Testosterone Injection Dosage Chart for Effective Treatment

Testosterone replacement therapy (TRT) is a widely recognized medical treatment for addressing low testosterone levels (hypogonadism) in men. There are many reasons you may experience low testosterone, such as age, pituitary or hypothalamic injury, primary hypogonadism, or vanishing testis syndrome. Testosterone therapy restores testosterone levels and improves the quality of life of those with low testosterone. Many individuals with low testosterone experience symptoms such as fatigue, reduced muscle mass, mood swings, and decreased libido, which can impact daily functioning and emotional well-being. Through carefully monitored testosterone replacement therapy (TRT), patients often notice improvements in energy levels, cognitive clarity, sleep quality, and physical performance. 

Determining testosterone injection dosage is an important aspect of TRT. This article will explain all you need to know about TRT, Testosterone injection dosage, and lots more.

What is Testosterone?

Testosterone is the primary male sex hormone. It occurs primarily in the testes in men and the adrenal gland/ovaries in women. It also aids the development of male sex organs, secondary sex characteristics (such as a deeper voice and facial hair), muscle mass, bone density, and sexual function.

Testosterone levels rise in the morning but fluctuate throughout the day. The normal range for testosterone in adult males is approximately 300 to 1000 ng/dL, but it varies due to lab standard and age. Testosterone hormone exists in two forms: bound (proteins like sex hormone binding globulin or SHBG) and free testosterone (biologically active).

What is Testosterone Replacement Therapy?

Testosterone Replacement Therapy is used to restore low testosterone to a healthy physiological range. It involves different TRT preparations like injections, gels, patches, cream, and oral formulations. They are also available as pellets.

Health providers will suggest TRT once it has been confirmed by a blood test that a patient has low testosterone (below 300 ng/dl).

Causes of low testosterone include testicular failure, aging, drug abuse, pituitary gland dysfunction, and congenital disorders like Klinefelter syndrome.

Benefits of TRT

TRT offers the following therapeutic benefits:

• Improved Libido and Sexual Function: TRT improves sexual desire and performance. People who used TRT reported an increased frequency of erections and greater satisfaction.
• Increased Muscle Mass and Bone Density: Testosterone supports protein synthesis and calcium retention, which leads to lean muscle growth and stronger bones. This is mostly important for aging males or those with osteoporosis risk.
• Improved Mood and Cognitive Function: Studies have shown that there is a relationship between testosterone therapy and mood improvements. Low testosterone levels can disrupt neurotransmitter balance, which leads to mood swings. TRT helps maintain emotions, reduce depression, and improve cognitive functions like memory and focus.
• Decreased Fatigue and Improved Energy Levels: One of the most debilitating symptoms of low testosterone serum is chronic fatigue. TRT restores energy levels in those with low testosterone.
• Better Control of Blood Glucose: Testosterone has been shown to decrease blood glucose and improve insulin sensitivity, particularly in men with metabolic syndrome or type 2 diabetes.
• Improved Cardiovascular Health Markers: Some evidence suggests that when testosterone is kept within physiological limits, it may support better cardiovascular outcomes by reducing visceral fat and improving lipid profiles.
• Enhanced Quality of Life and Daily Functioning: TRT contributes to satisfaction and confidence in day-to-day life, and it restores vitality, physical function, and emotional well-being.

These benefits result in a better quality of life, especially when testosterone is returned to optimal levels and monitored consistently.

What is the Best TRT Dose for Someone with Testosterone Deficiency?

The right TRT dosage varies based on the individual's age, weight, testosterone concentrations, underlying health conditions, and the patient's response to initial treatment. Medical practitioners often start with an initial dose on the lower side and increase gradually based on blood test results and symptom relief.

The best TRT dose for an individual should restore testosterone to the normal range without causing fluctuations that could lead to adverse reactions or unstable mood swings. For better control over hormone kinetics and to decrease effects, start with a lower dosage.

What is a Weekly Dose of Testosterone?

Depending on the formulation and clinical objectives, a weekly dose falls in the range of 50-200 mg for injectable testosterone.

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What is a Testosterone Injection Dosage Chart?

