A basic approach to improving symptoms related to low testosterone involves two main components:
Administration of exogenous testosterone – typically through gels, patches, injections or pellets.
Management of estrogen production – using an aromatase inhibitor (e.g., letrozole) to keep estrogen levels in a healthy range.
This combination can help restore energy, libido, mood and muscle mass while preventing the side‑effects that sometimes occur when testosterone is increased too rapidly or without regard for estrogen balance.
1. Exogenous Testosterone
Delivery Method Typical Dosage (Approx.) Frequency Pros Cons
Topical gel 50 mg/day (25 mg twice daily) Daily Easy to use, gradual absorption Risk of transfer to others
Nasal spray 200–400 µg/day Daily Rapid onset, no systemic peaks Expensive, requires prescription
Oral tablets 1–3 mg/day (e.g., dutasteride) Daily Oral convenience Variable absorption, GI side effects
- Pros: Rapid onset, high bioavailability, no chewing.
- Cons: Requires dissolution time (~5–10 min), limited to liquids.
Chewable Tablets
- Pros: No swallowing needed, suitable for patients who can chew; pleasant flavors.
- Cons: Chewing may reduce absorption; potential for irritation if not chewed properly.
Sublingual/Oral Films
- Pros: Fast onset (≤2 min), high bioavailability, convenient for on-the-go use.
- Cons: Requires careful placement under tongue, limited dosage per film, possible taste issues.
All three are designed to deliver a rapid therapeutic effect for pediatric patients needing immediate relief from pain or anxiety, ensuring safety and ease of administration in various settings.
