Topical forms include creams, gels, and lotions. These are applied to clean and dry skin. They are very good options as they provide a continuous steady release of testosterone and the doses are easy to adjust to provide the necessary amount of testosterone. The only problem with this form is than testosterone can be transferred to others by contact, but this can be prevented with proper preparation. Injectable forms are injected intramuscularly every two to four weeks. The biggest problem with injections is that blood levels do not stay steady between injections. Blood levels of testosterone are high immediately following the injection and are low just prior to the next injection resulting in fluctuations in mood, energy level, libido, and sexual function.
Implants require a surgical procedures every 3 months and the dose is difficult to adjust, therefore they are not used very often.
Patches are a good choice as they mimic natural levels of testosterone throughout the day.
Pills that are swallowed are not recommended for androgen replacement due to the potential for liver damage.
Buccal and sublingual routes are effective. A tablet placed under the tongue or between the gum and cheek release the testosterone and result in rapid absorption. Along with tablets, troches and lozenges are available as well.
Doses are easily adjusted with this route of administration.

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