Table 3: Advantages and disadvantages of testosterone preparations.

Administration methodFormulationAdvantages Disadvantages

Transdermal agentsTestosterone patchesMimics circadian rhythm; simple administrationSkin irritation, occasional allergic contact dermatitis, daily administration
Testosterone gel 1-2%Easy to apply, readily absorbed into skin. Flexible-dose modifications, skin irritation less common, T levels maintained in normal range.Transfer during intimate contact; direct contact with children and women should be avoided; skin irritation at the application site in a small number of men, daily administration
Underarm testosterone gel Skin irritation less common, T levels maintained in normal rangeTransfer during intimate contact; direct contact with children and women should be avoided, daily administration

Subcutaneous agentsImplantsImplants are inserted every 16 to 24 weeksInvasive procedure with risk of extrusion and infection

Intramuscular injectionsTestosterone cypionateRelatively low costPain and redness at injection site; fluctuations in circulating T levels high risk of polycythemia;
Testosterone enanthateRelatively low costPain and redness at injection site; fluctuations in circulating T levels, high risk of polycythemia
Testosterone undecanoateLess frequent administration, T levels maintained in normal rangePain at intramuscular injection site

Buccal formulation agentsBuccal testosteroneProvides sustained release of T; through the buccal mucosaUnpleasant taste, can stick to gums, gum pain, or tenderness, headache

Oral formulation agentsMethyltestosteroneOral; modifiable dosage, relatively low costPotential hepatotoxicity, drug not in use, may adversely affect lipid profile, decreasing HDL, and increasing LDL
Testosterone undecanoateOral; (approved in the Europe)Variable clinical effects and testosterone levels must be taken with meals, nonaromatizable to estrogen, Underevaluation in the United States

Abbreviations: T: Testosterone; High Density Lipoprotein: HDL; Low Density Lipoprotein: LDL.