I’m considering going on T. Which way of taking T has been most effective for the mods? I know that different ways are better for different people but I want to hear peoples experiences before I decide to go on it
Lee says:
The most effective method of T really depends on the person. Maybe your lifestyle is different than mine and you want to do your T once and forget about it for a few months while you go camping; maybe you want to do it daily to minimize hormone fluctuations which can be an issue for some people with certain mental illnesses.
In general, I’d recommend considering the likelihood that you’ll be able to actually be compliant with your HRT treatment with each method knowing yourself and your abilities and so on, consider the practicality, and consider the cost.
1: What method are you able to use?
- If you decide to do injections but you have a needle phobia and you avoid doing your shot and go for months without doing it because you’re too anxious, then injections are not going to be the most effective method for you and you should try gel
- If you decide to do gel, but you’re not able to consistently apply it every day because you forget or you’re too busy, and you end up only putting it on once or twice a week when you remember, then gel (which requires a daily application) isn’t the best option for you and you should try injections
- If you want to do injections but you have motor control issues or other disabilities that mean you can’t hold a syringe and inject yourself safely, and you don’t have reliable access to a caregiver who can do it for you or don’t want to be reliant on someone else, then maybe injections aren’t the best option for you and you should try implantable testosterone pellets
2: What method is best for your particular body?
- If you use patches and develop an allergic reaction at the application site, maybe patches aren’t the best option for you and you should switch to gel or injections
- If you’re using gel and you don’t experience enough changes and have low T levels, maybe switching to injections is better for you
- If you’re on injections and find that having high testosterone levels at the start of the week and low levels at the end of the week/injectable cycle causes mood swings/exacerbates your mental illness/cause PMS-like symptoms from fluctuating hormones, then maybe injections isn’t the best option and switching to gel is better for you. With gel you’ll have more stable T levels that mimic cis men’s levels, and there’ll be a slight high in the morning when you put on the gel and a slight dip at night but overall fewer big swings.
3: What method is most affordable with your insurance?
- If your insurance doesn’t cover testosterone gel and you appeal and they agree to cover it but the generic still has a $300/month copay for you, then maybe that is not affordable for your situation and you might end up not being able to pick up your prescription every month because you run out of money and can’t pay for it, so you should do the cheaper injections and pay like $15 per month instead
- If you want to have pellets placed, but travelling to the doctor’s office for appointments every 3 months is prohibitively expensive because you can’t afford appointments that often or the office is too far away for you to easily get to without paying a million dollars in uber fares, then maybe pellets aren’t the best option for you
- If you want to do injections but want to use an autoinjector instead of your typical syringe and your insurance won’t cover an autoinjector, then maybe you should consider using a typical syringe or switch to another form of T
- If you want a longer-lasting injectable form of T that only requires injections every 6 weeks instead of every other week but your insurance doesn’t cover that form, then decide if it’s worth it, etc
I might say that the form of testosterone that was most effective for me personally is weekly subQ injections because I was depressed when I started T and didn’t shower often enough so the gel built up in a gross layer on my skin and didn’t absorb, but if you know that you’re someone who could never stab yourself with a needle on a weekly basis then daily gel is going to be better for you than missing two out of three or four injections every month.
And you don’t necessarily need to stick with the form of T that you start with. Say you start with gel and find it isn’t effective for you. Then you can talk with your testosterone prescriber and raise the dose! If the higher dose works, then great! If it doesn’t work, talk with your testosterone prescriber and switch to shots, or patches, or whatever else you want to try!
It can be a bit of a trial-and-error process to find the right for of medication for you, and it’s pretty typical to switch forms of T at some point on your T journey. So you aren’t necessarily permanently locked into using the form that you started on forever.
There are different pros and cons for each type of T, so there’s no one “best” and most effective way to be on T. How effective it is depends on your body’s reaction and you can’t predict that in advance, you have to find it out as you go along and experiment.
So all things aside, if every form were equally accessible in price and availability and practicality, there still wouldn’t be a universal “best” and most effective option because different people have different bodies.
That being said, most people tend to have good results with injections after finding the right dose so it’s a good place to start if you are comfortable with needles— but some folks are allergic to the carrier oil and need to switch from cypionate to enanthate for example, and there is more than one type of injectable testosterone and more than one way to inject it (intramuscular vs subcutaneous, and even if you choose one type of injection like SubQ there different sites like thigh vs stomach) so even saying “do shots!” leaves you with a lot of choices too, and none are clearly superior, just different.
The various options for testosterone are listed in our Testosterone FAQ, and as always, talk to your healthcare providers about what they recommend for you!