Back
By GetOPT Review Team · Reviewed by Samuel Sarmiento, MD, MPH, MBA · September 27, 2026 · Part of our Testosterone Guide
Hormone Replacement Therapy for Men: 4 Types Compared
It’s no secret that as men get older, their testosterone levels decrease. A drop in testosterone leads men to become interested in different types of hormone replacement of therapy. For example, a significant reduction to unnaturally depleted levels in testosterone like the condition of hypogonadism makes testosterone replacement therapy (TRT) especially favorable. But, why?
The reason is that testosterone is essential for multiple facets of good health. For example, male sexual development, reproductive capabilities, increasing muscle mass, plus maintaining proper levels of red cells and bone density are all related to testosterone.
Thus, it’s essential to investigate what types of hormone replacement therapy may be beneficial for you. In this article, we’ll discuss a handful of different kinds and the inherent risks that may come with them.
RELATED: Low Testosterone Symptoms in Men
Subscribe for more
Join our newsletter to get the latest news, tips, and stories from Opt Health.
The Different Types of Hormone Replacement Therapy
In terms of types of hormone replacement therapy, there are main types: intramuscular testosterone injections, testosterone patches, and topic testosterone gels. After those three, there is also a different kind known as bioidentical hormone replacement therapy. Let’s take a quick look at all four types.
Within the injectable route, testosterone cypionate explains how the ester your prescriber chooses changes the vehicle and the treatment interval.
1. Intramuscular Testosterone Injections
If your testosterone drops below normal levels, the most common solution is an intramuscular testosterone injection. If done by a doctor, they are typically injected into the buttock muscles. Yet, your doctor may allow you to do the injection yourself, and in those cases, the injection site should be in your thigh muscles.
2. Testosterone Patches
The next type of therapy is a testosterone patch. A double-blind placebo-controlled study involving 39 men over the age of 40 showed an increase in testosterone after wearing a testosterone patch for six months.
Although further research indicates that intramuscular injections can produce greater musculoskeletal benefits while keeping cardiovascular risk low, testosterone patches are a feasible option if you don’t want to go through the hassle of setting multiple doctor appointments to receive testosterone injections.
3. Topic Testosterone Gel
A third common type of hormone replacement therapy is using a topic testosterone gel. Research has shown that gels are just as effective as injections and patches. The benefit of gels compared to the other options is a decreased risk of an injection site reaction.
4. Bioidentical Hormone Replacement Therapy
The final kind of therapy that is worth mentioning is bioidentical hormone replacement therapy. Similar to the other types, there are plenty of possible benefits in utilizing bioidentical hormones.
The key difference is that bioidentical hormones are explicitly tailored to what your body needs. One could say these types of “man-made” hormones are the closest somebody can get to an exact replacement. Research has shown that they are also effective in helping to restore testosterone levels for men with low T.
Weighing the Four Types Against Your Own Routine
Intramuscular injections are administered either by a physician in the buttock or through self-injection in the thigh, and research indicates they can produce greater musculoskeletal benefit while keeping cardiovascular risk low compared with some other routes. Testosterone patches are worn daily and offer an alternative for anyone seeking to avoid scheduling multiple doctor visits for injections. Research has shown topical gels provide similar effectiveness to injections and patches while reducing the risk of injection-site reactions. Because gel is applied to the skin, it requires daily precautions to prevent transferring the hormone to a partner or child through direct contact. Bioidentical hormone replacement therapy uses formulations tailored to what the body needs to restore testosterone levels. Discuss these administration steps, clinic visit requirements, and daily handling demands with your doctor to select the delivery method that fits your routine.
