Testosterone replacement therapy (TRT) is a treatment to raise testosterone levels in men who have hypogonadism, or low testosterone. Low testosterone can affect your energy, mood, and sexual function, making you feel unlike yourself.
If you and your doctor decide that TRT is right for you, you’ll have a choice in how you receive it. Two popular options are the testosterone patch and testosterone gel.
The testosterone patch is applied to the skin, where it slowly releases testosterone into your bloodstream. Gels are rubbed onto the skin daily and absorbed into the body.
Both patches and gels are effective ways to raise your testosterone levels, but they have different pros and cons. This article will help you compare the testosterone patch vs gel so you can discuss the best choice for you with your healthcare provider.
Understanding Testosterone Deficiency and TRT
Testosterone replacement therapy can be a helpful treatment, but it’s only for people who have a specific medical condition that causes their testosterone levels to drop too low. It’s important to understand the condition TRT treats and what the treatment is meant to do.
What is Hypogonadism?
Hypogonadism refers to a condition where the body doesn’t produce enough testosterone. It’s sometimes called “low T.”
Testosterone levels tend to decline as men age, starting around age 30. But for some men, the drop is so significant that they start experiencing symptoms that affect their quality of life. Some of these symptoms include:
- Fatigue
- Decreased libido (sex drive)
- Erectile dysfunction
- Loss of muscle mass
The Role of TRT
The main purpose of testosterone replacement therapy (TRT) is to bring testosterone levels back up to a normal, healthy range.
Doctors can deliver TRT in a few different ways. The most common include:
- Patches
- Gels
- Injections
There are other, less common methods as well.
Testosterone Patches: A Closer Look
Testosterone patches offer another way to deliver this important hormone into your system. Let’s dive into how they work, their advantages, and potential drawbacks.
How Testosterone Patches Work
Testosterone patches rely on transdermal absorption. This means the testosterone is delivered directly through your skin and into your bloodstream over a 24-hour period. The patch contains a reservoir of testosterone, and a special adhesive helps it stick to your skin while facilitating the transfer of the hormone.
Application is simple: you apply a new patch once every day. You’ll want to choose a clean, dry area of skin – often on the upper arm, back, or thigh – and rotate the application site daily to minimize skin irritation.
Pros of Testosterone Patches
- Steady Release: Patches provide a controlled and consistent release of testosterone, which can help avoid the peaks and valleys in hormone levels sometimes experienced with other delivery methods.
- Easy to Use and Non-Invasive: Many men find patches to be a convenient and non-invasive option. There are no injections involved, and the application process is straightforward.
Cons of Testosterone Patches
- Skin Irritation: This is one of the most common complaints. A 2003 clinical trial by Meikle et al. showed that patients using the patch tended to experience more skin irritation compared to those using the gel. This can range from mild redness to more significant itching and discomfort.
- Daily Application: You need to remember to apply a new patch every day, which can be a hassle for some.
- Patch Dislodgement: The patch can sometimes come loose, especially during physical activity or showering.
- Visibility: Depending on where you apply the patch, it may be visible under clothing.
Testosterone Gels: A Comprehensive Overview
Testosterone gels are another popular option for TRT, and they work a bit differently than patches.
How Testosterone Gels Work
Testosterone gels are designed to be absorbed directly through your skin. The gel contains testosterone, which is released and soaks into your bloodstream after you apply it to your body. Gels tend to absorb faster than patches.
The application process is simple: You’ll apply the gel once a day to clean, dry skin. This is typically on your shoulders or upper arms. Make sure the area is clean and dry so the gel can absorb properly.
Pros of Testosterone Gels
- Easy to apply: Gels are usually simple to use and can be applied quickly as part of your morning routine.
- Less frequent dosing: Compared to some other methods, like applying a patch multiple times a day, gels are only applied once, which can be more convenient.
- Less skin irritation: Some people find that gels cause less skin irritation than patches. If you have sensitive skin, a gel might be a better option.
Cons of Testosterone Gels
- Risk of transference: One of the biggest drawbacks of gels is the risk of transferring the medication to others through skin contact. You need to be very careful to avoid touching others, especially children and women, after applying the gel.
- Absorption issues: Showering or sweating soon after application can affect how much testosterone your body absorbs. You’ll need to plan your showers and workouts accordingly.
- Careful application needed: It’s important to apply the gel carefully to avoid contaminating other surfaces or people.
- Can be sticky: Some gels can feel sticky or leave a residue on your skin, which some people find unpleasant.
Patch vs. Gel: A Detailed Side-by-Side Comparison
So, you’re trying to decide between the testosterone patch and the gel? Let’s break down the key differences to help you make the right choice.
Efficacy
The good news is both patches and gels are effective at raising your testosterone levels. They’re designed to bring your serum testosterone up to a normal range, and often do so within the first week of treatment. A comprehensive review from 2015 backs this up.
Now, individual factors can play a role. How well your body absorbs the medication, your overall health, and even genetics can influence how well either method works for you. What works great for one person might be just okay for another.
Administration Convenience
This is where personal preference comes in. Gels tend to win out in terms of ease of application. You just squeeze it out and rub it in. Patches, on the other hand, need to be carefully applied to clean, dry skin, and you have to make sure they stick properly.
The application schedule is the same for both – once a day. But with the patch, you have to think about rotating application sites to avoid skin irritation. With the gel, you just need to be mindful of letting it dry completely before getting dressed or coming into contact with others (especially women and children).
Hormone Level Stability
The way each method delivers testosterone impacts how stable your hormone levels will be. Gels tend to provide a more consistent, gradual release of testosterone throughout the day. Patches, while also designed for a steady release, can sometimes lead to more fluctuations, depending on how well the patch adheres to your skin and how consistently your body absorbs the medication.