A testosterone injection dosage chart is a guide used by clinicians for TRT. It outlines starting doses, titration intervals, and maintenance ranges for various TRT preparations. The chart includes pharmacokinetics, clinical outcomes, and patient data to aid therapy. It takes into account the following:

• The Form of Testosterone: Different formulations (e.g., testosterone cypionate, testosterone enanthate, testosterone undecanoate) have different half-lives, solubility, and absorption characteristics. The chart helps determine the dosage for each form and how it should be administered.
• Frequency of Administration: Testosterone esters have different durations of action. For instance, testosterone propionate requires more frequent dosing compared to testosterone undecanoate, which is long-acting. The dosage chart helps mitigate peaks and troughs in serum testosterone levels.
• Half-Life and Bioavailability:  Bioavailability affects how much active hormone reaches systemic circulation. The amount of time testosterone remains effective in the bloodstream is determined by its half-life.
• Desired Serum Testosterone Levels: The desired physiological level ranges from 500-800 ng/dl. Maintaining this range reduces symptoms while minimizing the risk of adverse effects.
• Patient Characteristics and Medical Treatment Goals: Age, body composition, pre-existing health conditions like cardiovascular disease, thyroid dysfunction, and previous response to TRT will all affect the dosing strategy. The goal of treatment is to restore the normal physiologic range, which then can relieve testosterone symptoms.

The Testosterone Injection Dosage Chart for TRT

Below is a detailed testosterone injection dosage chart. These values are general guidelines and should be individualized by a healthcare provider.

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You can get a more individualized testosterone injection dosage chart with Feel30.

How to Interpret Your Testosterone Injection Dosage Chart

Navigating a testosterone injection dosage chart may seem complex at first, but understanding how to use it can improve your treatment outcomes. Here's a breakdown to help patients make sense of their TRT dosing regimen.

Step-by-Step Guide for Patients

1. Identify Your Formulation: Start by confirming the type of testosterone you're prescribed - cypionate, enanthate, propionate - as this will determine dosing frequency and volume.
2. Find the Starting Dose: Locate your initial dose on the chart based on your doctor’s prescription. Common starting doses range from 50–100 mg per week.
3. Understand Frequency: The chart will recommend how often to inject based on the half-life of your formulation. Shorter-acting esters like propionate require more frequent dosing.
4. Track Maintenance Adjustments: Your healthcare provider may adjust your dose over time to maintain optimal testosterone levels. This should be guided by lab work and how you feel.

Common Mistakes

• Assuming Higher Is Better: Supraphysiological doses can lead to negative effects. The aim is to reach optimal, not excessive, serum testosterone concentrations.
• Ignoring Injection Timing: Irregular injection schedules can lead to fluctuating hormone levels, causing mood swings or fatigue.
• Self-Titrating Without Labs: Adjusting your dose without lab confirmation and doctor input can increase the risk of complications.

Integrating Symptom Tracking with Lab Values

• Maintain a journal tracking mood, energy, libido, sleep, and physical performance.
• Pair this subjective data with objective lab values to give your healthcare provider a complete picture.
• Share this information during appointments to help fine-tune your TRT.

Using the dosage chart correctly, along with lab results and personal feedback, helps you to achieve stable, effective testosterone therapy.

How to Adjust Your Testosterone Injection Dose Safely

Adjusting your TRT dosage is a critical part of achieving results while reducing risks. Approach dose adjustments carefully and under medical supervision to ensure safety and effectiveness.

Signs You May Need a Dose Adjustment

• Persisting symptoms of low testosterone (e.g., fatigue, low libido, depression)
• Symptoms of excessive testosterone (e.g., acne, irritability, insomnia)
• Lab results showing serum testosterone levels below or above the optimal range (500–800 ng/dL)
• Negative effects such as hematocrit, blood pressure, or estradiol levels

How Physicians Assess the Need for Titration

• Comprehensive Lab Testing: Blood tests for total testosterone, free testosterone, estradiol, hematocrit, SHBG, and lipids guide dose decisions.
• Symptom Review: Doctors evaluate how patients feel relative to their hormone levels, balancing lab results with quality of life.
• Clinical Guidelines: Physicians follow evidence-based protocols to increase or decrease doses based on response and tolerability.

Risks of Self-Adjusting Without Medical Supervision

• Risk of overdosing and developing serious reactions
• Hormonal imbalance leading to mood swings, cardiovascular strain, or infertility
• Potential suppression of the hypothalamic-pituitary-gonadal axis
• Inability to track and manage other hormone interactions, like estradiol or SHBG

Always consult your healthcare provider before making any changes to your TRT regimen. Safe and strategic dosage, based on labs and symptoms, is more likely to give you a successful, long-term outcome.

