What type of TRT is right for me?

With so many testosterone replacement therapy (TRT) options to choose from, it can get confusing. From injections, creams, gels, and capsules, how do you and your doctor make the right choice?

This guide breaks down the pros and cons of each type of treatment so you can make a more informed decision with your TRT expert.

Contents

• Injectables
  • Testosterone cypionate
  • Testosterone enanthate
  • Sustanon® (Mixture of 4 esters)
  • Nebido® (testosterone undecanoate)
• Creams and gels
  • Scrotal creams
  • Testogel®, Testavan®, Tostran®
• Capsules
  • Kyzatrex®

 

What are the different types of TRT?

TRT is usually administered in one of three ways:

• Injectable TRT — Testosterone is injected either into the muscle (intramuscular) or into the fat, just under the skin (subcutaneous). 
• Topical TRT — Creams or gels are rubbed into the skin and absorbed into the bloodstream.
• Oral TRT — Capsules are swallowed, usually twice a day.

  

---

Injectable TRT

Injectable TRT is the most popular form and for good reason. Injections are very effective, deliver reliable results, and their dose can be fine-tuned.

There are many different types of injectable TRT, called esters, which have different properties. Each ester is absorbed and processed by the body at various rates. This means there are both long- and short-acting preparations to suit different lifestyles.

Understandably, some men don’t enjoy the idea of self-injecting. But some types of TRT can be administered subcutaneously, into the fat just beneath the skin. These injections use very small needles and many men say they barely feel a thing.

Pros of injectable TRT:

• Highly effective
• Reliable and predictable results
• Long- and short-acting preparations available
• Precise dosage control
• Quick results
• Cost-effective

Cons of injectable TRT:

• Not ideal for men with a severe needle phobia
• Potential for irritation or discomfort at the injection site
• Slightly higher risk of side effects compared with gels
• Testosterone levels may trough between injections

 

There are several injectable preparations to choose from, including cypionate, enanthate, Sustanon®, and Nebido®. 

 

Testosterone cypionate

Cost: About £35–55 per month, plus injection equipment.

Administration: Intramuscular or subcutaneous.

Dosing schedule: Usually 3 injections a week, or sometimes once a week.

Pros:

• Highly regarded by experts as one of the most effective forms of TRT
• Can be injected into subcutaneous fat for minimal discomfort
• Can be used at lower doses for more frequent injections
• Pre-supplied in 10ml multi-dose vials
• Can be self-administered

Cons: 

• Can be more expensive
• If injecting regularly, some men find frequent injections are a pain

 

Testosterone enanthate

Cost: About £10–15 per month, plus injection equipment. Please note that supplies of enanthate are not always reliable. 

Administration: Intramuscular, occasionally subcutaneous.

Dosing schedule: Usually 2 injections a week, or sometimes once a week.

Pros:

• Single ester for more predictable stable levels
• Well-researched and widely used
• Relatively inexpensive
• Preferred route is injected into muscle but may be injected into fat
• Can be self-administered

Cons: 

• Carrier oil is seasame oil which may cause reactions in some men

 

Sustanon® (mixture of 4 esters)

Cost: About £10 per month, plus injection equipment.

Administration: Intramuscular.

Dosing schedule: Usually 2 injections a week, or sometimes once a week.

Pros:

• Blend of 4 esters designed to provide immediate and long-lasting effects
• One of the cheapest TRT options
• Can be used at lower doses for more frequent injections
• Can be self-administered

Cons: 

• Mix of esters doesn’t agree with some men
• Regarded as a less refined option by some experts
• Slightly higher risk of side effects
• Injection can be uncomfortable for some men

 

Nebido® (testosterone undecanoate)

Cost: About £60 per month.

Administration: Intramuscular, must be injected by a professional.

Dosing schedule: Usually once every 10 to 14 weeks.

