUB]), and testosterone decanoate (C[SUB]29[/SUB]H[SUB]46[/SUB]0[SUB]3[/SUB]). In the past, Omnadren consisted of a blend of different esters, but now is essentially the same formula as Sustanon, mentioned above. It features both fast-acting and slow-acting esters, and can be injected anywhere from once every week to once every four weeks. It is sometimes prescribed in parts of Europe.
Aqueous testosterone suspension
In the United States, injectable aqueous (non-esterified) testosterone is available, but it is very short-acting (it is completely released in the system within a matter of hours). Therefore, it is not typically used for men in transition, as it would require constant re-injection to maintain regular blood levels. The brand name for aqueous testosterone suspension is "Aquaviron."
Transdermal testosterone
The term "transdermal" refers to topical delivery through the skin, by the use of a patch, gel, or cream.
Transdermal testosterone is usually applied to the skin daily in small doses in an effort to keep a steady level of testosterone in the system at all times. This approach avoids the "peaks and valleys" in T-levels sometimes associated with injectable testosterone. With injectables, T levels can reach a low-point a few days before the next shot is due, which can cause irritability, hot flashes, and low energy in some users. Daily transdermal application can help alleviate such problems. Indeed, some trans men who regularly use injectable testosterone sometimes supplement with a gel or patch during the last few days of their dosing cycle to maintain their T levels.
Transdermal application is also attractive to those individuals who are not comfortable with needles and injections.
However, there are some disadvantages to transdermal delivery. Some forms of daily transdermal testosterone application, particularly the patch, are substantially more expensive than injectable testosterone. Testosterone patches often cause skin irritation and/or allergic reactions to users. They can fall off with excessive sweating, and they must be fully protected with plastic when swimming. Testosterone cream and gel can be transferred by direct skin contact with a partner; special care must be taken with female partners who wish to avoid potential virilization.
Testosterone patches
There are currently two brand-name testosterone patches available in the United States: "Androderm" and "Testoderm." (Note that there are two forms of Testoderm available: a scrotal patch and a non-scrotal patch. The non-scrotal patch, "Testoderm TTS," is described herein). Generic testosterone patches are not yet available. Both Androderm and Testoderm TTS are very fast-acting once they have permeated the skin. The testosterone in the patches is suspended in an alcohol-based gel.
In order to deliver testosterone efficiently into the body, chemical enhancers are added to the patch to increase permeability of the skin. It is these enhancers that are often the cause of skin irritation in many users. Some individuals find Testoderm TTS to be less irritating to the skin than Androderm, but this will vary from person to person.
Androderm
Androderm patches come in two doses: 2.5 mg/patch and 5.0 mg/patch. The actual amount of testosterone in the 2.5 mg patch is 12.2 mg, and the actual amount in the 5.0 mg patch is 24.3 mg. The reason is that much of the testosterone in the patch will not manage to get into the system. So, for example, the aim of the 2.5 mg patch is to get about 2.5 mg successfully into the bloodstream per day. Therefore, it is possible to absorb slightly more or slightly less than the 2.5 mg of the patch's ideal dosage (the same reasoning, of course, applies to the 5.0 mg patch as well).
Androderm patches are usually applied on the back, abdomen, thighs, or upper arms. Because the active area of the patch is covered, the wearer does not have to worry about skin contact with a partner. Dosages will vary between 2.5 mg - 10 mg daily, by applying a single patch or combination of patches. As with any form of testosterone, dosage should be determined by your overall health, your testosterone levels as checked by your doctor, and your progress in masculinization.
Testoderm TTS
There are two types of Testoderm patches: one is intended for scrotal application, and one for application on other areas of the body. Testoderm TTS refers to the non-scrotal version of the patch-- this is the patch that should be used by trans men.
Testoderm TTS patches come in two doses: 4.0 mg/patch and 6.0 mg/patch. As with Androderm, the actual amount of testosterone in these patches is greater than the listed dose. The reason is the same as explained above in the Androderm section.
