{"id":4916,"date":"2022-04-15T08:00:00","date_gmt":"2022-04-15T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=4916"},"modified":"2026-08-29T05:07:13","modified_gmt":"2026-08-28T22:07:13","slug":"%e7%9d%be%e9%85%ae%e6%9b%bf%e4%bb%a3%e7%96%97%e6%b3%952","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/zh\/2022\/04\/15\/testosterone-replacement-therapy-2\/","title":{"rendered":"Short-Acting vs Long-Acting Testosterone Injection: How the Choice Is Made"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, 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2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Once a man has a confirmed testosterone deficiency and has decided with his doctor to treat it by injection, a second question follows: which injectable preparation? There are two broad answers \u2014 a <strong>shorter-acting<\/strong> ester such as testosterone enanthate, and <strong>long-acting testosterone undecanoate<\/strong> \u2014 and they are not simply two versions of the same thing. They differ in how steady your levels are, how often you attend, how reversible the treatment is, and, most importantly, in whether the injection can ever be given outside a medical setting.<\/p>\n\n\n<script type=\"application\/ld+json\">\r\n{\r\n  \"@context\": \"https:\/\/schema.org\",\r\n  \"@type\": \"FAQPage\",\r\n  \"mainEntity\": [\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What is the difference between Testosterone Enanthate and Testosterone Undecanoate?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Testosterone Enanthate (Testoviron) contains 250 mg per dose and is injected every 3 weeks into the buttock or thigh. Testosterone Undecanoate (Nebido) contains 1000 mg per dose and is injected every 12 weeks into the buttock only. The key practical difference is the injection frequency and the self-injection option.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"Can I self-inject testosterone at home?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"It depends on the formula. Testosterone Enanthate (Testoviron) allows self-injection at home in the buttock or thigh. Testosterone Undecanoate (Nebido) must be administered by a healthcare professional and is not suitable for self-injection.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"How often do I need testosterone injections?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Testosterone Enanthate requires an injection every 3 weeks. Testosterone Undecanoate requires an injection only every 12 weeks, making it more convenient for patients who prefer fewer clinic visits.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"How long does testosterone replacement therapy take to show results?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Clinical studies confirm that both sexual behavior and general well-being parameters show significant improvement after 30 weeks of regular testosterone injection therapy.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What sexual benefits does testosterone replacement therapy provide?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Testosterone replacement therapy has been shown to improve sexual visualization, sexual desire, sexual satisfaction, number of ejaculations per week, number of erections per week, and frequency of morning erections.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What general well-being improvements can I expect from testosterone replacement therapy?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Beyond sexual benefits, testosterone replacement therapy improves focus, reduces agitation, boosts self-confidence, decreases dizziness, increases energy levels, and leads to a better overall mood.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"Which testosterone injection formula is right for me?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"The choice between Testosterone Enanthate and Testosterone Undecanoate depends on your preference for injection frequency, whether you want to self-inject at home, and your doctor's recommendation. Consult your urologist or andrologist for a tailored testosterone replacement therapy plan.\"\r\n      }\r\n    }\r\n  ]\r\n}\r\n<\/script>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>This article does not give doses or intervals.<\/strong> The preparation, the dose and the spacing are chosen by the doctor who prescribes them, from your blood results, and are adjusted over time. They are not a menu to pick from, and the right answer for one man is the wrong answer for another.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"4934\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2022\/04\/15\/testosterone-replacement-therapy-2\/close-up-of-muscular-athlete-with-injection-of-performance-enhancing-drugs\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;3.5&quot;,&quot;credit&quot;:&quot;Drazen Zigic&quot;,&quot;camera&quot;:&quot;Canon EOS 5DS&quot;,&quot;caption&quot;:&quot;Close up of male bodybuilder using recreational drugs before in locker room before sports training.&quot;,&quot;created_timestamp&quot;:&quot;1546778775&quot;,&quot;copyright&quot;:&quot;@drazen_zigic&quot;,&quot;focal_length&quot;:&quot;155&quot;,&quot;iso&quot;:&quot;320&quot;,&quot;shutter_speed&quot;:&quot;0.008&quot;,&quot;title&quot;:&quot;Close up of muscular athlete with injection of performance-enhancing drugs.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Today we will compare between 2 intramuscular injection brands, Testoviron &amp;#038; Nebido.