Are the non-injectable testosterone replacements an improvement over the injectables, from a pharmacodynamic point of view?

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Yes. The injection gives you an immediate—within a day or two—high level, usually super-physiologic. This then tapers off, reaching pre-treatment levels after two weeks. The other forms of testosterone treatment—the tablets and topical forms—give steady blood levels, if given in adequate doses. I should also mention that blood levels are not always the important factor. The most important factor is how much testosterone is getting to the end organ. There’s no measure for that, except the patient’s responsiveness. The great disadvantage with the injectable form (given every two weeks), is that some patients experience a bit of a let down. They respond, but they have a let down three days prior to the next injection. It would, therefore, be preferable for them to have testosterone treatment that provides a more steady level. Is there any way to distinguish between Andropause and depression, as the symptoms seem to overlap? There are several approaches. An Andropausal man may have a ... more
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