Hypogonadism, also known as low testosterone or “low T,” can lead to symptoms of decreased energy and libido, difficulty building lean muscle mass, moodiness, difficulty concentrating, and even loss of bone density.  Men who are symptomatic and demonstrate low testosterone on a blood draw are candidates for testosterone replacement therapy (TRT).  There are many options for TRT, each of which has its benefits and disadvantages.  The decision about which one is right for you will depend on your personal preferences and a discussion with Dr. Hakky.  In some cases, different insurance companies may cover one option and not another, which may also be taken into consideration.  If the desired effects are not achieved with your initial choice, a different option can be tried to see if it is a better fit for you, your health, and your lifestyle.


Which option is right for you?

Transdermal Patch

No longer recommended due to skin irritation.

  • Androderm: Transdermal patches, in two different strengths: 2mg testosterone per 24-hour patch and 4mg testosterone per 24-hour patch. The usual starting dose is one 4mg patch applied to skin daily. Formerly used but no longer recommended due to skin irritation.


Advantages include efficacy and patient satisfaction, dosing ranging from weekly to as infrequently as every 10 weeks, and low cost. Disadvantages include increased fluctuation (peaks and valleys) in testosterone levels compared to daily dosing options and the requirement for needles and self-injection.

  • Testosterone Cypionate (TC): 200mg testosterone per cc, which is injected into the muscle (IM). Injections can be done in the clinic, or you can be taught by our nurse how to self-administer. The usual starting dose is 1cc IM weekly to every other week.
  • Testosterone Enanthate: 200mg testosterone per cc, which is injected into the muscle. Some patients may experience less water retention than with TC.
  • Testosterone Undecanoate (Aveed): 750mg in 3cc is injected into the muscle. Injections are performed in the clinic upon initiation, at 4 weeks, and then every 10 weeks.


The advantages of this therapy include convenience and decreased frequency of dosing. As this requires a short office procedure, there are risks including bleeding, infection, and pellet extrusion in less than 1% of cases.

  • Testopel (Subcutaneous Testosterone Pellets): This comes in cylindrically shaped pellets that are about the size of a grain of rice. Each sterile pellet contains 75mg of testosterone. The usual starting dose is 10-14 pellets implanted subcutaneously in the office under sterile conditions once every 3 months.


The advantages of this modality is that avoids needles, and implants. Additionally it cannot be passed from skin to skin contact between people.

  • Natesto ( Inhalable Testosterone): After you blow your nose one can administer the gel by inhalation. It is recommended to apply one pump to each nostril three times daily.

Men’s Health Georgia: The State’s Premier Provider of Men’s Health Treatment

Men’s Health Georgia is a world class men’s health clinic. We are here to help you restore a fantastic, enjoyable, and youthful sex life. We have state of the art technology and therapies that can help you in just one visit, guaranteed! We accept all major insurances for your convenience.