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Administration method | Formulation | Advantages | Disadvantages |
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Transdermal agents | Testosterone patches | Mimics circadian rhythm; simple administration | Skin 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 range | Transfer during intimate contact; direct contact with children and women should be avoided, daily administration |
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Subcutaneous agents | Implants | Implants are inserted every 16 to 24 weeks | Invasive procedure with risk of extrusion and infection |
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Intramuscular injections | Testosterone cypionate | Relatively low cost | Pain and redness at injection site; fluctuations in circulating T levels high risk of polycythemia; |
Testosterone enanthate | Relatively low cost | Pain and redness at injection site; fluctuations in circulating T levels, high risk of polycythemia |
Testosterone undecanoate | Less frequent administration, T levels maintained in normal range | Pain at intramuscular injection site |
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Buccal formulation agents | Buccal testosterone | Provides sustained release of T; through the buccal mucosa | Unpleasant taste, can stick to gums, gum pain, or tenderness, headache |
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Oral formulation agents | Methyltestosterone | Oral; modifiable dosage, relatively low cost | Potential hepatotoxicity, drug not in use, may adversely affect lipid profile, decreasing HDL, and increasing LDL |
Testosterone undecanoate | Oral; (approved in the Europe) | Variable clinical effects and testosterone levels must be taken with meals, nonaromatizable to estrogen, Underevaluation in the United States |
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