Injections vs gels vs pellets vs patches - picking a delivery form

There is no single best delivery form for testosterone. Each has a different pharmacokinetic pattern, a different side-effect profile, a different practical footprint in your week, and a different cost. The right choice is the one that fits your life and produces stable blood levels in the mid-normal range without the side effects that bother you most.

This article walks through each UK-available form, with the real-world trade-offs.

Testosterone gels (Testogel, Tostran, Testavan)

Daily transdermal application to the shoulders, upper arms, or abdomen. A 50mg sachet (Testogel) or pump dispenser (Tostran) delivers a dose that maintains physiological levels with relatively stable pharmacokinetics across the day.

Strengths: very even blood levels (no peaks and troughs), easy to titrate (just change the daily amount), easy to stop (clears within days), no injections, can be self-adjusted carefully with clinical oversight.

Weaknesses: transfer risk to partners and children (must wash hands, cover application site, avoid skin contact with others for several hours), some men do not absorb well (about 10 to 15 percent are "gel non-responders" who need higher doses or a switch), daily discipline required, small but real ongoing mess.

Cost (2026 UK private): Testogel 50mg daily £35 to £45 per month wholesale plus dispensing margin.

Best for: men who prefer daily routine, want easy adjustability, have young children and are prepared to manage transfer risk carefully, or want a delivery form that is easy to stop if fertility becomes a consideration.

Testosterone undecanoate injection (Nebido)

Deep intramuscular injection (gluteal), 1000mg every 10 to 14 weeks after initial loading. The classic "long-acting" regimen.

Strengths: minimal appointments (four injections per year after stabilisation), no daily routine, very stable once established, no partner transfer risk.

Weaknesses: the injection itself is large-volume (4mL oil-based), needs a clinician or a trained partner to administer, peak-trough variation over the dosing interval can produce mood or libido fluctuations in some men, harder to fine-tune (you cannot rapidly change dose), rare injection-site reactions can be prolonged.

Cost: Nebido 1000mg injection £65 to £85 per dose, so roughly £260 to £340 per year for medication plus the cost of administration if not self-administered.

Best for: men who want minimal routine, are stable on dose, do not need fine-tuning, and either self-inject comfortably or have convenient access to a nurse.

Testosterone enanthate or cypionate (Sustanon-style regimens)

Short-acting intramuscular injections, typically 250mg every 7 to 14 days self-administered. This is the classic gym-forum regimen but has real clinical utility when used properly.

Strengths: very fine-tunable (weekly dose can be adjusted easily), cheap (generic enanthate vials are inexpensive), predictable kinetics if dosed every 7 days, widely available.

Weaknesses: frequent injections, variable steadiness of blood levels depending on frequency, slightly higher tendency to aromatise to oestradiol at peak, requires self-injection skill.

Cost: testosterone enanthate 250mg weekly roughly £30 to £50 per month wholesale.

Best for: men who want predictable self-administered regimens, are comfortable with injections, want dose flexibility, and are willing to learn safe injection technique.

Testosterone patches (Andropatch)

Daily transdermal patch. Rarely used in the UK now because the patches have been associated with higher rates of skin reactions than gels and are largely superseded. Still available in some formulations.

Strengths: daily steady dose, no gel transfer issues.

Weaknesses: skin reactions are common (20 to 30 percent of users), visible adhesion, frequent patch failure, supply has been inconsistent.

Cost: patches are typically more expensive than gels on a monthly basis.

Best for: very few patients in 2026 unless there is a specific gel intolerance.

Testosterone pellets (subcutaneous implants)

Subcutaneous pellet insertion under local anaesthetic every 4 to 6 months. Each pellet contains around 200mg testosterone that releases slowly.

Strengths: very long-acting, minimal touch points (two or three procedures per year), no injection or gel routine.

Weaknesses: requires a minor procedure each time, risk of pellet extrusion or infection (uncommon but consequential), very limited UK availability through private clinics, hard to rapidly stop if needed (the pellet continues to release for weeks).

Cost: varies widely; not commonly offered in the UK private market.

Best for: patients with established preference from abroad, or in specific clinical contexts. Not a first-line choice in UK practice.

Oral testosterone undecanoate (Jatenzo, Tlando)

Oral testosterone designed to bypass hepatic first-pass. Approved by the FDA; not widely used in the UK in 2026.

Strengths: oral convenience, no injections or gels.

Weaknesses: needs to be taken with fat-containing meals, variable absorption, still some concern about long-term liver safety despite new formulations, relatively new and long-term UK experience limited.

Cost: currently premium-priced compared to gels and injections.

Best for: patients with strong preference against injections or gels who accept the limitations. We prescribe it occasionally where appropriate.

What we usually recommend first

For most men with no strong preference, we suggest Testogel or Tostran as first-line. It is easy to start, easy to stop, easy to adjust, and the monitoring data at 12 weeks tells us whether you are absorbing appropriately.

For men who find gels inconvenient, who have small children in close contact, or who want minimal routine, we move to injections - usually Nebido for stability or enanthate for fine-tuning.

We do not prescribe patches as first-line. We do not routinely use pellets. We use oral preparations only where injections and gels are both unacceptable.

Switching between forms

This is usually straightforward. Stop the current form, wait for washout (4 to 5 days for gels, 2 to 3 weeks for enanthate, 10 to 12 weeks for Nebido), then start the new form with appropriate titration. We repeat bloods at 6 and 12 weeks after any switch.

Men switching from injections to gels often notice smoother mood and libido day-to-day. Men switching from gels to injections often notice less routine demand and more convenience.

The cost in practice

At LoveMyLife, all TRT delivery forms are included in the same monthly care plan (£125 per month for ongoing care). We do not charge different rates for different forms. Your choice of form does not change what you pay. This is deliberate: the choice should be clinical, not financial.

The honest bottom line

Pick the form that fits your life and produces stable blood levels without the side effects that bother you most. The differences between forms matter at the margin but all deliver effective replacement when properly dosed. Switching is easy when the first choice does not work.

Ready to start?

If this article has made you think an assessment might help, the next step is a short consultation with one of our men's health doctors.

Begin your consultation at this link. Online or in person at Westfield London.