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Today we will compare between 2 intramuscular injection brands, Testoviron &amp;#038; Nebido. &lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Testosterone injection ampoules and syringe \u2014 short-acting and long-acting injectable testosterone preparations\" class=\"wp-image-4934\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Testosterone-injection.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Injectable testosterone comes in short-acting and long-acting forms that behave quite differently.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The One Difference That Is Not About Convenience<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Long-acting testosterone undecanoate must be given in a medical setting, with a period of observation afterwards.<\/strong> The usual explanation \u2014 that the volume is large \u2014 is not the real reason. The reason is a rare but serious reaction called <strong>pulmonary oil microembolism<\/strong>, in which some of the oily vehicle reaches the lungs shortly after injection, causing coughing, an urge to cough, breathlessness, chest tightness or dizziness. Anaphylaxis has also been reported. Both typically occur within minutes, which is precisely why a patient waits under observation rather than walking straight out.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So <strong>long-acting testosterone undecanoate is never a home self-injection<\/strong>, under any circumstances, no matter how competent the patient becomes at injecting. If anyone offers to supply it for use at home, that is a reason to walk away. Only the shorter-acting preparations can be self-administered, and then only after being taught and supervised in person until you are competent \u2014 the technique is covered in <a href=\"https:\/\/drsoaraweeurology.com\/2021\/12\/24\/testosterone-injection-how-to-do\/\">this guide to intramuscular self-injection<\/a> and, for the gentler route, <a href=\"https:\/\/drsoaraweeurology.com\/2026\/06\/09\/subcutaneous-testosterone-injection-how-to-do-it-yourself\/\">subcutaneous injection<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How the Two Compare<\/h2>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><tbody><tr><td class=\"has-text-align-left\" data-align=\"left\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><strong>Shorter-acting (e.g. testosterone enanthate)<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\"><strong>Long-acting (testosterone undecanoate)<\/strong><\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">How often<\/td><td class=\"has-text-align-center\" data-align=\"center\">Every few weeks<\/td><td class=\"has-text-align-center\" data-align=\"center\">Every few months<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Where<\/td><td class=\"has-text-align-center\" data-align=\"center\">Buttock in clinic, or thigh if self-injecting<\/td><td class=\"has-text-align-center\" data-align=\"center\">Buttock, in a medical setting only<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Self-injection possible?<\/td><td class=\"has-text-align-center\" data-align=\"center\">Yes, after in-person training<\/td><td class=\"has-text-align-center\" data-align=\"center\"><strong>Never<\/strong> \u2014 requires observation after each dose<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Steadiness of levels<\/td><td class=\"has-text-align-center\" data-align=\"center\">More peak-and-trough; some men feel flat before the next dose<\/td><td class=\"has-text-align-center\" data-align=\"center\">Steadier across the interval<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">If a side effect appears<\/td><td class=\"has-text-align-center\" data-align=\"center\">Easier to adjust or stop \u2014 clears sooner<\/td><td class=\"has-text-align-center\" data-align=\"center\">Harder \u2014 the dose stays in the body for months<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Clinic visits<\/td><td class=\"has-text-align-center\" data-align=\"center\">More, unless self-injecting<\/td><td class=\"has-text-align-center\" data-align=\"center\">Fewer, but each one is longer<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The row that decides it most often is not the top one but the fifth. Long-acting preparations are attractive precisely because you can forget about them \u2014 and that is also their drawback: if your haematocrit climbs or a side effect appears, the testosterone is already in you and stays there. Shorter-acting injections give up convenience in exchange for the ability to change course quickly. A gel gives that up-and-down control to an even greater degree.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Improves, and How Honestly It Can Be Stated<\/h2>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"4933\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2022\/04\/15\/testosterone-replacement-therapy-2\/games-of-intimate-partners-in-bedroom-hot-lovers\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Games of intimate partners in bedroom, hot intimacy lovers. Passionate love couple, erotic in bed&quot;,&quot;created_timestamp&quot;:&quot;1514117019&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Games of intimate partners in bedroom, hot lovers&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"There are confirmed literatures on sexual desire improvement after 30 weeks of testosterone injection therapy.