I went to my urologist today and was given my "options" for replacement; either a once monthly shot or gel (pump). I'm going to retest in 6 weeks to see if my total (309) and free might have come back up (it did last summer after quitting cholesterol med.-Crestor). This time, I've stopped Vytorin for the time being to see what effect, if any (the Vytorin is having on testosterone). Assuming my PSA comes back good, then I'll be cleared to start replacement.

Can anyone(s) give me input on shots v. gel? My concerns are cost (insurance coverage too), side effects and suppression of natural testosterone production. PLEASE advise me of any others! I was told I would have to go for a shot once per month (I think) or could use the pump at home. My doctor is approx. 60 miles from me so in the travel regard, the pump sounds better although I'm one who likes to get it over and done. So, the shot sounds good too :confused: .

Thanks for any input.

You don't give enough information to give good advise to you. I would need to know your age, general health, and blood test results and whether or not you want to remain fertile.

Both treatments will render you with low sperm count. In my opinion after having been on both the shots are better but once a week is the least often I would suggest for shots. Once a month is not going to work. You would have to have a huge dose and that would put you on a hormonal roller coaster. T and Estradiol way too high early and then way too low at the end of the month. Given the choice you have I would do the pump. But if you can choose I would find another doctor to work with. You can give yourself the shots once a week if your doc will let you. For most men the gel does not get their T high enough to work well.

If you are interested in remaining fertile or keeping your testicles a working and a reasonable size then neither treatment is appropriate.

The self injection once a week is more effective, easy, & the least expensive.

You also need to keep track of your estradiol E2. My doc said E2, not testosterone was a problem with the prostate.

JinL,

What is the cost (vial) to do the once per week shot?

Thanks.

Hayfarmer,

My age is 40, my health is good (other than high cholesterol) and my blood test result was only Total=308. I am going to repeat the test in mid-June which will include free.

Thanks.

The cost of T cypionate for me is about $60 for 10 ml at 100 mg/ml incluinding syringes. I take about 0.70 ml per week so this is about a 14 week supply for $60. Compare that to 10g per day of androgel which has a retail cost of over $500 per month.

Hopefully stopping the Vytorin will solve your problem. If not you need to have additional blood work done to see why your T is low. You need to test total T, LH. FSH, prolactin, estradiol, total estrogen, vitamin D, and TSH to start with.

Be aware if only on T shots or gel your testicles will shut down and atrophy (shrink) and your sperm count will drop dramatically. If you dan't want that to happen you need to either find a way to increase the LH from you pituitary which keeps the testicles working or take HCG which is almost identical to LH. You can take the HCG with T replacement if necessary. But first you need to find out why your T is low and you need to do that before you start any treatment or the blood test results will be skewed by the treatment.

Thanks so much. This advise is much needed and I'm not in a big hurry. I'll check out all the avenues before starting.

Hayfarmer (or anyone else),

My prolactin was 2.0 (low being below 2.1)? Do you know the significance of such???

Thanks.

you have me stumped on that one. I have not had any prolactin issues so I have never really studied it. My guess is as long as its not too high you are ok there.

I read, with interest, the question and the replies. I have tried both treatments and neither of them helped me. In fact, both treatments had the opposite effect on me. I was told that they would energize me and increase my sex drive. What happened was they made me feel tired ... very tired! My doctor took me off both of them and now I'm back to square one. My T-testosterone was under 300. I'm 55 and have been an insulin-dependent diabetic since the age of 16. I now seriously struggle with ED and have been unsuccessful finding products (drugs or supplements) that successfully address this issue. If you, or anyone reading these posts, have some productive thoughts on this matter - please share them. Thank you.

rebdr,
The key to making T replacement therapy work is to monitor T levels AND estradiol levels. You must also keep estradiol to between 20-30 pg/ml. Most doctors do not monitor this. What was your T level when on gels and shots? 300 is way too low. Also you need to either monitor your free T level or get an SHBG reading so you can now what total T to try to get to so you feel good.

Its very possible when you were on T replacement your dose was not right. What happens is your body senses the externally supplied T and your testicles will stop producing T. SO you can actually end up with a lower T level then when you started. To fix this you need to adjust your dose of gel or T shots upward until you get to the right level. Also HCG can keep your testicles working at the same time if you don't want them to shut down and shrink.

The ED issues could be related to the long term diabetes or low T or a combination of both. Certainly getting your T level right would be a step in the right direction for the ED issue.

I feel best when my Testosterone:Estradiol ratio is over 30:1 up to 50:1

When I started HRT my T:E2 ratio was 2:1 & I was a mess mentally & physically.

Always get your Estradiol E2 tested when testinging testosterone.

My testosterone is in the upper 1/4 of the range & the Estradiol is now in the lower 1/4 of its range. I have to take 1/2 tablet of Arimidex 3 or 3 times a week to keep the E2 down.

One of the reason seems to be cholestrol drugs. (read the other thread). so why not stop (with docs advice, if it is not too high) wait and try clomid to kickstart HPTA. once on TRT always on TRT.