Modes of Delivering Testosterone

Intramuscular Injections

Intramuscular injections are used in delivering testosterone, such as testosterone cypionate, testosterone enanthate, and testosterone undecanoate. They are administered into the gluteal muscle, vastus lateralis (outer thigh), dorsogluteal (traditional gluteal), ventrogluteal (hip/side glute), and shoulder (depending on low volume, which allows for slow release and fast absorption. With less frequent dosing, a patient may experience hormonal peaks and troughs. Doctors should change injection sites regularly to avoid complications

Subcutaneous Injections

Subcutaneous injections are administered in the abdominal area, into the fatty tissue beneath the skin. It is popular for microdosing protocols. This method provides a comparable effect to intramuscular injection, with benefits of reduced injection pain and inflammation.

Topical Creams and Gels

You can apply topical testosterone to clean, dry skin, shoulders, upper arms, or the abdominal area; picking an area with less hair is needed because hair can interfere with dosing/absorption. It allows for relatively consistent absorption and stable testosterone when administered as directed. However, there is a risk of accidental transference to others through skin contact. Patients are advised to wash their hands thoroughly and cover the area with clothing.

Patches

Transdermal testosterone patches are applied to the back, thighs, or upper arms once daily; applying to the area with less hair is also necessary. The testosterone is released slowly but continuously over 24 hours. However, many users report skin irritation or contact dermatitis, with this method, leading to compliance issues.

Oral Capsules (e.g., Testosterone Undecanoate)

You absorb oral formulations like testosterone undecanoate through the lymphatic system, bypassing first-pass liver metabolism to some extent. Despite this, their bioavailability still changes and is influenced by dietary fat intake. Oral testosterone requires taking a dose multiple times a day under close monitoring. The newest oral testosterone pill is used twice daily and has consistent levels, although not as consistent as subq injections. 

Sustanon Dosages for TRT

The sustanon dosage aims to provide immediate and sustained testosterone release by the different esters' absorption rates. It is a formulation of different testosterone esters - testosterone propionate, testosterone phenylpropionate, testosterone isocaproate, and testosterone decanoate.

• Starting Dose: 125 mg every 2 weeks
• Maintenance Dose: 125–250 mg every 2–3 weeks
• Pharmacokinetics: The fast ester propels an increase in testosterone, and the slow ester maintains testosterone levels over time. This can result in uneven testosterone concentration, leading to hormonal fluctuations.
• Consideration: Sustanon is commonly used in Europe and some other regions; it's not approved by the FDA in the United States. Patients may experience changes in therapeutic effect due to different ester types, which may necessitate careful monitoring through tests.

Cypionate Dosages for TRT

Testosterone cypionate is one of the most commonly prescribed esters for testosterone replacement therapy in the United States. It has a relatively long half-life of approximately 8 days, making it suitable for weekly or biweekly injections. Due to its slow-release nature, testosterone cypionate allows for a gradual increase in testosterone concentrations, which supports stable therapeutic effects.

• Initial Dose: 50–100 mg administered weekly, or 100–200 mg every two weeks. Starting low helps reduce the risk of negative reactions and allows the body to adjust to increased hormone levels.
• Typical Maintenance Dose: Most patients stabilize on 100–200 mg weekly, which helps maintain consistent serum testosterone within the desired therapeutic window.
• Serum Testosterone Monitoring: Total and free testosterone, estradiol, hematocrit, and lipid profiles are assessed through regular tests. Blood should be drawn midway between injections (e.g., 3.5 days after dosing) to evaluate the trough level.

Consideration: Testosterone cypionate injection is administered intramuscularly, into the muscle. The use of this ester is well-supported by clinical data for treating delayed puberty, primary hypogonadism, and other causes of androgen deficiency. It is often used for its predictable hormone kinetics and flexibility in dosing adjustment.

Side Effect: Although generally well-tolerated, testosterone cypionate can lead to side effects in some users:

• Erythrocytosis (elevated red blood cell count), which may increase the risk of cardiovascular events
• Acne and oily skin
• High blood pressure
• Mood swings or increased irritability
• Suppression of natural testosterone production and luteinizing hormone-releasing hormone

To maintain optimal testosterone levels, close monitoring and periodic dose adjustment are important.