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;There are confirmed literatures on sexual desire improvement after 30 weeks of testosterone injection therapy.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?resize=800%2C533&#038;ssl=1\" alt=\"A couple together \u2014 sexual desire and satisfaction are among the domains that improve with testosterone treatment in deficient men\" class=\"wp-image-4933\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Sexual-drive.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">In men with a genuine deficiency, sexual desire is usually the domain that responds most clearly.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">In men with a <em>confirmed<\/em> deficiency, treatment studies have reported improvement in sexual desire, frequency of sexual thoughts, spontaneous and morning erections, and sexual satisfaction, together with energy, mood and body composition. Different domains improve on different timescales \u2014 libido and mood tend to move within weeks, while changes in muscle and fat take many months.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two honest qualifications belong beside that list. First, these findings come from men who were deficient to begin with; testosterone is not a performance enhancer for men whose levels are normal, and giving it to them is not treatment. Second, erectile function itself responds far less reliably than desire does \u2014 a man whose main problem is getting an erection often has a vascular cause that testosterone will not fix, which is why the <a href=\"https:\/\/drsoaraweeurology.com\/2020\/07\/31\/erectile-dysfunction-ed\/\">cause of the erectile problem<\/a> should be established rather than assumed to be hormonal.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"555\" data-attachment-id=\"4932\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2022\/04\/15\/testosterone-replacement-therapy-2\/blond-man-hero-angry-expression\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?fit=1200%2C833&amp;ssl=1\" data-orig-size=\"1200,833\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;8&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark II&quot;,&quot;caption&quot;:&quot;blond man hero angry expression&quot;,&quot;created_timestamp&quot;:&quot;1442341057&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;blond man hero angry expression&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"There are confirmed literatures on self confidence improvement after 30 weeks of testosterone injection therapy.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;There are confirmed literatures on self confidence improvement after 30 weeks of testosterone injection therapy.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?fit=800%2C555&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?resize=800%2C555&#038;ssl=1\" alt=\"A confident man at work \u2014 energy and mood are among the general well-being domains reported to improve on testosterone treatment\" class=\"wp-image-4932\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?resize=300%2C208&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?resize=1024%2C711&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?resize=768%2C533&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/04\/Self-confidence.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Energy and mood often shift before any change in body composition appears.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What Both Preparations Ask of You<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Fertility.<\/strong> Testosterone given from outside switches off the brain signal that drives the testicles, and sperm production commonly falls to zero \u2014 with either preparation. It is usually reversible after stopping, but recovery takes months and cannot be guaranteed, and it takes longer to clear a long-acting preparation. <strong>If you may want children now or later, say so before the first dose<\/strong>: clomiphene citrate, hCG or an aromatase inhibitor raise your own testosterone instead, and a semen analysis beforehand is worth having.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Blood thickening.<\/strong> Testosterone stimulates red cell production, and a rising haematocrit is the finding that most often forces a dose reduction, a change of preparation or a pause. It produces no symptoms you could notice \u2014 which is why the blood tests are not optional.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is worth being precise about how well established this one is, because it bears directly on the choice above. Of everything the large TRAVERSE safety trial measured, <strong>erythrocytosis was the adverse effect it demonstrated most clearly<\/strong> \u2014 by a wide margin, and unlike several other signals it is not a borderline finding. That is the strongest available argument for preferring a preparation you can stop or adjust quickly over one you cannot: the side effect most likely to force a change is also the one the evidence is surest about.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Prostate, sleep and the rest.<\/strong> PSA and a prostate assessment before starting and during treatment; sleep apnoea looked into if you snore heavily or wake unrefreshed, since it can worsen; and the ordinary effects worth knowing about \u2014 acne, breast tenderness, mood changes, testicular shrinkage, fluid retention. Higher is not better: the aim is a normal level with symptoms improved.