Side Effects
Side effects are a crucial consideration. Patches are notorious for causing skin irritation at the application site. Gels are generally better tolerated in that regard, but you still need to be aware of potential systemic side effects.
Serious side effects are possible with both, including mood changes (irritability, aggression), and, in rare cases, increased risk of prostate or breast cancer, so it’s important to address concerns if finasteride is not working after 1 year. It’s vital to discuss your individual risk factors with your doctor.
Cost and Accessibility
Cost can be a major factor, especially when considering if HRT is affordable. Let’s look at some examples (prices can vary):
- Androderm (patch, brand name): About $670 for 30 patches (4mg each), which works out to around $22 per day.
- Androderm (patch, generic): Much more affordable, ranging from about $3.50 to $10.00 per patch.
- Testim (gel, brand name): A single 88g container can cost around $600, or roughly $20 per day.
- Testim (gel, generic): Significantly cheaper, around $160 for a single container (up to 90 grams).
Insurance coverage can greatly impact your out-of-pocket costs. Check with your insurance provider to see which forms of testosterone replacement therapy are covered and what your co-pays will be. Accessibility can also vary depending on your location and your pharmacy’s stock.
Lifestyle Compatibility
Finally, think about your lifestyle. If you’re very active and sweat a lot, a patch might not stay in place as well. If you travel frequently, gels might be more convenient to pack and apply. If you have young children or a partner who might come into contact with the application site, you’ll need to take extra precautions with gels to avoid accidental testosterone transfer. Consider these factors when weighing your options.
Dosage and Treatment Regimens
Testosterone patches typically deliver between 2 and 4 mg of testosterone per day. Gels usually start at 50 mg per day, but the dose can be adjusted anywhere from 20 mg to 100 mg daily, depending on the individual’s response to treatment.
Finding the right dosage is key. It’s not about hitting some arbitrary number; it’s about achieving optimal testosterone levels while minimizing potential side effects. What works for one person might not work for another, which is why a cookie-cutter approach simply doesn’t cut it when it comes to hormone replacement therapy.
Regular monitoring and follow-up with your healthcare provider are essential. They’ll track your testosterone levels, assess any symptoms you’re experiencing, and make dosage adjustments as needed to ensure you’re getting the most benefit from your treatment while staying safe and healthy.
Who shouldn’t use testosterone patches or gels?
Testosterone patches and gels are contraindicated in men with prostate cancer or breast cancer. It’s super important to talk to your doctor about your full medical history before starting testosterone therapy.
Beyond those contraindications, there are a number of precautions to keep in mind. For example, testosterone therapy can worsen sleep apnea. It can also cause your body to retain fluids, which can be problematic if you have heart or kidney issues. And, testosterone can affect your cholesterol levels and red blood cell count, so your doctor will need to monitor you regularly.
Never start testosterone therapy without close medical supervision. Your doctor can help you weigh the risks and benefits and make sure you’re using the treatment safely.
Popularity and Trends
Testosterone gel is much more popular than the patch. In 2020, doctors in the United States wrote about 1.5 million prescriptions for testosterone gel compared to around 500,000 for the patch.
Testosterone replacement therapy (TRT) is becoming more common as the population ages and awareness of low testosterone (low T) increases. The gels are favored by many due to ease of use, but some men prefer the patch for its convenience and consistent dosing. Both methods are experiencing continued use in TRT.
Frequently Asked Questions
What is the number 1 way to increase testosterone?
While lifestyle factors like diet, exercise, and sleep play a role, the most direct way to increase testosterone, if you have clinically low levels, is through testosterone replacement therapy (TRT) prescribed by a healthcare provider. Never attempt to self-treat.
Is gel better than patches?
Neither is inherently “better.” The best choice depends on individual factors like skin sensitivity, lifestyle, and personal preference. Gels offer more flexible dosing, while patches provide a more consistent release. Discuss the pros and cons of each with your doctor.
Where is the best place to put a testosterone patch?
The best place to apply a testosterone patch is generally on the upper arm, thigh, or back. It’s important to rotate application sites to avoid skin irritation. Follow your doctor’s instructions and the manufacturer’s guidelines carefully.
Do testosterone patches work as well as injections?
Testosterone patches can be effective, but some research suggests injections may lead to more stable testosterone levels. Patches deliver testosterone through the skin, which can sometimes result in lower absorption compared to direct injection into the muscle.
What is the gold standard for TRT?
Testosterone injections are often considered the “gold standard” for TRT due to their reliability, cost-effectiveness, and ability to achieve stable testosterone levels. However, the ideal treatment ultimately depends on individual needs and preferences, so it’s essential to discuss all available options with a healthcare professional.
Closing Thoughts
Testosterone patches and gels both deliver testosterone to your body, but they do so in different ways. Patches are applied directly to the skin and provide a steady dose, while gels are rubbed on and can have more variable absorption. Patches may cause skin irritation for some, and gels require careful application to avoid transferring testosterone to others.
If you think testosterone replacement therapy (TRT) might be right for you, it’s essential to talk with your doctor. They can assess your individual needs and help you decide if TRT is appropriate and, if so, which delivery method is best.
The choice between a patch and a gel often comes down to personal preference and how your body responds. Some people prefer the convenience of a patch, while others prefer the flexibility of a gel. No matter which method you choose, it’s important to monitor for any side effects and work with your healthcare provider to adjust your treatment plan as needed. TRT is not one-size-fits-all, so finding the right approach for you is key.