Testosterone Enanthate Dosages for TRT

Testosterone enanthate is a long-acting testosterone ester with pharmacological properties similar to testosterone cypionate. It is used across Europe and globally for the treatment of androgen deficiency in men with primary or secondary hypogonadism. This ester is administered intramuscularly and is known for providing consistent relief from symptoms associated with low testosterone serum concentrations.

• Starting Dose: 50–100 mg administered once per week. Physicians start with a conservative dose that allows them to evaluate the patient's response and avoid excessive serum testosterone.
• Maintenance Dose: 100–200 mg per week or every 10 days, but it depends on individual pharmacokinetics, patient symptoms, and test results.
• Delivery Method: IM testosterone enanthate is injected into the muscle. It may also be administered hypodermically in some cases with clinical oversight.

Consideration: Enanthate allows for relatively stable hormone levels when dosed weekly, due to its half-life of approximately 4.5 days. It's important to monitor serum testosterone levels midway between injections to ensure consistency and avoid fluctuations that could cause mood instability or other effects. Due to its cost-effectiveness, availability, and predictable serum testosterone profile, it's a preferred ester

Side Effect: Like other injectable esters, testosterone enanthate may cause some side effects, particularly when dosed too high or without adequate monitoring:

• Fluid retention or bloating
• Increased red blood cell count (erythrocytosis)
• Elevations in blood pressure
• Acne or skin changes
• Mood swings or increased aggression
• Suppression of the hypothalamic-pituitary-gonadal axis

Adjustment of the Individualized dose, supported by routine laboratory work and symptom assessment, helps minimize these risks and ensures long-term success with TRT.

Testosterone Propionate Dosages for TRT

Testosterone propionate is a short-acting ester that delivers fast therapeutic effects but requires more frequent dosing compared to other esters like testosterone enanthate or cypionate. Due to its short half-life of approximately 2 days, it is generally used in specialized cases or for patients who benefit from faster hormone kinetics.

• Initial Dose: 25–50 mg administered every other day. This frequent schedule will maintain serum testosterone within a consistent therapeutic level.
• Maintenance Dose: 50–100 mg per week, often divided into 2–3 doses spaced evenly throughout the week.

Consideration: The fast absorption of testosterone propionate relieves symptoms quicker in some patients, making it useful for initiating therapy. However, due to its frequent dosing requirements, it can be less convenient for long-term use. Injections are administered intramuscularly or subcutaneously, depending on patient preference and physician guidance.

Side Effect:

• Testosterone propionate is known for causing more injection site reactions, such as pain, swelling, and inflammation, particularly when injected intramuscularly.
• Peaks and troughs in serum testosterone levels are more common due to the ester’s short duration of action, which may contribute to mood instability or inconsistent symptom relief if not dosed carefully.
• Close monitoring through frequent blood tests is necessary to maintain serum testosterone levels and to avoid supraphysiological peaks.

This ester may be appropriate for patients using microdosing protocols or for those who demonstrate fast metabolism of longer-acting formulations.

Testosterone Cream Dosages for TRT

Testosterone creams are topical solutions designed for transdermal absorption and are used by patients who prefer to avoid injections. They can provide consistent hormone levels when used as prescribed, but require diligent application habits.

• Starting Dose: 25–50 mg/day, applied once or twice daily
• Adjustment: Adjustments are made to maintain values within the normal range (usually 400–700 ng/dL). Dosing is titrated based on regular blood tests, measuring serum testosterone levels, and patient-reported symptom relief.
• Application Guidelines: Apply to clean, dry, hairless areas such as the shoulders, upper arms, abdomen, or directly to the scrotum. It’s essential to allow the cream to dry fully and to wash hands thoroughly after application.
• Risk Factors: There is a risk of testosterone transfer through skin-to-skin contact with others. Avoid contact with partners or children until the application area is washed or covered. Furthermore, some users may experience skin irritation, rash, or discoloration when first beginning treatment.
• Advantages: Creams allow for daily dose adjustments, provide non-invasive administration, and have demonstrated effective absorption in many users when applied consistently.

