Different Types of Testosterone: What Type of TRT Is Right for Me?

Table of Contents

Introduction

Low testosterone can affect energy, mood, body composition, and sexual health. Today, men have more choices than ever in how testosterone replacement therapy (TRT) is delivered: injections, gels, patches, pellets, oral capsules, and nasal gels. Each option has different pros and cons depending on your goals, lifestyle, and medical profile.

At Florida Men’s Health, we help patients compare testosterone injections for men, testosterone gel, pellet therapy, oral testosterone pills, and more. This guide breaks down the different forms of TRT, updated safety information from 2025 FDA labeling, and how to decide which type of testosterone therapy is right for you.

What Are the Different Types of Testosterone Therapy?

TRT is available as injections, topical gels or patches, implanted pellets, oral testosterone undecanoate, and intranasal gel. Each has unique pros, cons, and dosing schedules.

Injectables: cypionate, enanthate, undecanoate (short to long-acting).
Transdermals: gels, creams, patches.
Implants: subcutaneous pellets lasting 3–6 months.
Oral TU capsules: modern, food-dependent absorption.
Nasal gel: newer option with multiple daily doses.

Quick Comparison Table of Testosterone Types

Form	Examples/Brands	Typical Dosing	Pros	Cons	Best For	Notes/Warnings
Injections	Testosterone cypionate, Testosterone enanthate	Weekly to biweekly (cyp/enan); every 10–14 weeks (undecanoate)	Cost-effective, flexible	Peaks/troughs, needles	Men comfortable with self-injection	Monitor H/H for erythrocytosis
Gels & Creams	Testosterone gel	Daily	Steady levels, easy titration	Skin-to-skin transfer risk, rash	Needle-averse, steady dosing	Transfer warnings (children/partners)
Patches	Androderm	Nightly	Mimic natural rhythm	Rash, fixed dose	Men wanting physiologic cycle	Rotate sites to reduce dermatitis
Pellets	Testosterone pellets therapy	Every 3–6 months (office)	“Set-and-forget”	Minor surgery, limited titration	Busy professionals	Extrusion/infection risk
Oral TU	Testosterone pills for men	2–3x daily with fat	Needle-free, avoids liver	Cost, BP warnings, frequent dosing	Needle-averse, compliant patients	Monitor BP regularly
Intranasal Gel	Natesto	2–3x daily	No transfer risk, quick use	Multiple doses/day	Men with kids at home	Possible nasal irritation

How Does TRT Work and When Is It Recommended?

TRT restores testosterone levels in men with hypogonadism confirmed by testing and symptoms, not just age-related decline.

TRT is medically indicated for men with hypogonadism, diagnosed through morning testosterone tests and symptoms such as fatigue, low libido, or loss of muscle. The FDA continues to restrict approval to hypogonadal men rather than “age-related low T.”

In 2025, labels were updated after large clinical trials showed no increased risk of major cardiovascular events (MACE). However, the FDA required standardized blood-pressure warnings across products, especially for oral testosterone undecanoate.

Baseline evaluation includes:

Total testosterone, free testosterone if indicated, SHBG.
Hemoglobin/hematocrit (to monitor red blood cells).
PSA and prostate exam where clinically appropriate.
Blood pressure monitoring.

For men unsure whether TRT is appropriate, Florida Men’s Health provides comprehensive labs and a testosterone FAQs resource to answer common questions.

Injectable Testosterone: Cypionate, Enanthate, Undecanoate

Injections are the most common and affordable TRT option, given weekly to every few months depending on formulation.

Cypionate & Enanthate

Dosing: ~50–200 mg IM or SC weekly; some use biweekly but weekly often reduces mood swings.
Pros: inexpensive, flexible titration, widely available.
Cons: self-injection needed, fluctuations possible.
Best fit: men who prefer low cost and control; athletes and busy patients often use testosterone cypionate or testosterone enanthate.

Undecanoate

Dosing: large loading doses followed by injections every 10–14 weeks.
Pros: very stable testosterone levels.
Cons: must be given in clinic with observation due to rare reactions.
Best fit: men who dislike frequent injections and prefer clinic monitoring.

