When TRT doesn’t feel as good as expected, the first instinct is usually to adjust the dose. If your symptoms follow a pattern based on your injection timing, your frequency may need adjustment. Rather than a steady baseline, your body is experiencing repeated ups and downs. The right choice depends on how your body responds and whether consistency or simplicity matters more for your situation. Patches result in skin irritation in a substantial number of patients, and sweating during the summer can affect patch adherence (13). Timeline of various testosterone formulations available since Brown-Sequard’s experiments in 1889. We have come a long way since the days of Brown-Séquard, who self-administered an extract of animal testes by subcutaneous (SC) injection in 1889 (Fig. 1) (3). Testosterone is the main male sex hormone and is essential for the development and maintenance of male secondary sexual characteristics. In addition, we provide guidance for clinicians on how to counsel and manage their patients who opt for the SC route. In addition to men, some women with specific medical conditions or hormonal imbalances may also be prescribed testosterone therapy, though in much smaller doses. This treatment is most commonly given to men who have low testosterone levels due to aging, illness, or injury. It’s also helpful to understand who typically receives testosterone injections. It’s important to know that testosterone levels naturally decline with age, but sometimes they can drop to levels that negatively impact health and well-being. Understanding how these injections work and what to expect can help patients feel more confident and informed when starting treatment. For the best results, work closely with an experienced provider who can guide you through the process and tailor your treatment to your specific needs. To address these concerns, medical providers often recommend shortening the injection frequency to every five days. With proper monitoring, lab work, and doctor support, you can find the rhythm that works best for your body and lifestyle. Whether you’re new to TRT or refining your current routine, your treatment plan is always supervised by a qualified medical team. They are inactive until enzymes cleave off the ester chain, releasing active hormone. Understanding the pharmacokinetics of TRT formulations helps explain why injection frequency matters. Although the published studies of SC testosterone administration have not observed serious local adverse reactions (23, 47), mild local reactions were common. The main benefit of using the SC route for administration of testosterone esters over the traditional IM route is the ease of self-administration. Serum total A, testosterone; B, 5-dihydrotestosterone; and C, estradiol concentrations after subcutaneous (SC) or intramuscular (IM) administration of 1000 mg of testosterone undecanoate. Serum testosterone profile after SC injection displayed a slower time to peak concentration (8.0 vs 3.3 days) with no significant differences in model-predicted peak concentration compared with the IM route (26). Depending on the rest of your progress, your doctor may increase your dosage further if they believe you will benefit more from a higher dose. So, to effectively treat hypogonadism or low testosterone, physicians will typically prescribe androgen medication for TRT based on the age, diagnosis, and needs of each patient. Ultimately, we want to utilize the method of replacement that provides you with the results you desire and the treatment schedule you prefer. I have been with them for over a year now and feel terrific getting my levels in check.