Hormone Replacement for Low Libido
A drop in sexual desire often prompts men to investigate testosterone levels, because sexual function depends on multiple circulating hormones working together. In a clinical trial published in the New England Journal of Medicine, Finkelstein et al. medically induced hypogonadism with low testosterone and low estrogen in healthy men, then administered testosterone replacement while giving some participants an aromatase inhibitor to separately suppress estrogen. Their findings demonstrated that deficiencies in testosterone and estrogen both contributed to the decline in sexual function observed during the study. This controlled experiment induced temporary hormone suppression in healthy volunteers, which differs from the gradual, naturally occurring hormone changes that men experience as they age. Addressing changes in libido starts with a physician who reviews your complete blood panel, assessing testosterone and estrogen together so your treatment addresses the full hormonal picture.
The Risks For All Different Types of Hormone Replacement Therapy
With any therapy, there are inherent risks that you should be aware of. The risks for different types of hormone replacement therapy can be placed into two categories: minor risks and major risks.
Minor risks include:
- Acne outbreaks
- Fluid retention
- Increased urination throughout the day
Major risks include:
- Breast enlargement
- Reduction in testicle size
- Reduction in sperm count
- Increased levels of cholesterol
- Increased levels of red blood cells
- Increased risk of infertility
- Worsening of sleep apnea (if you have experienced it already)
RELATED: 8 Testosterone Killing Foods and 5 That Help Boost It
Regardless of what types of hormone replacement therapy you consider, it is always best to consult with your doctor before moving forward. Whether you want to try injection, patches, gels, or bioidentical hormone replacement therapy, It’s important to determine for yourself whether the benefits outweigh the risks and go from there.
If you have questions about types of hormone replacement therapy or any of the conditions discussed here, connecting with a doctor in a discrete setting has never been easier.
Opt Health is a telehealth platform that reconnects men with wellness, fitness, strength, and sexual vitality through scientific preventive medicine. From your own home, you can schedule with a physician, meet one-on-one via video conference, receive test results, and have medications delivered to your door.
For questions, inquiries, or appointments, don’t hesitate to contact us. Get personalized support and insight from top-tier physicians available 24/7.
How testosterone injections are given sets out the routes and sites each product label specifies.
Up Next:
- The Benefits of Strength Training in Your 40’s and 50’s
- Why NAD+ Levels Decline as You Age and How to Restore It
- Maintain Your Physical Vitality with These Life Hacks
Read more Opt Health Blogs
Get industry insights and hot news around the world of men’s health. We bring to you helpful and educative resources in our blog.
Frequently Asked Questions
Early shifts in energy, mood, and libido often appear within the first few weeks of starting therapy. Changes in body composition and other physical markers take longer to develop, building over several months as hormone levels stabilize. Your physician orders repeat bloodwork during this period to confirm your levels are moving in the intended direction.
Long-term hormone replacement therapy requires ongoing physician supervision rather than a one-time prescription. Regular bloodwork tracks your hormone concentrations alongside relevant safety markers like hematocrit. Safety remains a function of that continuous monitoring, which allows your physician to adjust your protocol based on your laboratory results.
Hormone replacement therapy is a broad medical term covering treatments that replace deficient hormones in the body. Testosterone replacement therapy refers specifically to restoring testosterone. In men's healthcare, TRT functions as a specific subtype of HRT that a physician tailors to your baseline lab results. The diagnostic bar that decides which one applies to you is covered in the guide to HRT vs TRT.
Androgenic side effects such as acne and changes in hair growth can occur during testosterone-based hormone replacement therapy. These responses depend on how your body naturally metabolizes and converts testosterone into other compounds. Your prescribing physician monitors for these physical changes during routine follow-ups and can adjust your treatment plan if they occur.
Primary signs you need hormone replacement therapy evaluated by a physician include a lack of energy, low sex drive, erectile dysfunction, and decreased brain performance. Symptoms alone do not establish a clinical diagnosis, so the necessary next step is comprehensive bloodwork. A physician evaluates your lab values alongside these physical signs before determining whether treatment is appropriate. Check our clinical guide to low testosterone to review the complete symptom list before scheduling your blood panel.
This article is part of our guide to testosterone. See how physician-managed TRT works at Opt Health.
Start Today
Your health, your terms. Discover how personalized care can transform not just the way you feel, but how you live.