[Dr. Smith]

I'd be interested in hearing/reading members experiences with the various Low Testosterone treatment alternatives:

Transdermal Patch (e.g. Androderm)
Transdermal Gels (e.g. Androgel, Axiron, Testim, Fortesta)
Compounded Transdermal Cream (by compounding pharmacy)
Implants
Intramuscular Injections

Clomid (clomiphene citrate/clomifene citrate)

Others(?)

I think such a discussion would be useful for this forum.

Doc

PS: If you'd prefer, response via Private Message is OK.

[kellyma1973]

Hi there. Curious whether low testosterone can be caused be chronic neuropathic pain like CRPS? I'm 40 years old, I have low T but insurance doesn't cover androgel/testim. I have pretty good insurance too. Frustrated.

[Lightrail11]

I get good results with Testim gel 1% 50mg. Don't remember the exact numbers but went from the 200's to about 750 ng/dL. Much improved libido and general feeling of well being (maybe because of the improved libido? )

Apply the gel once a day, easy to use, doesn't sting or smell, have had no side affects, PSA levels remain normal. Co-pay with my insurance runs $30/month. Satisfied with it.

[tnthomas]

My brother(age:69) tried Androgel, but discontinued use due to swelling in ankles, which apparently outweighed any benefit gained.

[Dr. Smith]

Originally Posted by kellyma1973

Hi there. Curious whether low testosterone can be caused be chronic neuropathic pain like CRPS? I'm 40 years old, I have low T but insurance doesn't cover androgel/testim. I have pretty good insurance too. Frustrated.

My understanding is that intractable pain can cause low testosterone. Many medications—opioids in particular, but others as well—can also cause low T. For these and other effects of intractable pain, see:

Hormone Treatments in Chronic and Intractable Pain—An Emerging Practice

Hormone Replacements and Treatments in Chronic Pain: Update 2010

Testosterone Replacement in Chronic Pain Patients

...and other similar articles by Dr. Tennant

Have you contacted your insurance carrier and asked if there are any that they do/will cover? Many companies don't cover (e.g.) Androgel, but may cover another such as Fortesta, or injections. Topicals can also be made by a compounding pharmacy for much less than some name-brands. From the articles above, many precursors of testosterone (pregnenolone, DHEA, etc.) can be gotten OTC, but I'd have a doctor on-board to help with testing, dosing, & monitoring.

Doc

[Dr. Smith]

Originally Posted by Lightrail11

I get good results with Testim .... doesn't sting or smell,

I believe you. From what I've read online, many review sites have claims that it does smell; others have said that the odor—allegedly from the addition of a pheremone(? )—is objectionable to some, unnoticeable to others, and pleasant to still others (including a few S.O.s). I have no personal experience/knowledge of this, so by all means check it out elsewhere.

Doc

[Dr. Smith]

Originally Posted by tnthomas

My brother(age:69) tried Androgel, but discontinued use due to swelling in ankles, which apparently outweighed any benefit gained.

Sorry to hear that; from what I've read, some have bad reactions. Is it enough of an issue for him that he'd be amenable to trying another approach, like injections or Clomid (if his doctor was agreeable)?

Doc

[Lightrail11]

Originally Posted by Dr. Smith

I believe you. From what I've read online, many review sites have claims that it does smell; others have said that the odor—allegedly from the addition of a pheremone(? )—is objectionable to some, unnoticeable to others, and pleasant to still others (including a few S.O.s). I have no personal experience/knowledge of this, so by all means check it out elsewhere.

Doc

Other than the expected alcohol scent from the drying agent when it's first applied there is no noticeable odor (to me or my spouse) whatsoever.

I also did use Axiron for about a year (they had a special going at $25/co-pay). It was OK and there were no side affects, but my levels with it were in the 500-600 range vs. 750 or so with the Testim. My insurance doesn't cover the Axiron so the cost went to $300+ for a month; my insurance does cover the Testim.