Testoderm TTS patches are usually applied on the back, abdomen, thighs, or upper arms. Because the active area of the patch is covered, the wearer does not have to worry about skin contact with a partner. Dosages will vary between 4.0 mg - 10 mg daily, by applying a single patch or combination of patches. As with any form of testosterone, dosage should be determined by your overall health, your testosterone levels as checked by your doctor, and your progress in masculinization.
Testosterone gel and creamAndroderm patches come in two doses: 2.5 mg/patch and 5.0 mg/patch. The actual amount of testosterone in the 2.5 mg patch is 12.2 mg, and the actual amount in the 5.0 mg patch is 24.3 mg. The reason is that much of the testosterone in the patch will not manage to get into the system. So, for example, the aim of the 2.5 mg patch is to get about 2.5 mg successfully into the bloodstream per day. Therefore, it is possible to absorb slightly more or slightly less than the 2.5 mg of the patch's ideal dosage (the same reasoning, of course, applies to the 5.0 mg patch as well).
Androderm patches are usually applied on the back, abdomen, thighs, or upper arms. Because the active area of the patch is covered, the wearer does not have to worry about skin contact with a partner. Dosages will vary between 2.5 mg - 10 mg daily, by applying a single patch or combination of patches. As with any form of testosterone, dosage should be determined by your overall health, your testosterone levels as checked by your doctor, and your progress in masculinization.
Testoderm TTS
There are two types of Testoderm patches: one is intended for scrotal application, and one for application on other areas of the body. Testoderm TTS refers to the non-scrotal version of the patch-- this is the patch that should be used by trans men.
Testoderm TTS patches come in two doses: 4.0 mg/patch and 6.0 mg/patch. As with Androderm, the actual amount of testosterone in these patches is greater than the listed dose. The reason is the same as explained above in the Androderm section.
Testoderm TTS patches are usually applied on the back, abdomen, thighs, or upper arms. Because the active area of the patch is covered, the wearer does not have to worry about skin contact with a partner. Dosages will vary between 4.0 mg - 10 mg daily, by applying a single patch or combination of patches. As with any form of testosterone, dosage should be determined by your overall health, your testosterone levels as checked by your doctor, and your progress in masculinization.
There are currently two brand-name versions of testosterone gel available in the United States: Androgel and Testim. There are no brand-name testosterone creams at this time. Both cream and gel formulations of testosterone can be made by compounding pharmacies. ) Gel formulations of testosterone are typically alcohol-based, whereas creams are typically safflower oil-based. The testosterone in creams and gels is typically very fast-acting once absorbed through the skin. Thus, it must be applied once or twice daily to maintain T levels.
Creams and gels are applied directly onto the skin. Care must be taken to avoid skin-to-skin contact with a partner on the site of application. Transfer of the testosterone from the site can be prevented by keeping the area covered.
Androgel
Androgel is a clear, alcohol-based gel that contains 1% non-esterified testosterone. It is very fast-acting once it has been absorbed by the skin, and so must be applied 1-2 times daily to maintain T levels. It is available in either unit-dose packets or multiple-dose pumps. The unit dose packets contain either 25 mg or 50 mg of testosterone. Approximately 10% of the applied testosterone from the packets is absorbed into the system, resulting in an effective dose of 2.5 mg or 5.0 mg, respectively.
Androgel should be applied to clean, dry skin and should not be applied to the genital area. Application sites should be allowed to dry for a few minutes prior to dressing. Hands should be washed thoroughly with soap and water after application.
In order to prevent transfer to another person, clothing should be worn to cover the application sites. If direct skin-to-skin contact with another person is anticipated, the application sites should be washed thoroughly with soap and water. Users should wait at least 2 hours after applying before showering or swimming; for optimal absorption, it may be best to wait 5-6 hours.
Testim
Testim, like Androgel, is a clear, alcohol-based gel that contains 1% non-esterified testosterone. It is very fast-acting once it has been absorbed by the skin, and so must be applied 1-2 times daily to maintain T levels. It is available in 5.0g unit-dose tubes. A 5.0g unit dose tube contains 50 mg of testosterone. Approximately 10% of the applied testosterone from the tube is absorbed into the system, resulting in an effective dose of 5.0 mg.
