There are four different ways to replace testosterone in the body that are approved in Canada:
- Through the skin by application of a gel, solution or wearing a patch
- Injection with a needle
- Orally by swallowing a capsule
- Intranasal application of nasal gel
Which treatment you choose depends on what you and your doctor determine is appropriate based upon your lifestyle needs and preferences.
Only your doctor can determine if you have Low T. Low T is diagnosed based upon a set of specific symptoms3 and a blood test3 to indicate that your testosterone level is below a normal range.
Testosterone replacement therapy is not recommended to be used in all men. Men with illness that involve the prostate, heart, kidney or liver will be assessed by their doctor to determine if testosterone therapy is appropriate for them.7
Be sure to speak to your doctor about your heart health; specifically if you have heart or blood vessel problems or a history of heart attack(s), stroke or blood clot(s) in the lung(s) or leg(s).7, 10-12
Have suspected or known prostate cancer 7-13 Have breast cancer 7-14
For a full list of side effects associated with testosterone replacement therapy please consult the specific patient information provided with your medication. Alternatively consult your doctor or pharmacist.
If you are currently receiving testosterone replacement therapy and experience any unexpected effects you should contact your doctor or pharmacist.
Description
Testosterone gels are applied daily to upper arms and shoulders. The testosterone in the gel is absorbed into the body through the skin.
There are two kinds of gels available in Canada, one available in either multiple dose pumps or single dose packets and the other available in single dose tubes.
Dosage
Once a day, usually in the morning.
Benefit
Ease of topical application.
Risk
It's important to make sure the gel doesn't transfer to others. Patients should cover application sites with clothing and wash skin and hands with soap before having skin-to-skin contact with another person.
Application site reactions may occur in patients who use testosterone gels.
Description
Testosterone nasal gel is applied intranasally into the nostril.
The testosterone gel is absorbed into the body through the nose.
Dosage
One actuation in each nostril twice a day (morning and evening) or three times a day (morning, afternoon and evening).
Benefit
Testosterone levels reach normal range
No risk of transference
Absorbs quickly
Risk
Testosterone levels dip at end of dosing period
Temporarily discontinue use if severe rhinitis occurs
Nasal adverse reactions may occur
Two or three times daily administration
Description
Testosterone solution is applied daily to the skin of the underarm using a no-touch applicator. The testosterone in the solution is absorbed into the body through the skin.
Dosage
Once a day, usually in the morning. One to four applications alternating between armpits.
When repeated application to the same armpit is required, the underarm should be allowed to dry completely between applications.
Benefit
Ease of topical application.
Risk
It’s important to make sure the solution doesn’t transfer to others. Patients should cover application sites with clothing and wash skin and hands with soap before having skin-to-skin contact with another person.
Application site reactions may occur in patients who use testosterone solution.
Description
Patches allow testosterone to be absorbed by the skin.
Dosage
One (or two) patches are applied nightly on non pressure areas.
Benefit
Ease of topical application.
Risk
Skin irritation at the application site may occur in patients who use testosterone patches.
Description
Testosterone is given as an injection, by a health care professional only, deep in the buttock.
Dosage
Every two weeks.
Benefit
Requires infrequent administration.
Risk
It’s important to maintain regular visits to a doctor when taking injections.
Some adverse events resulting from injections may include skin irritation or redness or rash at the application site.
Description
Capsules swallowed, taken with a meal.
Dosage
Three to four capsules are taken daily (half of dose taken in the morning, half of dose taken in the evening) with a meal, for the first two to three weeks of treatment. Your doctor may then adjust the dose to one to three capsules per day daily based upon your response to treatment.
Benefit
Convenience of oral administration.
Risk
Some adverse events resulting from capsules may include nausea, vomiting or stomach pain.
