Testosterone Therapy With Subcutaneous Injections: A Safe, Practical, and Reasonable Option.

Area of Science:

• Endocrinology
• Pharmacology
• Men's Health

Background:

• Intramuscular (IM) testosterone ester injections have been a standard for nearly 80 years, offering predictable levels and cost-effectiveness.
• However, IM injections present challenges in self-administration and can cause discomfort.
• Subcutaneous (SC) administration is emerging as a more accessible self-administration option.

Purpose of the Study:

• To review the pharmacokinetics and safety of subcutaneous testosterone therapy.
• To provide clinical guidance for managing patients choosing the SC route for testosterone esters.

Main Methods:

• Systematic review of existing literature on SC testosterone administration.
• Inclusion of clinical trials, case series, and case reports.
• Review of testosterone absorption pharmacology following SC administration.

Main Results:

• Limited data suggest SC testosterone therapy yields comparable pharmacokinetics and mean serum levels to IM injections.
• Patients can be trained for safe and relatively easy SC self-administration with reduced discomfort.
• The SC route has the potential to enhance patient adherence to testosterone therapy.

Conclusions:

• SC testosterone therapy is a feasible and potentially advantageous route compared to IM injections.
• Clinicians should discuss the SC option with patients due to its ease of self-administration and adherence benefits.
• Further comparative safety studies between SC and IM routes are warranted.