Hypogonadism is a condition in which the body fails to make enough hormones because of a problem with the testicles, pituitary gland, or brain.

Men use testosterone products to help with fatigue, erectile dysfunction, and loss of sex drive. A number of prescription testosterone products are available to treat hypogonadism. Testosterone products come in different forms, including gels, injectable solutions, patches, pills, and pellets implanted under the skin.

Once a patient starts testosterone therapy, they usually undergo lifelong treatment which means that doctors will monitor the patient’s hormone levels every six months to a year. Depending on the patient, the checkups may be more frequent.

Subtle Symptoms of Low Testosterone

The symptoms of low testosterone are sometimes obvious, but they also can be subtle. Testosterone levels decline naturally in men as they age over the decades. But certain conditions can also lead to an abnormally low level. Symptoms of low testosterone include:

• low sex drive (libido);
• erectile dysfunction;
• fatigue and poor energy level;
• decreased muscle mass;
• body and facial hair loss;
• difficulty concentrating;
• depression;
• irritability;
• low sense of well-being.

If men have symptoms of low testosterone and tests show they have an abnormally low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended.

Types of Testosterone Products

Testosterone can be administered in a skin patch, skin gel, pill, or cream form — or as an injection, a solution applied to the armpit or a patch, or a buccal system applied to the upper gum or inner cheek.

While many testosterone products are available only with a prescription, some drug stores and health food stores sell them over the counter. A few of these products also claim to be all-natural.

Gels (Androgel and Testim)

Testosterone gel is a prescription medication applied directly to a man’s skin — on the shoulders and upper arms and/or abdomen, depending on the brand. Testosterone gel can inadvertently transfer from your body to others and can lead to serious health reactions.

To avoid such contact, apply testosterone gel to clean, dry, intact skin that will be covered by clothing. Wash your hands right away with soap and water after applying. Once the gel has dried, cover the area with clothing and keep it covered until you have washed the area well or have showered.

Injections (Depo-Testosterone)

First approved in 1979, Depo-Testosterone is one of the older drugs of its kind on the market. It’s a liquid and is designed for injection deep into the gluteal muscle. The active ingredient, testosterone cypionate, is a white or creamy white powder mixed with other ingredients to make a solution. The drug is available in two strengths, 100 mg, and 200 mg.

Patches (Androderm)

Testosterone transdermal patches, including Androderm, come as patches to apply to the skin. Patches work best when applied around the same time each night and are left in place for 24 hours. Testosterone patches are meant to be worn at all times until replaced with new patches. Androderm patches should be changed every 24 hours. The old patch should be removed before applying the new one. You should apply the patches to different spots each night and wait at least seven days before re-using a spot.

Capsules (Methyltestosterone and Android)

The testosterone capsules Methyltestosterone and Android have been discontinued but have been used in men and boys to treat conditions caused by lack of the hormone, such as delayed puberty, and in women to treat breast cancer that has spread to other parts of the body.

Methyltestosterone is a man-made form of testosterone. It can affect bone growth in boys who are treated for delayed puberty.