What are the effects of testosterone pellets (testosterone replacement therapy)?

From the Guidelines

Testosterone pellets are a viable treatment option for testosterone deficiency, with the most recent and highest quality study suggesting that testosterone therapy, including pellets, can improve sexual functioning and quality of life in men with low testosterone levels 1.

Benefits and Risks of Testosterone Pellets

The benefits of testosterone pellets include improved energy, libido, muscle mass, and mood, while potential side effects include infection at the insertion site, pellet extrusion, and hormone-related effects like acne or hair growth.

• The typical dose ranges from 600-1200mg for men and 75-150mg for women, with the exact amount determined by body weight, symptoms, and blood test results.
• Patients should expect the procedure to take about 15 minutes, with minimal downtime afterward, though strenuous activity should be avoided for a few days.
• The pellets work by gradually dissolving and releasing testosterone directly into the bloodstream, bypassing the liver and potentially causing fewer side effects than other delivery methods.

Monitoring and Safety

Regular blood tests are necessary to monitor testosterone levels and adjust future dosing appropriately.

• The evidence suggests that testosterone therapy is not associated with an increased risk of prostate cancer, pulmonary embolism, or deep venous thrombosis 1.
• However, the risk of erythrocytosis is a concern, particularly with injections, and patients should be monitored for this potential side effect 1.

Conclusion is not allowed, so the answer will continue without one.

The most recent study found that testosterone treatment improved vitality and fatigue by a less-than-small amount, and also showed a less-than-small improvement in depressive symptoms 1.

• The study also found that the evidence for long-term safety is lacking, and most studies excluded men with recent cardiovascular disease.
• The American College of Physicians recommends that clinicians discuss the potential benefits and harms of testosterone treatment with patients and consider their individual preferences and values when making treatment decisions 1.

From the FDA Drug Label

CLINICAL PHARMACOLOGY Endogenous androgens are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics INDICATIONS AND USAGE Testosterone cypionate injection is indicated for replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous testosterone.

The question about testosterone pellets is not directly addressed in the provided drug labels, which discuss testosterone cypionate injection.

• The labels do not mention testosterone pellets.
• The indications for testosterone cypionate injection are for replacement therapy in males with conditions associated with symptoms of deficiency or absence of endogenous testosterone 2.
• The pharmacokinetics and clinical pharmacology of testosterone esters, such as testosterone cypionate, are described, but not specifically for testosterone pellets 2.

From the Research

Testosterone Pellets Overview

• Testosterone pellets are a form of testosterone replacement therapy used to treat hypogonadism, a condition characterized by low testosterone levels in men 3.
• The goal of testosterone replacement therapy, including pellets, is to achieve serum testosterone levels in the mid-normal range during treatment 4.

Administration and Effects

• Testosterone pellets are implanted under the skin and release testosterone slowly over time, providing a long-acting formulation of testosterone replacement therapy 3.
• The use of testosterone pellets can help improve bone mineral density, muscle mass and strength, sexual function, and quality of life in men with low testosterone levels 4.
• However, testosterone replacement therapy, including pellets, is not recommended for all older men with low testosterone levels and should be avoided in patients with certain medical conditions, such as prostate or breast cancer, hyperviscosity, erythrocytosis, untreated obstructive sleep apnea, or severe heart failure 4, 5.

Comparison with Other Treatments

• Testosterone pellets are one of several available testosterone treatment modalities, including intramuscular injections, nongenital patch or gel, bioadhesive buccal and oral testosterone 4.
• Other treatment options for hypogonadism, such as selective estrogen receptor modulators and aromatase inhibitors, are also available and may have more favorable side effect profiles 6, 7.
• The choice of treatment for hypogonadism depends on various factors, including the individual's medical history, lifestyle, and personal preferences 6, 7.