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There isn't one best way to take testosterone. Injections, pellets, gels and patches all deliver the same hormone, and each comes with a trade-off. The right pick depends on your routine, your budget, how steady you want your levels and how often you can get to an office. Fertility plans matter too, since they decide whether testosterone makes sense at all.
Not diagnosed yet? Start with how testosterone replacement therapy is evaluated at Keystone.
Injections cost the least and are the easiest to adjust, but levels rise and fall between doses. Pellets last three to six months, yet they need a small procedure and can't be stopped quickly. Gels and patches give steady daily levels. Gels can rub off onto other people, and patches often irritate the skin.
| Method | How it's given | How often | How steady | Common downsides | Tends to suit |
|---|---|---|---|---|---|
| Injections | Shot into a muscle | Every 1 to 2 weeks in many practices | Peaks, then dips before the next shot | Sore site; swings; raises red cell count more often | Men fine with needles who want low cost and easy changes |
| Pellets | Placed under the skin of the hip | Every 3 to 6 months | Rise, then taper | Procedure each round; extrusion or infection; can't be stopped quickly | Men on a settled dose who want fewer visits |
| Gels | Rubbed onto the skin | Daily | Steady | Transfer to women and children (FDA boxed warning) | Men who want no needles and can follow transfer rules |
| Patches | Adhesive patch on the skin | Daily, at night | Steady | Itching, redness or rash | Men who want daily dosing and tolerate adhesives |
Testosterone injections are the most common choice and usually the cheapest. Many practices give a shot every one to two weeks, and the dose is simple to change after a lab check. The main drawback is the swing: levels peak after the shot and drift down before the next one.
Most programs use testosterone cypionate or enanthate. Their FDA labels list doses every two to four weeks, but many prescribers give smaller weekly shots to flatten the peaks. What does the dip feel like? Tired. A little flat, right before shot day.
You can learn to give the shot yourself. The Endocrine Society guideline notes that injections push up hematocrit (the share of your blood made of red cells) more often than gels or patches, so lab checks matter more with shots, not less.
Testosterone pellets are about the size of a grain of rice and are placed under the skin of the hip during a short office procedure. One round usually lasts three to four months, sometimes up to six. No weekly routine. The trade is control, because a pellet dose can't be lowered or stopped quickly once it's in.
The FDA-approved testosterone pellet is Testopel. Its label calls for 150 to 450 mg (two to six 75 mg pellets) every three to six months, placed through a small cut after the skin is numbed. Levels climb, then taper, so some men feel symptoms creep back near the end of a round.
The label lists extrusion (a pellet pushing back out through the skin) and infection at the site, plus bruising and soreness. If a side effect shows up, there's no next dose to skip. The pellets keep releasing testosterone until they dissolve, and removing them takes another procedure.
Some clinics use compounded pellets, which are not FDA-approved and are not reviewed by the FDA for safety, effectiveness or quality. It's fair to ask any clinic, ours included, which kind it uses.
Testosterone gel is rubbed onto clean, dry skin once a day, usually in the morning, on spots like the shoulders and upper arms. Levels stay fairly steady. No needles. No procedure. The catch is transfer: the hormone can rub off onto anyone who touches the area before it's covered or washed.
That risk earns testosterone gels an FDA boxed warning, the agency's strongest kind. Children exposed to a parent's gel have developed signs of early sexual development (virilization), and women can be affected too. Labels say to wash your hands, cover the area once dry, and wash the skin before close contact. Young kids who climb on you every morning? That alone is a good reason to pick another method.
Absorption varies, so doses often need a tweak after the first labs.
A testosterone patch is a thin adhesive you wear on the skin and replace every day. The FDA label for Androderm, a testosterone patch, says to put it on at night on the back, belly, upper arm or thigh. Levels follow a steady daily rhythm. Skin trouble is the most common reason men stop.
Itching, redness and blistering are the side effects the label reports most. Rotating sites helps some men; others can't tolerate the adhesive. Transfer is less of a worry than with gel.
Every form of testosterone follows the same rules. Low testosterone should be confirmed with lab work first. Testosterone isn't for men trying to conceive. Blood count and PSA need regular checks, and some men shouldn't start at all. The method changes your routine, not these basics.
The American Urological Association guideline says low testosterone should be diagnosed only after two total testosterone tests on separate early mornings, alongside symptoms or signs, with below 300 ng/dL as a reasonable cutoff. The Endocrine Society guideline also calls for a repeat morning test. Unsure about symptoms? Read common signs of low testosterone in men.
Testosterone from any source makes your body produce less of its own, and sperm counts drop with it. The AUA guideline says not to prescribe it to men trying to conceive.
Testosterone raises red blood cell production. The Endocrine Society guideline says to check hematocrit before you start, at 3 to 6 months, at 12 months and then yearly, and to stop therapy if it tops 54% until it comes down. PSA, a prostate blood test, is checked before you start in men 40 and older (AUA). For men 55 to 69, and higher-risk men 40 to 69, who choose prostate monitoring, the Endocrine Society advises a repeat 3 to 12 months in.
