Testosterone implants in the form of small pellets slowly deliver testosterone over the course of three to six months. The testosterone pellets are implanted under the skin by your physician.
Imbedded in the fat, the testosterone pellets gradually dissolve over a few months. This testosterone replacement therapy (TRT) administration method gives a slow, steady constant infusion of testosterone into the body.
Overall, testosterone pellets offer a viable testosterone therapy option with low rates of adverse side effects.1-4 Testopel is the only FDA approved implantable testosterone treatment. For more information on Testopel, see the Step-by-Step Testopel Insertion Guide Video.
Testosterone implants are ideal for men who prefer a very low regularity of application. The pellets are implanted in the lower abdominal wall or upper buttock area by the hip in the subdermal fat layer. The insertion is performed under a local anesthetic and one pellet typically lasts three to six months. The testosterone pellets are very small (9mm by 3mm); only a small incision (~1 cm) is required to insert the pellets. Most men return to work the day of, or the day after, implantation but are advised to avoid bending or vigorous physical activity. The vast majority of men treated with testosterone implants find this delivery system to be extremely effective.1-4
- Testosterone implants provide relatively even concentrations of total testosterone levels in the blood. Even concentrations mean less side effects.
- This TRT form is very convenient for men who do not want another daily medication requirement and/or travel frequently. Testopel specifically helps restore testosterone levels in men with low T for 3 to 4 months, sometimes up to 6 months. Pellets have one of the longest durations among all forms of TRT.
- Most patients return to work the day of, or the day after, implantation but are advised to avoid bending or vigorous physical activity.
- Does not carry the risk of transfer.
- The implantation procedure is invasive and requires a physician who is trained in the procedure.
- Infection and/or pellet extrusion occurs in 5% to 10% of treated men.5,6
- It is difficult to adjust the testosterone dose once the pellet has been implanted (unlike injectable or transdermal forms). Surgical removal may be required if treatment needs to be stopped. (For more information on general TRT side effects, see EMG’s Side Effects of Testosterone Therapy Article).
The only testosterone pellets approved by the FDA is Testopel (Auxilium Pharmaceuticals, Inc). Auxilium provides further information like cost and coverage, treatment and administration, and important safety information about Testopel HERE. Full prescribing information is also available HERE.
Testopel costs approximately $75 per pellet. The average man needs six to eight pellets per two to three months plus doctor fees. This amounts to anywhere between $150 to $300 dollars plus doctor fees per month. Some insurance companies will cover Testopel treatment. (Note: These are self-pay prices and do not take into account any discounts or prescription insurance coverage that you may have.)
For more information on the different available TRT administration methods, select any of the the links below.
EMG’s TRT Resource: Types of Testosterone
- Testosterone Injections
- Testosterone Gel
- Testosterone Nasal Gel
- Testosterone Lozenges
- Oral Testosterone
External Resources: Medscape: Testosterone Implants
Updated: April 30, 2015
1. Handelsman DJ, Mackey MA, Howe C, Turner L, Conway AJ. An analysis of T implants for androgen replacement therapy. Clin Endocrinol (Oxf) 1997; 47: 311–316.
2. Jockenhövel F, Vogel E, Kreutzer M, Reinhardt W, Lederbogen S, Reinwein D. Pharmacokinetics and pharmacodynamics of subcutaneous testosterone implants in hypogonadal men. Clin Endocrinol (Oxf) 1996; 45: 61–71.
3. Handelsman DJ, Conway AJ, Boylan LM. Pharmacokinetics and pharmacodynamics of T pellets in man. J Clin Endocrinol Metab 1990; 71: 216–222.
4. Kelleher S, Turner L, Howe C, Conway AJ, Handelsman DJ. Extrusion of T pellets: a randomized controlled clinical study. Clin Endocrinol (Oxf) 1999; 51: 469–471.
5. Miner MM. Low Testosterone Medscape CME Expert Column Series. Issue 3: Delivering Safe and Effective TRT. Medscape Education. 2011.
6. Kaminetsky JC, Moclair B, Hemani M, Sand M. A phase IV prospective evaluation of the safety and efficacy of extended release testosterone pellets for the treatment of male hypogonadism. J Sex Med. Apr 2011; 8 (4) : 1186-1196.