Testosterone Dosage Charts for Women on TRT

While testosterone replacement therapy is most commonly associated with male hypogonadism, women can also benefit from low-dose testosterone treatment under specific medical conditions. These include postmenopausal symptoms and low libido.

TRT in Women: Clinical Indications

• Postmenopausal Women: Testosterone may be prescribed to improve sexual desire, mood, and energy levels when traditional hormone replacement therapy (HRT) proves insufficient.
• Premenopausal Women with Low Androgens: Rarely, women may experience androgen deficiency not related to menopause that impacts their quality of life.

Microdosing TRT

Microdosing testosterone is a method of administering small doses of testosterone frequently, two to three times per week. This approach is growing in popularity among practitioners and patients alike for its ability to maintain consistent serum testosterone levels while minimizing the likelihood of side effects.

What is Microdosing?

Microdosing involves using smaller amounts of testosterone, such as 20–40 mg per injection, given multiple times per week instead of administering larger doses once weekly or biweekly. This strategy is often applied using testosterone cypionate, enanthate, or even subcutaneous testosterone preparations.

Benefits of Microdosing

• Stable Hormone Levels: Frequent administration of low doses helps avoid the rise and falls associated with traditional dosing schedules, maintaining stable serum testosterone concentrations.
• Reduced Risk of Side Effects: Microdosing is associated with an incidence of erythrocytosis, mood swings, acne, and other effects common with larger dosing regimens.
• Improved Symptom Control: Patients often report smoother relief of symptoms, including improved libido, energy, and mood stability.
• Better Tolerability: Smaller doses reduce the burden on the body’s cardiovascular and hematologic systems, which may be particularly advantageous for older patients or those with comorbid conditions.

Who Benefits Most from Microdosing?

Microdosing may be suitable for:

• Patients sensitive to hormonal fluctuations
• Individuals experiencing mood instability or side effects from larger doses
• Those seeking finer control over serum testosterone levels
• Patients interested in subcutaneous administration or less invasive protocols

Clinical Considerations

While microdosing can offer better outcomes, it also requires more frequent administration and close monitoring. You should go for blood tests regularly to ensure optimal testosterone levels, and dosing should be adjusted as needed. Practitioners must also evaluate hematocrit, estradiol, and lipid panels to monitor for complications.

Overall, microdosing represents an individualized approach to testosterone replacement therapy. With clinical oversight, microdosing offers improved stability, better symptom control, and fewer side effects

What are the Issues with Large Dosing in TRT?

Administering large doses of testosterone can lead to spikes in serum testosterone concentrations, which may exceed the body's actual physiological range. This approach often produces negative consequences due to excessive androgen exposure and a lack of hormonal stability.

Risks of Large Doses

• Erythrocytosis: Red blood cell count increases blood viscosity, potentially leading to complications like stroke or thrombosis.
• Hypertension: Large doses can raise blood pressure by promoting sodium retention and vascular stiffness.
• Endocrine Suppression: High testosterone levels suppress the natural production of luteinizing hormone-releasing hormone and other pituitary signals, leading to testicular atrophy and infertility.
• Dermatological Issues: Acne, oily skin, and increased sebum production are common with supra-physiological testosterone levels.
• Cardiovascular Impact: Excessive dosing is associated with adverse effects on lipid profiles (e.g., decreased HDL cholesterol) and increased risk of atherosclerosis.
• Prostate Concerns: There is an ongoing debate about the relationship between high testosterone and prostate cancer. However, large dosing may contribute to prostate enlargement or exacerbate undiagnosed malignancies.
• Psychological and Neurological Symptoms: Hormone fluctuations can trigger mood swings, irritability, and insomnia.
• Serious Reactions: These include chest pain, deep vein thrombosis, congestive heart failure, and upper respiratory tract infection in predisposed individuals.

Clinical Oversight and Monitoring

To avoid these complications:

• Frequent Blood Tests: Monitor serum testosterone, hemoglobin and hematocrit, estradiol, liver function, and lipid panels regularly.
• Individualized Dose Adjustment: Tailor dosing based on the patient’s metabolic profile, symptom response, and lab values.
• Education and Communication: Ensure patients understand the importance of adherence to prescribed doses and the risks of self-adjusting or using unregulated sources.

Maintaining testosterone within a controlled, physiologic range improves treatment outcomes and also minimizes the risk of adverse effects and long-term health consequences.