Testim should be applied to clean, dry skin-- preferably to the shoulders and/or upper arms. It should not be applied to the genitals or to the abdomen. Application sites should be allowed to dry for a few minutes prior to dressing. Hands should be washed thoroughly with soap and water after application.
In order to prevent transfer to another person, clothing should be worn to cover the application sites. If direct skin-to-skin contact with another person is anticipated, the application sites should be washed thoroughly with soap and water. Users should wait at least 2 hours after applying before showering or swimming; for optimal absorption, it may be best to wait 5-6 hours.
Compounded creams and gels
Compounded creams and gels can be mixed by compounding pharmacies, and are similar in dosing, application, and precautions to what is described above for Androgel and Testim.
There are two advantages of using compounding pharmacies for testosterone gel or cream. The first is cost: until a generic version of the gel is available, compounded gel will usually be the cheaper alternative. The second is customization: your doctor can write a prescription of varying concentration for gels or creams.
Androgel is a clear, alcohol-based gel that contains 1% non-esterified testosterone. It is very fast-acting once it has been absorbed by the skin, and so must be applied 1-2 times daily to maintain T levels. It is available in either unit-dose packets or multiple-dose pumps. The unit dose packets contain either 25 mg or 50 mg of testosterone. Approximately 10% of the applied testosterone from the packets is absorbed into the system, resulting in an effective dose of 2.5 mg or 5.0 mg, respectively.
Androgel should be applied to clean, dry skin and should not be applied to the genital area. Application sites should be allowed to dry for a few minutes prior to dressing. Hands should be washed thoroughly with soap and water after application.
In order to prevent transfer to another person, clothing should be worn to cover the application sites. If direct skin-to-skin contact with another person is anticipated, the application sites should be washed thoroughly with soap and water. Users should wait at least 2 hours after applying before showering or swimming; for optimal absorption, it may be best to wait 5-6 hours.
Testim
Testim, like Androgel, is a clear, alcohol-based gel that contains 1% non-esterified testosterone. It is very fast-acting once it has been absorbed by the skin, and so must be applied 1-2 times daily to maintain T levels. It is available in 5.0g unit-dose tubes. A 5.0g unit dose tube contains 50 mg of testosterone. Approximately 10% of the applied testosterone from the tube is absorbed into the system, resulting in an effective dose of 5.0 mg.
Testim should be applied to clean, dry skin-- preferably to the shoulders and/or upper arms. It should not be applied to the genitals or to the abdomen. Application sites should be allowed to dry for a few minutes prior to dressing. Hands should be washed thoroughly with soap and water after application.
In order to prevent transfer to another person, clothing should be worn to cover the application sites. If direct skin-to-skin contact with another person is anticipated, the application sites should be washed thoroughly with soap and water. Users should wait at least 2 hours after applying before showering or swimming; for optimal absorption, it may be best to wait 5-6 hours.
Compounded creams and gels
Compounded creams and gels can be mixed by compounding pharmacies, and are similar in dosing, application, and precautions to what is described above for Androgel and Testim.
There are two advantages of using compounding pharmacies for testosterone gel or cream. The first is cost: until a generic version of the gel is available, compounded gel will usually be the cheaper alternative. The second is customization: your doctor can write a prescription of varying concentration for gels or creams.
Oral testosterone
Chemically unbound testosterone, if taken orally, is not effective for masculinization since it is immediately deactivated by the liver. However, two chemically-modified forms of testosterone have been successfully shown to induce masculine secondary sex characteristics when taken orally: methyltestosterone and testosterone undecanoate.
Methyltestosterone (C-17 alpha methylated testosterone)
Methyltestosterone is one of the earliest available oral testosterones. Its chemical structure is the hormone testosterone with an added methyl group at the c-17 alpha position of the molecule. The use of oral c-17 alpha methylated testosterone for masculinization is obsolete due to its toxicity to the liver. As such, methyltestosterone is not recommended for FTM hormone therapy. Brand names include "Metesto," "Methitest," "Testred," "Oreton Methyl," and "Android."
