How Effective Are the Alternatives to Injectable Testosterone?

Jay Campbell

By Jay Campbell

August 30th, 2018


When it comes to Testosterone Optimization Therapy (TOT), we’ve already established that testosterone injectables are the most effective way to receive testosterone. However, men who fear needles are keen on exploring other options. Fortunately, there are different ways to administer testosterone such as creams and gels. And while there are oral forms, none of them are FDA-approved. Other options include testosterone pellets and patches. The question is, how effective are they?

Testosterone Pellets

With the testosterone pellet option, small 3 mm x 9 mm pellets containing testosterone are surgically implanted under the skin. If you’re not a fan of needles, you’re probably also not a fan of local anesthetics and incisions. However, testosterone pellet insertion is done less frequently compared to injectables. Testosterone injectables are typically given every two to four weeks while testosterone pellets slowly release testosterone over the course of 3-6 months. Of all forms of TOT on the market today, pellets are believed to have the most extended duration and therefore, the longest-lasting effects.

However, although the pellets last a long time, this form of therapy is suboptimal. First of all, testosterone pellets inserted surgically come with the risk of infection. There is always the danger of infection and bleeding with any surgical procedure, even a simple outpatient one. More importantly, once you’ve implanted the TOT pellet into your body, it’s challenging to control the concentration of the testosterone dosage released because of how unpredictable your body responds to the treatment. If your blood levels indicate you need more or less of your current dosage, your doctor has to cut you open to add or remove pellets. Ultimately, being cut open again and again is much more invasive compared to injectables.


Transdermal testosterone is also available as a skin patch. However, skin patches like Androderm® can cause skin irritation at the place of adhesion. They also produce high levels of dihydrotestosterone. And because the proper application requires shaving the area where it’s applied, many find it inconvenient due to the frequency of body preparation. Without prior shaving the application area, the patch won’t stick. Androderm® can be applied onto the back, stomach, upper arms, or thighs nightly for 24 hours. At the end of the 24-hour period, you replace the used patch by applying a new one.

The manufacturers recommend that users rotate the areas of application, leaving seven days before reapplying to the same site. The manufacturer claims it is safe to swim or shower with the patch; however, you have to wait 3 hours after applying it. They also claim that users are allowed to maintain normal activities while wearing the patch such as sexual activity; however, strenuous exercise and excessive sweating may loosen the patch and cause it to fall off. Conclusively, these TOT options can work. However, our experience shows them to be far from optimal. Their benefits do not outweigh the potential side effects nor their many inefficiencies in preparation for application, especially when compared with injectable testosterone therapies. To find out much more about Testosterone and its role in helping us achieve optimal mental health and physical performance, purchase The TOT Bible.

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