How to Read Blood Test Results in TRT

Understanding your blood work is important in managing TRT. It helps us know if our dosage is correct, we are absorbing testosterone properly, and any side effects are developing.

Key Markers to Monitor

• Total Testosterone: Measures the overall amount of testosterone in your bloodstream, including free and bound forms. Normal range: 300–1000 ng/dL (normal range varies based on the lab used from the start).
• Free Testosterone: The unbound, biologically active form of testosterone. Important when SHBG is abnormal. Optimal range varies but is generally 0.3–1.0 ng/dL.
• SHBG (Sex Hormone Binding Globulin): A protein that binds testosterone and affects its bioavailability. High SHBG can reduce free testosterone.
• Estradiol (E2): Monitored to ensure aromatization from testosterone. It doesn’t cause estrogenic side effects like gynecomastia or mood changes. Suitable range for men: ~20–40 pg/mL.
• Hematocrit & Hemoglobin: Increased levels may indicate erythrocytosis, increasing cardiovascular risks.

Understanding Units and Reference Ranges

• ng/dL: Nanograms per deciliter, the standard unit for measuring serum testosterone levels.
• Lab reference ranges can differ slightly. Always interpret your results in context with symptoms and consult your prescribing physician.

When to Test

• Timing: Blood samples should be taken midway between injections (for weekly injections, 3.5 days post-dose) to accurately measure trough levels.
• Consistency: Always test at the same time of day (preferably morning) and under similar conditions (fasted, rested).

Monitoring these values consistently allows for dose adjustment, symptom control, and adverse effect reduction.

Injection Site Matters: Gluteal vs. Thigh vs. Subcutaneous

Where you inject testosterone affects its absorption, efficacy, and side effect profile. Different sites offer varying benefits and drawbacks depending on the formulation used and patient preference.

Gluteal Muscle Injections

• Overview: The most traditional and commonly used site for intramuscular (IM) injections, for testosterone cypionate and enanthate.
• Advantage: Deep muscle tissue provides slow and steady absorption. Often better for long-acting esters.
• Consideration: Requires a long needle and proper technique to avoid hitting nerves or blood vessels. Best administered by a healthcare professional or with training.

Thigh Injections (Vastus Lateralis)

• Overview: An accessible alternative to gluteal injections for IM or subcutaneous delivery.
• Advantage: Easier for self-administration; allows for consistent depth and injection angle.
• Consideration: May cause soreness or bruising; rotate sites regularly to prevent tissue irritation.

Subcutaneous (SubQ) Injections

• Overview: Involves injecting testosterone into the fatty tissue just beneath the skin, often in the abdomen or thigh.
• Advantage: Less painful, lower risk of injection site complications, and associated with more stable serum testosterone levels.
• Consideration: It requires smaller doses or microdosing strategies. Not all formulations are approved for subQ use, but many are used this way off-label with good results.

Best Practices for Self-Injection

• Aseptic: Always use alcohol swabs and clean hands to minimize infection risk.
• Needle Size: Use the correct gauge and length for your injection type (e.g., 1" for IM, 5/8" for SubQ).
• Rotation: Rotate sites to avoid tissue damage, lumps, or irritation.
• Technique: Inject slowly and steadily; aspirate when necessary (for IM) and follow up with gentle massage.

Choosing the right injection site and using proper techniques are necessary for decreasing side effects and ensuring consistent testosterone absorption.

References

Bhasin S, et al. "Testosterone Therapy in Men with Hypogonadism: An Endocrine Society Clinical Practice Guideline." J Clin Endocrinol Metab. 2018.

Basaria S. "Male Hypogonadism." The Lancet. 2014.

Saad F, et al. "Testosterone Replacement Therapy: Long-term Safety and Efficacy." Aging Male. 2017.

Nieschlag E, et al. "Testosterone: Action, Deficiency, Substitution." Springer, 2012.

Handelsman DJ. "Pharmacokinetics of Testosterone Preparations." J Endocrinol Invest. 2004.

Matsumoto AM. "Andropause: Clinical Implications of the Decline in Serum Testosterone Concentrations with Aging in Men." J Gerontol A Biol Sci Med Sci. 2002.

Snyder PJ, et al. "Effects of Testosterone Treatment in Older Men." N Engl J Med. 2016.