Hey Virgil - I just read you article on compounded gels vs. Androgel. What about injection based test vs. topical? I was told the topical forms are a safer and more efficient delivery system but injection based seems to be easier to use on some level because it's 1x every one or two weeks vs. putting stuff on every day. I do have a compounding RX which seems to work okay but Androgel seems better overall and the injection based test always seems to give me better results than that. What do you think? Thanks. Tripp

Hi Tripp

It's a matter of personal preference and life style.

Yes, topical gels tend to provide a more stable testosterone blood level, but you have to apply it every day. Some men forget, so they tend to want something less frequent like injections every one or two weeks. Some men are terrified of needles, so they tend to use gels.

Some men say they feel much better when using injections since they enjoy the "peak" that is achieved in blood levels right after an injection. But injections do not provide testosterone blood levels that mimic what a healthy man would produce (about 5 mg of testosterone a day).

Most doctors start men on a gel. They retest your testosterone blood levels and adjust the dose accordingly. If a month after the adjustment no quality of life improvement is seeing, sometimes they switch patients to injections.

I am looking forward to the approval of Aveed, a long acting testosterone undecanoate injection that can be injected less frequently. The FDA is currently reviewing the data on this drug.

Some limited data shows that gels may increase estradiol conversion a lot more than injections in men with high fat content under their skin and who have high aromatase enzyme activity. Other small studies have also shown higher DHT conversion of gels, which could worsen prostatic inflammation in older men. So, gels are sometimes not the clear "first line" choice for some men. (More details on this in my book "Testosterone: A Man's Guide" available on testosteronewisdom.com)

Nelson