Education
The Different Types of TRT
Written and reviewed by Dr. Slava Fuzayloff, DO · Board-Certified Internal Medicine · Last updated: July 2026
Education
Written and reviewed by Dr. Slava Fuzayloff, DO · Board-Certified Internal Medicine · Last updated: July 2026
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There are five main types of TRT (testosterone replacement therapy): injections, skin gels, oral capsules, implanted pellets, and nasal gel. They all raise low testosterone. They differ in how often you use them, whether they involve a needle, cost, and how steady they keep your levels.
No single type is "best." The right one depends on your routine, your budget, how you feel about needles, and your health.
Injections are the most common type of TRT. Most men use testosterone cypionate or enanthate — two nearly identical forms with a half-life of about 8 days (how long it stays active in your body). A typical dose is 50–100 mg once a week, or 100–200 mg every two weeks.
The shot can go into the muscle (intramuscular) or under the skin (subcutaneous). Under-the-skin shots use a smaller needle and give steadier levels. Injections are the cheapest option and give the most dose control. The trade-off is a needle on a schedule, and levels that peak and dip between doses.
BEST FOR lowest cost and precise dose control.
Gels are a needle-free type of TRT you rub into the skin once a day — usually the shoulders or upper arms. They keep testosterone steady through the day, without the peaks and dips of injections.
Two downsides: the gel can rub off on a partner or child through skin contact until it dries, so the area must be covered — and it only works if you apply it every day.
BEST FOR avoiding needles, if you'll apply it daily.
Oral TRT is a pill taken by mouth, usually twice a day. Three forms are FDA-approved: Jatenzo, Tlando, and Kyzatrex — the only oral testosterone products cleared for TRT in the U.S. (older oral testosterone was linked to liver problems; these newer forms bypass that).
The trade-offs are twice-daily dosing and absorption that varies with food.
BEST FOR no needles and no transference risk around family.
Pellets are rice-sized implants placed under the skin that last about 3 to 6 months. A quick in-office procedure inserts two to six pellets, which release testosterone slowly.
The trade-off is control: once pellets are in, the dose can't be adjusted until they wear off.
We do not offer pellet therapy at Testosterone Clinic NYC. We use injections, gels, and oral testosterone — methods that let us adjust your dose based on your bloodwork instead of locking it in for months.
Nasal gel (brand name Natesto) is applied inside the nostrils a few times a day. Because it isn't on the skin, there's no risk of rubbing off on others. It's uncommon and requires dosing multiple times daily.
BEST FOR no transference, if frequent daily dosing is fine.
| Type | How often | Needle? | Cost | Level stability |
|---|---|---|---|---|
| Injections | Weekly or every 2 weeks | Yes | Lowest | Peaks and dips |
| Gels | Daily | No | Higher | Steady |
| Oral capsules | Twice daily | No | Higher | Varies with food |
| Pellets | Every 3–6 months | Procedure | Highest | Steady |
| Nasal gel | Few times daily | No | Higher | Steady |
The best type of TRT is the one that fits your life so you use it consistently. All five work when dosed correctly, so the choice comes down to needles, daily routine, cost, and whether you live with young kids or a partner.
Needles? If a dealbreaker: gels, oral, or nasal.
Daily routine? If you won't apply something daily: injections or pellets.
Cost? Injections are cheapest by a wide margin.
Live with kids or a partner? Gels carry transference risk; oral and nasal don't.
You don't have to get it right the first time. Switching types later is simple.
Injections may add slightly more lean muscle than gels, likely due to higher testosterone peaks. But the difference is modest — your dose matters far more than the delivery method.
Not sure which type fits you? That's what the evaluation is for.
Book an evaluation ($175, same-day available). Dr. Fuzayloff evaluates every patient in person.
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