Since this is a common subject amongst those who have/are XXY and/or Klinefelter Syndrome, and since testosterone therapy (also known as Hormone Replacement Therapy (HRT)), I felt it important to list the currently available types of therapy and some pros and cons related to each. This list is as of January 2020 and is subjective to my thoughts and information with usage and/or discussions with others who have used those types of medication for help with this genetic condition. I will attempt to separate out the methods available in the United States of America (USA) and the ones that are only available in areas outside of the USA. For the outside of the USA list, I will only add types that I know are not available in the USA.
USA Testosterone therapy types
- Depo-Testosterone: (Cypionate, Enanthate)
- Intramuscular (IM)Testosterone Injections: Video: How to do an Intramuscular Testosterone Injection?
- Subcutaneous Testosterone Injections: Video: How to do a Subcutaneous Testosterone Injection?
- Weekly auto-injector – Xyosted
- Long-acting testosterone injections – Aveed
- Testosterone gel – AndroGel; Testim; Fortesta; Axiron
- Nasal spray – Natesto
- Oral pill – Jatenzo
- Patches – Androderm
- Testopel Pellets
- Buccal mouth patch – Striant
Specific types only available Outside of the USA
- Long-acting testosterone injections – Nebido
- Multiple ester testosterone: Sustanon
If anyone has additions to the above lists, please email me.
Personal Perspective of using Testosterone Therapy
Hormone replacement therapy (HRT) or testosterone replacement therapy is useful to help those with Klinefelter Syndrome or XXY. The medication is necessary to bring our low testosterone level to its proper level. This is vitally important to make sure our bones are healthy and that we aren’t developing early-onset osteoporosis or low bone density. The testosterone types mentioned above should start at the point that one’s testosterone level has decreased below normal. Our LH (Luteinizing Hormone) and FSH (Follicle Stimulating Hormone) levels have typically increased above the normal range.
The range of testosterone, LH, and FSH varies depending on the age of the individual. Replacement therapy should not begin before puberty unless the teenager never gets into puberty on their own. The types above vary in terms of pros and cons. For me, personally, I self inject and I do a combination of Intramuscular and Subcutaneous. I alternate between the types every other week and for me, it works very well. I used to inject Intramuscular injections every 11 days for about 15 years and that worked very well for me. A lot of boys and men do not like the injectable method simply because it hurts and you have to deal with the highs and lows after your injection. The highs are great right initially and for a few days after the injection. But the lows are difficult and can be difficult to cope with.
Daily vs Other Testosterone Types
These days it is a better recommendation to use something that you can be applied daily. Whether that is a daily patch, gel or oral medication, or even the implanted pellets, it is better to achieve a daily dose of testosterone as it keeps you from having to deal with the highs and lows of the injectables. Right now, the AndroGel 1.62% pump and Jatenzo oral tablet are top products and give a daily dosage that must be taken each day. Those methods are much more expensive than injectables. Jatenzo is a very new product that has been available for less than a year. AndroGel has been on the market for more than 10 years. There are other types of gel that are considered to be less expensive, but I also don’t feel they are as effective.
I am frequently asked if there is a way to avoid testosterone therapy or to take something natural or a supplement. Some who follow this route are not on testosterone therapy. I am not a doctor, but testosterone therapy is replacing what we are unable to make on our own. It greatly improves the quality of life. I have seen immense improvements in my life and also in the lives of many men I have personally met over the years since my diagnosis occurred.