Method Matters: a practical guide to hormone preparations in the UK part 2 - testosterone

By: Dr Rhy Brignell

Dr Rhy Brignell BA MA Ph.D

Rhy is Director of Service Delivery at Eden New Life and is responsible for ensuring all of our subscribers get fast, high quality care in accordance with our treatment protocols. They hold a PhD from the University of East Anglia and have specialised in gender services for more than 4 years, managing and advising on service delivery for thousands of patients. This is one of a series of articles where they share answers to common questions we receive from our members.

Following on from my previous article on oestrogen preparations, our specialists often also get asked about the differences between types of testosterone hormone preparations. As with oestrogen, there’s a lot of anecdotal information on the internet about whether some testosterone preparations are more effective than others; whether you’ll get faster or bigger results if you use gel or injections. This article offers some straightforward information about the different testosterone hormone preparations to support your conversations with our specialists and consider the right option for you.

What do we mean by preparation?

In this context, preparation is a term used in medicine to describe the form that the medication comes in. In gender medicine, it might refer to tablets, gels, patches, or injections. These preparations are just different forms of the same medicine. Each form gets the medicine into your body in a different way, which can lead to different effects on your health.

There is no evidence of a difference in outcomes between preparations; no preparation works better or quicker than any other. It’s important to also note that taking higher doses than prescribed does not cause desired changes to happen more quickly, and, can put your health at risk. If you are receiving hormone treatment from Eden New Life, our specialists will advise you about the different preparations and dosages in your prescription and review sessions.

What are the different preparations of testosterone?

Testosterone can be given as a gel applied to skin daily or as an injection. There are two types of injection available to approved Eden New Life clients - Sustanon, which can be self-injected every 3-4 weeks after receiving safe injection training from our specialist nurses, or Nebido, which must be injected by a trained professional usually every 12 weeks. There are currently no testosterone tablet options available on prescription in the UK.

How do different testosterone preparations work?

Gel

Testosterone gel is rubbed into your skin, usually on a daily basis. The medicine is absorbed through your skin and into your bloodstream.

Gel provides a steady application of hormones into your body, meaning there tends to be fewer ups-and-downs in your hormone levels over a given period when compared to injections. Your dose can also be adjusted more gradually by our specialists if required. It’s also a great option if you want to avoid the pain of injections or if, like me, you really don’t like needles!

If you are beginning hormone treatment with Eden New Life, our specialists will start you out on the gel preparation to ensure that you do not experience any significant side effects from testosterone before you move to injections (though you don’t have to move to injections if you’d prefer to stay on gel). It’s far easier for our specialists to adjust or stop your treatment if necessary with gel than it is with a treatment that has already been injected into your body.

As with oestrogen gel, testosterone gel absorption can vary depending on a number of factors, including your skin, where you apply it, and your daily habits (like showering, bathing, or sweating), and there is some risk of transfer to others via skin-to-skin contact which should be considered.

Injections

The injections available to approved Eden New Life clients are injected intramuscularly. This means that the medicine is injected into a muscle (usually in your thigh or buttock), which acts like a sponge, slowly releasing the medicine into your bloodstream.

Some of our clients prefer injections over gel because of the convenience of only having to administer every few weeks, rather than having to apply gel every day. Testosterone injections tend to be more affordable than gel too.

However, testosterone injections carry an increased risk of polycythemia. Polycythemia is when your body makes too many red blood cells, meaning your blood becomes thicker, making it harder for your heart to pump blood around your body. This can raise the risk of problems like headaches, high blood pressure, clots, stroke, or heart attack. This risk is not completely eliminated by using gel, it’s just more common with injections, and is why our specialists will monitor for this in your regular blood tests, whether you’re using gel or injections.

There are also risks associated with injections more generally, such as bruising and swelling, or infection. For Sustanon, self-injecting carries more risk still, as you could cause significant damage to yourself if you inject in the wrong place. This is why it’s crucial to get proper guidance and training on safe self-injection practice. Eden paid subscribers get expert live online self-injection training with a nurse included in their subscription.

Which preparation is right for me?

The preparation that works best for you is highly dependent on a number of factors, including your individual health, risk factors, lifestyle, and where possible, your preferences. This article is intended to provide you with some general information about the ways different preparations work on the body and the factors that should be considered, and is not a substitute for medical advice from a trained professional.

If you are starting hormone therapy with our service, or all set for a regular review, our expert specialists will be able to talk you through the different preparations available to you and they will tailor their recommendations to your individual circumstances and health needs.