Testosterone undecanoate
Testosterone undecanoate is not a c-17 alpha alkylated hormone. Therefore, it is considered a safer oral form of testosterone. It is designed to be absorbed through the small intestine into the lymphatic system, posing less burden on the liver. Brand names for testosterone undecanoate include "Andriol," "Androxon," "Understor," "Restandol," and "Restinsol." It is not available in the United States.
One disadvantage of orally administered undecanoate is that it is eliminated from the body very quickly, usually in 3-4 hours. Thus, frequent administration is necessary-- usually between 3-6 capsules a day. This can prove to be expensive when compared to injectable testosterone.
Finally, when used in FTM hormone therapy, it has been reported that oral testosterone undecanoate has not always been successful in suppression of menstruation.
Methyltestosterone is one of the earliest available oral testosterones. Its chemical structure is the hormone testosterone with an added methyl group at the c-17 alpha position of the molecule. The use of oral c-17 alpha methylated testosterone for masculinization is obsolete due to its toxicity to the liver. As such, methyltestosterone is not recommended for FTM hormone therapy. Brand names include "Metesto," "Methitest," "Testred," "Oreton Methyl," and "Android."
Testosterone undecanoate
Testosterone undecanoate is not a c-17 alpha alkylated hormone. Therefore, it is considered a safer oral form of testosterone. It is designed to be absorbed through the small intestine into the lymphatic system, posing less burden on the liver. Brand names for testosterone undecanoate include "Andriol," "Androxon," "Understor," "Restandol," and "Restinsol." It is not available in the United States.
One disadvantage of orally administered undecanoate is that it is eliminated from the body very quickly, usually in 3-4 hours. Thus, frequent administration is necessary-- usually between 3-6 capsules a day. This can prove to be expensive when compared to injectable testosterone.
Finally, when used in FTM hormone therapy, it has been reported that oral testosterone undecanoate has not always been successful in suppression of menstruation.
Sublingual/buccal testosterone
Sublingual and buccal testosterone delivery works by either placing a dissolving tablet under your tongue (sublingual) or by placing a tablet against the surface of the gums (buccal). It is different from oral delivery in that very little of the substance is swallowed, avoiding potential liver toxicity.
Sublingual
Sublingual testosterone can be obtained through compounding pharmacies. (For more information about compounding pharmacies, click here.)
Buccal
In 2003, the FDA approved a sustained-release buccal testosterone tablet called "Striant." It acts by adhering to the buccal mucosa (the small depression in the mouth where the gum meets the upper lip above the incisor teeth). Once applied, the tablet softens and delivers testosterone through the buccal mucosa, where it is then absorbed directly into the bloodstream, bypassing the gastrointestinal system and liver.
The recommended dosage for Striant is to replace the tablet about every 12 hours, though a different dosing schedule or number of tablets might be required depending on the needs of the patient.
Sublingual testosterone can be obtained through compounding pharmacies. (For more information about compounding pharmacies, click here.)
Buccal
In 2003, the FDA approved a sustained-release buccal testosterone tablet called "Striant." It acts by adhering to the buccal mucosa (the small depression in the mouth where the gum meets the upper lip above the incisor teeth). Once applied, the tablet softens and delivers testosterone through the buccal mucosa, where it is then absorbed directly into the bloodstream, bypassing the gastrointestinal system and liver.
The recommended dosage for Striant is to replace the tablet about every 12 hours, though a different dosing schedule or number of tablets might be required depending on the needs of the patient.
Subcutaneous testosterone pellet
Another relatively new form of testosterone delivery is via a pellet of pure, crystalline testosterone implanted beneath the skin. The pellets are about the size of a grain of rice, and are typically placed in the buttocks or abdomen. The insertion of the pellets is a quick procedure, usually done under local anesthesia. Pellets are typically replaced after 3-4 months. "Testopel" is a brand name for testosterone pellets in the United States.
A 200 mg testosterone pellet releases testosterone at a steady rate of 1-3 mg per day. Several pellets can be inserted at the same time to increase dosage.
Some users have reported problems with the pellets working their way out from under the skin.