Transdermal Gels & Creams

Daily gels and creams offer steady testosterone but carry transfer risk.

Applied to clean skin daily, gels and creams allow smooth testosterone absorption. Men must avoid contact with others until fully dry.

Pros: easy titration, steady state, needle-free.
Cons: risk of transferring testosterone to partners or children, skin irritation.
Best fit: men who value convenience and steady energy, but can commit to careful application of testosterone gel.

Transdermal Patches

Patches provide nightly dosing that mimics natural testosterone rhythm but often cause rashes.

Worn on the skin for 24 hours, patches deliver steady hormone levels. They must be rotated to avoid irritation.

Pros: physiologic pattern, daily routine.
Cons: dermatitis, fixed doses.
Best fit: men who dislike gels and want a nightly habit.

Subcutaneous Pellets

Pellets last 3–6 months and are ideal for men who want “set-it-and-forget-it” TRT.

Implanted under the skin in a short office procedure, testosterone pellets therapy releases steady hormone levels.

Pros: few visits, steady levels.
Cons: minor surgery, limited dose adjustment, rare extrusion.
Best fit: busy professionals or men seeking maximum convenience.

Oral Testosterone Undecanoate (TU)

Modern oral TU avoids liver toxicity but requires multiple daily doses with food and carries blood-pressure warnings.

Oral testosterone pills for men represent a modern option.

Pros: needle-free, avoids liver metabolism.
Cons: must be taken with fat-containing food, multiple doses daily, cost, blood pressure rise.
Best fit: men who strongly prefer capsules and can commit to dosing schedule.

Intranasal Testosterone

Nasal gel requires 2–3 daily applications but avoids skin transfer risks.

Delivered into the nostrils, nasal gel provides fast absorption.

Pros: minimal transfer risk, easy for men with children at home.
Cons: multiple doses/day, nasal irritation.
Best fit: men prioritizing safety for household members.

Side Effects and Risk Management in 2025

Snippet: Most TRT risks are dose-related and manageable with monitoring; 2025 FDA labels highlight blood-pressure checks and cardiovascular reassurance.

Erythrocytosis: monitor hemoglobin/hematocrit, adjust dose or donate blood if necessary.
Fertility suppression: TRT reduces sperm production; men seeking fertility may need alternatives like clomiphene or hCG.
Blood pressure: especially important with oral TU; 2025 labels emphasize BP monitoring.
Topical transfer risk: use proper precautions with gels and creams.

Monitoring Schedule & Lab Targets

Labs at baseline, 3 months, and then 6–12 months help ensure safe, effective TRT.

Baseline → 3 months → 6–12 months.
Hemoglobin/hematocrit, total T (trough for injections), PSA when indicated.
Blood pressure checks every visit.

Cost, Insurance, and Access

Injections are usually cheapest; gels, patches, pellets, and oral TU vary in coverage and cost.

Injections: most affordable.
Gels/patches: higher but often covered.
Pellets/oral TU: premium cost.

Compare your insurance formulary and clinic vs. pharmacy pricing. At Florida Men’s Health, we discuss testosterone replacement therapy services and provide transparent cost guidance.

FAQs

What is the most effective form of TRT?
All FDA-approved forms work when dosed correctly; choice depends on lifestyle, adherence, and risk profile.

Is weekly better than biweekly injections?
Weekly dosing often reduces highs and lows, improving mood and energy.

Are gels safer than injections?
Not necessarily—gels risk transfer, injections risk higher red blood counts. Safety depends on monitoring.

Is oral testosterone safe?
Modern oral TU avoids liver strain but requires blood-pressure monitoring.

Conclusion

TRT is not one-size-fits-all. Injections, gels, patches, pellets, oral capsules, and nasal gels each serve different needs. The right type depends on your health profile, family situation, convenience preferences, and budget.

If you’re wondering what type of TRT is right for you, the specialists at Florida Men’s Health can guide you through testing, options, and long-term monitoring. Request an appointment today to personalize your testosterone therapy plan.