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After review of the results of the initial blood tests, if the doctor decides that it’s safe and appropriate to start testosterone replacement therapy, a prescription for one month’s testosterone replacement therapy will be authorised. A further blood test will be needed after three weeks to see how you are responding to treatment. All being well, a further five months of treatment will be authorised before another blood test is needed to check your testosterone levels , a year after treatment is initiated, and each year after that, further blood tests will then be needed to ensure that the ideal level of testosterone in your body is maintained and that your continued use of testosterone replacement therapy remains safe. We will be checking for indications of prostate or blood problems that can occur.

Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin and into the bloodstream. Testosterone-containing creams and gels that are applied daily to the skin are also available, but absorption is inefficient (roughly 10%, varying between individuals) and these treatments tend to be more expensive. Individuals who are especially physically active and/or bathe often may not be good candidates, since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself; children and women are highly sensitive to testosterone and can suffer unintended masculinization and health effects, even from small doses. Injection is the most common method used by individuals administering AAS for non-medical purposes. [45]

Testim® was evaluated in a randomized multicenter, multi-dose, active and placebo controlled 90-day study in 406 adult males with morning testosterone concentrations ≤ 300 ng/dL. The study was double-blind for the doses of Testim and placebo, but open label for the non-scrotal testosterone transdermal system. During the first 60 days, patients were evenly randomized to Testim 50 mg, Testim 100 mg, placebo gel, or testosterone transdermal system. At Day 60, patients receiving Testim were maintained at the same dose, or were titrated up or down within their treatment group, based on 24-hour averaged serum testosterone concentration obtained on Day 30.

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