Per the Endocrine Society guideline, testosterone generally isn't started in men with prostate or breast cancer, a high hematocrit, untreated severe sleep apnea, uncontrolled heart failure, or a heart attack or stroke in the past six months. For a wider look at fit, see is testosterone replacement therapy right for you?
On February 28, 2025, the FDA announced class-wide label changes. Ambulatory blood pressure studies showed that testosterone products can raise blood pressure, so every label now carries a blood pressure warning, and higher blood pressure can raise the risk of heart attack and stroke. The FDA also added the results of the TRAVERSE trial, which found no increase in heart attack, stroke or cardiovascular death with testosterone gel in men 45 to 80 with low testosterone who had, or were at high risk of, heart disease, and it removed older boxed-warning language about cardiovascular risk. TRAVERSE did see more atrial fibrillation, acute kidney injury and blood clots in the lungs with testosterone. Labels still say safety and effectiveness aren't established for low testosterone from aging alone, though in June 2026 the FDA asked manufacturers to remove that line. So blood pressure belongs in every follow-up.
At both Keystone Medical Wellness offices, the choice starts with a provider visit and lab work. Keystone offers four delivery forms (injections, long-acting pellets, transdermal gels and patches), so the method can fit your situation. Chad Dance, FNP-C, MSN, MS, leads the men's hormone program at both locations.
The first visit takes about 45 minutes and includes a basic exam and baseline labs: total and free testosterone, estradiol, hematocrit and PSA. Keystone reviews results at a second visit and does not prescribe testosterone without labs. Follow-up labs come at six weeks and three months, then every three to six months once levels are stable.
Most men start on weekly injections to find the dose, then can discuss pellets or gel. See also what to expect from testosterone replacement therapy.
The services pricing page lists injectable testosterone for men at $25 (amounts tailored to your blood work) and the male testosterone pellet package, with all necessary pellets and the procedure, at $575. Gel and patch prices aren't posted. Keystone is out-of-network, accepts HSA and FSA, and offers financing through Cherry.
Both Keystone Medical Wellness offices offer all four options, with the same posted prices and the same hours: Monday 8 a.m. to 6 p.m., Tuesday and Thursday 8 a.m. to 5 p.m., Wednesday 7 a.m. to 5 p.m. and Friday 7 a.m. to 1 p.m. The two offices are about 14 road miles apart.
Gilbert. 3076 E. Chandler Heights Road, Suite 115, Gilbert, AZ 85298. (480) 499-4441. See the Gilbert testosterone replacement program.
Mesa Eastmark. 10706 E. Point Twenty-Two Blvd, Suite a106, Mesa, AZ 85212. (480) 485-9677. See the Mesa Eastmark testosterone replacement program.
For diagnosis, exclusions and monitoring in more depth, see men's testosterone replacement or the hormone replacement therapy overview.
Per the Testopel label, one insertion usually works for three to four months, and sometimes up to six. Keystone's TRT pages say three to six months is typical. Follow-up labs show when yours is wearing off.
The skin is numbed with a local anesthetic before the pellets go in through a small cut. Afterward, soreness, bruising and itching at the site are listed side effects on the Testopel label. Report spreading redness, drainage or a pellet working its way out.
Often, yes. Keystone usually starts men on weekly injections, finds the dose that works on labs, and then talks about pellets for convenience. Starting on shots means an early side effect can be handled by changing or stopping the dose.
Yes. Testosterone therapy lowers sperm production with every method, and the American Urological Association guideline says it should not be prescribed to men trying to conceive. If you want children now or later, tell your provider before you start.
There's no good evidence that they are. Pellets, gels and patches contain the same hormone your body makes, and injections use a form the body turns into it. Risks like a higher red blood cell count and lower sperm counts come with testosterone itself, whatever the method.
FDA, class-wide labeling changes for testosterone products (February 28, 2025). HHS and FDA, requested testosterone label updates (June 18, 2026). Lincoff et al., TRAVERSE trial, New England Journal of Medicine (2023). FDA labels for Testopel, AndroGel, Androderm and testosterone cypionate. American Urological Association, Evaluation and Management of Testosterone Deficiency (2018, validity confirmed 2024). Endocrine Society, Testosterone Therapy in Men With Hypogonadism (Bhasin et al., 2018).
General information, not medical advice. Talk with a licensed provider about your own health.
Keystone Medical Wellness, LLC is a nurse practitioner-led medical wellness practice with offices in the City of Mesa (Eastmark) and the Town of Gilbert, both in Maricopa County in the Phoenix metropolitan area of Arizona. Chad Dance, FNP-C, MSN, MS, leads the clinical team. Services include hormone replacement therapy, medical weight loss, IV therapy, ketamine infusion therapy, peptide therapy and regenerative therapy, with posted prices.
