Injection Vs Oral Testosterone Therapy - Which is More Effective?

Injection Vs Oral Testosterone Therapy - Which is More Effective?

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Injection vs oral testosterone therapy: which is more effective? Let's take a look at the pharmacokinetics profile (PK), side effects, and costs of each. The main difference between the two testosterone therapies is their method of administration. For a full analysis of the two methods, read on! Despite their similarity, however, there are important differences between the two.

Side effects

There is some controversy regarding the side effects of oral versus injection testosterone. The results of a recent study suggest that men may experience different side effects if they take testosterone by mouth or injection. While the doses of testosterone used in the two types of treatments are similar, some men may experience side effects of one or the other. Some men may experience liver problems, skin color changes, difficulty urinating, or too frequent erections.

Injections were associated with an increased risk of heart attack, stroke, and hospitalization. Gels and patches had similar risks. Injections were prescribed earlier than oral testosterone. The risk of cardiovascular events and death was lower in the oral treatment group. Injection users were more likely to experience heart problems than those who use testosterone patches or gels. The results of the study may be misleading, however. It would be better to avoid testosterone injections altogether unless you're experiencing a deteriorating cardiovascular condition.

What is the PK Profile?

The PK profile of a drug is a series of concentrations of the drug in bodily matrices from subjects enrolled in a clinical trial. Samples of bodily matrices are collected from the subjects at pre-specified time points, and their concentrations are analyzed. Bioanalytical laboratories determine the concentration of a drug in a biological system and use the data as the basis for a computational noncompartmental analysis (CNA).

PK profiles are used to determine the correct dosage and frequency of an infusion. These measurements help the physician tailor treatment for each patient, while enabling them to monitor the progress of the disease. In hemophilia A, for example, treatment is focused on maintaining a high enough level of factor VIII in the body to prevent bleeding episodes. Patients receive regular infusions to help maintain the requisite levels. This treatment is known as prophylaxis in the United States.

PK studies are important in the early development of drugs and can help in identifying the best way to administer the drug. This study can answer different questions, such as the correct PK exposure in humans, the schedule for administration, and the correlation between PK values and toxicities. For example, a drug's toxicity profile can correlate with the maximum concentration of the drug, the area under the curve, the schedule used to administer the drug, and the number of drug-drug interactions.

A comprehensive integration of PK and PD information can help drug discovery scientists answer key questions at various stages of drug development. In vivo PK/PD modeling allows researchers to quickly and efficiently select promising compounds. It also enables them to predict the effects of off-target activities, such as toxicity and pharmacokinetics. The PK/PD models can also assist in determining the most appropriate dosages and regimens to test.

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Testosterone PK profile: Oral vs Injection 

The PK profile of oral versus injection testosterone has long been a controversy. However, this study highlights some of the advantages of oral testosterone over injections. In particular, it found that oral testosterone had a lower incidence of cardiovascular events than injections. Compared with CPRD and MarketScan databases, the US cohort had lower cardiovascular event rates. Further, the gel initiators had a lower crude rate of all cardiovascular outcomes, even after accounting for age and presence of comorbidities.

Choosing the right testosterone preparation depends on several factors, including the preference of the patient and the PK profile. The cost, insurance coverage, and treatment burden are also considerations. Patients may eventually need to switch between the two forms depending on their response. It is critical that the patient and physician have a transparent and ongoing dialogue so that the correct testosterone treatment regimen is selected for each individual. This way, both parties will know the right dosage for each patient and can make an informed choice.


The efficacy of oral testosterone was not found to differ from that of injection testosterone. In general, a male testosterone injection should be used at lower dosages than a female testosterone gel or injection. Females should consult their doctor for the appropriate dose, as testosterone is contraindicated in certain populations. In addition, an insufficient dosage can cause unwanted side effects, and transference issues may occur, making it vital to incorporate counseling into testosterone therapy.

A recent study reported that there were no major differences in mortality between the two groups. The studies varied widely in their definitions and ascertainment. However, the incidence was similar in both groups. The Peto OR was 0.94, and I2 = 0%. The study was powered to detect no difference between the groups, so the results were weak. However, the Peto OR (or odds ratio) was 0%, and there were no significant differences in the number of withdrawals due to adverse events.


The initial cost of injection testosterone treatment is more than three times higher. However, these costs are expected to decrease as the duration of treatment continues. This treatment is expensive, due in part to the time-consuming tasks required to determine the root cause of symptoms and tailor a treatment plan. Most insurance providers cover prescription costs, with additional expenses typically covered by the patient. However, the initial cost is often high, and the future cost of a hormonal imbalance is significantly higher.

Oral testosterone is also expensive, typically costing $100 to $300 per month. However, it is more affordable than injectable testosterone. Oral testosterone tablets are a great alternative for men who don't want to use an injection. Although oral testosterone can be inexpensive, it can have negative effects on the liver and is not commonly recommended for long-term use. To find the best option for you, discuss the pros and cons with your doctor.


Both treatments for low testosterone are similar in regards to effectiveness, and both come with their own risks although oral testosterone shouldn't be considered a long term solution as it may damage the liver. The cost for injected testosterone is more expensive than oral by a considerable margin which may steer some towards oral prescriptions. 

That said, your sutability will be assessed by a medical professional, who will ultimately steer you towards what would work best for you and your safety. 

However, if you do not like injections, oral may be the only option you would considered, however, in these cases, a cream or gel may be a suitable course of action. 

Injected testosterone is more expensive, but may reduce the risk of liver damage, but there's the actual injection to consider that may be a deciding factor for some people. 

Before you consider any form of prescription testosterone replacement, you should ensure that your diet, recovery and activity levels are promoting good hormonal health.  

Other areas of your lifestyle may need to be scrutinized, drinking habits, smoking or recreational drug use may need to be addressed. 

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