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Types of Testosterone Therapy

There are several different kinds of testosterone therapy available today that can be delivered via patches, gels, injection, and even gum. Choice of therapy depends on the patient's preference for a particular delivery system, the side effects, and the cost, according to an article published online by the Mayo Clinic called, "Testosterone therapy: The answer for aging men?" (www.mayoclinic.com/health/testosterone-therapy/MC00030).

Types of testosterone replacement include:

? Oral (Android, Testred, Virilon)?The recommended dose for adult men is 120 mg to 160 mg, divided into 2 daily doses for 2 to 3 weeks. Oral testosterone therapy is not recommended for long-term treatment due to adverse effects, including an unfavorable cholesterol profile, increased risk of blood clots, and heart and liver problems.

? Injection (Delatestryl, Depo-Testosterone)?Intramuscular testosterone injection has been found to a safe and effective method for providing supplemental testosterone. Injections are given every 2 weeks. The recommended dose for adult men is 25 mg to 50 mg injected 2 or 3 times a week.

? Gel (AndroGel, Testim)?Testosterone gel is applied to a patient's skin on the lower abdomen, upper arm, or shoulder. The recommended starting dose for adult men is 5 g applied once daily.

? Patch (Androderm)?This testosterone patch is applied each night to a patient's back, abdomen, upper arm, or thigh. The site of the application is rotated to maintain 7-day intervals between applications to the same site to reduce skin reactions. The recommend dose for adults and teenagers aged ≥15 years is 2.5 mg to 7.5 mg (1 to 3 patches) applied once daily.

? Gum (Striant)?The gum is a small, putty-like substance that delivers testosterone directly into the bloodstream by adhering to a patient's buccal cavity. Side effects can include gum irritation or pain, bitter taste, or headache; however, clinical research has found that this form of delivery may deliver a steadier dose of testosterone throughout the day compared with other delivery methods. The recommended dose is 1 buccal system applied to the gum twice daily, in the morning and evening, about 12 hours apart. Each delivery system contains 30 mg of testosterone.

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