Pros:

• Very long-acting means fewer injections
• Well-researched

Cons: 

• Expensive
• Some men feel the effects wearing off by about week 6
• If it causes side effects, they'll likely last for 12 or more weeks until the body metabolises the bolus dose of testosterone
• Must be injected by a professional
• Injection can be uncomfortable
• More difficult to adjust levels
• Slow onset

 

---

Creams and gels

Cost: About £55–120 per month.

Administration: Topical.

TRT creams and gels are rubbed into the skin, where it’s gradually absorbed into the bloodstream.

Creams are thicker, oil-based, and best applied to thinner skin areas, like the scrotum. On the other hand, gels are alcohol- or water-based and are typically applied to the arms, shoulders, or belly.

Pros of TRT creams and gels:

• Easy to apply
• Easy to adjust dosing
• No injections required
• Gels especially are a well-established form of TRT
• Smaller risk of side effects compared to injectables

 

Cons of TRT creams and gels:

• Some men don’t respond well or reach adequate testosterone levels
• Low but possible risk of transfer through skin contact — must be particularly careful around pregnant women or children
• Can be messy to apply
• Must avoid washing, swimming, or activities that make you sweat for a few hours after application
• Absorption varied based on skin thickness and application site
• Possible skin irritation or reactions

 

Broadly speaking, two types exist — scrotal creams (applied to the scrotum) and testosterone gels (e.g. Testogel®, Testavan®, and Tostran®). Gels are applied to the arms, shoulders, or belly.

 

Scrotal creams

Cost: About £100-120 per month.

Dosing schedule: Applied once a day to the scrotum. 

Pros: 

• High absorption
• Some studies show higher bioavailable testosterone than gels
• Some men have better results compared to gels
• Smaller application area

Cons: 

• Newer treatment so fewer long-term studies compared to gels
• May not achieve the same peak testosterone levels as injections

 

Gels

The most common gels include Testogel®, Testavan®, and Tostran®. 

Cost: Most gels are a similar price, about £55 to £120 per month. 

Dosing schedule: Applied daily to the arms, shoulders, or belly.

Pros: 

• Widely prescribed and researched, especially Testogel®
• Comes in multiple forms including a metered-dose pump

Cons: 

• May not achieve the same peak testosterone levels as injections

 

---

Capsules

Oral TRT is probably one of the most convenient forms of TRT. No injecting, no messy creams, just a couple of capsules twice a day. Newer preparations, like Kyzatrex®, are much safer on the liver, reducing the risk of side effects.

Kyzatrex® is taken twice a day and is effective for most men. One of the main drawbacks is that it doesn’t come cheap. You can expect it to set you back £80 to £180 per month, depending on the dose you need.

Pros of oral TRT:

• Super convenient
• Ideal for men uncomfortable with injections
• Portable and travel-friendly
• No risk of irritation or mess associated with creams or gels

 

Cons of oral TRT:

• One of the most expensive forms of TRT
• Must be taken with food for proper absorption
• May increase blood pressure which can contribute to cardiovascular risk
• Possible gastrointestinal side effects like nausea or diarrhoea
• May not achieve the same peak testosterone levels as injectables

 

---

Which type of TRT is best? 

We find that most men go for injectable TRT — it's highly effective, and gives reliable results, and with subcutaneous cypionate injections, many men say they don't feel a thing.

However, just because it works for most men, doesn't mean it's the best option for you. Every treatment type comes with its pros and cons. Here's a quick reminder:

Injectables

• Best for: reliable results and less frequent administration
• Not ideal if: you're less keen on injections, though subcutaneous options exist

Creams and gels

• Best for: easy application and dose changes
• Not ideal if: daily application is inconvenient for you or if you have close contact with kids and partners (risk is small but possible)

Capsules

• Best for: convenience
• Not ideal if: you're on a tight budget or want more reliable results

 

Still stumped?

That’s what we’re here for. Whether you’ve just found out you’ve got low testosterone or if you’re already on TRT, request a consultation with one of our experts to discuss treatment options with you in more detail.