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Cardiovascular safety, reported accurately<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">TRAVERSE, the largest trial to date, randomised 5,246 men aged 45 to 80 with existing cardiovascular disease or risk factors. It found <strong>no increase in heart attack, stroke or cardiovascular death<\/strong>, and no increase in prostate cancer or prostate enlargement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Its other findings differ considerably in strength, and an earlier version of this page reported them as though they were equivalent. Separated properly: <strong>erythrocytosis and, in the fracture subtrial, a roughly 43% increase in clinical fractures reached statistical significance.<\/strong> <strong>Atrial fibrillation, pulmonary embolism and acute kidney injury were numerically higher but did not.<\/strong> Those three should not be described as established harms \u2014 and equally, a trial of this size failing to reach significance is not proof of no effect, so a previous clot, a clotting disorder or a known arrhythmia is still worth raising before starting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The trial demonstrated the absence of the harm that had been feared, not a cardiovascular benefit. The full account is in <a href=\"https:\/\/drsoaraweeurology.com\/2026\/09\/23\/testosterone-therapy-heart-safety-traverse\/\">what the TRAVERSE trial actually found<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Get Help the Same Day If Any of These Happen<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Immediately after a long-acting injection:<\/strong> coughing, an urge to cough, breathlessness, chest tightness, dizziness or a feeling of faintness \u2014 tell the staff at once, before leaving<\/li>\n\n\n<li><strong>Chest pain, or breathlessness on less exertion than usual<\/strong><\/li>\n\n\n<li><strong>Pain, swelling or warmth in one calf<\/strong>, or sudden breathlessness with chest pain on breathing in<\/li>\n\n\n<li><strong>Sudden severe headache, one-sided weakness or numbness, or difficulty speaking<\/strong>, even if it passes<\/li>\n\n\n<li><strong>At the injection site:<\/strong> spreading redness, pain increasing after the first couple of days, fever or discharge<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Attend an emergency department or call <strong>1669<\/strong> in Thailand. The first item on that list is specific to long-acting testosterone undecanoate; the rest are symptoms anyone should act on regardless of medication, and listing them here is prudence rather than a claim that testosterone caused them. Do not stop a prescribed medicine on your own because of something you have read here \u2014 tell the doctor who prescribed it.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What is the difference between short-acting and long-acting testosterone injections?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Shorter-acting esters such as testosterone enanthate are given every few weeks and can be self-administered after in-person training; levels rise and fall more between doses. Long-acting testosterone undecanoate is given every few months, gives steadier levels, and must be administered in a medical setting with observation afterwards. The trade-off is control: the shorter-acting preparation can be adjusted or stopped quickly, while a long-acting dose stays in the body for months.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can long-acting testosterone undecanoate be self-injected at home?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No \u2014 never, under any circumstances. It carries a rare risk of pulmonary oil microembolism, in which oil reaches the lungs shortly after injection causing coughing, breathlessness, chest tightness or dizziness, and a risk of anaphylaxis. Both occur within minutes, so the injection is given in a medical setting and the patient is observed afterwards. Anyone offering to supply it for home use should be refused.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Which preparation should I choose?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It is not a patient choice made from a menu \u2014 it is a clinical decision made with you, from your blood results, your other conditions, your fertility plans and how easily you can attend. Convenience is one input among several, and it is usually outweighed by the need to be able to change course quickly if the haematocrit rises or a side effect appears. That point carries real weight, because erythrocytosis is the adverse effect the largest safety trial demonstrated most clearly.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How long before testosterone treatment makes a difference?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Different things move on different timescales. Sexual desire and mood often shift within weeks, while changes in muscle and body fat take many months, and bone density longer still. Erectile function responds less reliably than desire does. All of this applies to men with a confirmed deficiency; testosterone is not a performance enhancer for men whose levels are already normal.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Does testosterone injection affect fertility?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yes, with either preparation. Sperm production commonly falls to zero because the treatment suppresses the brain signal driving the testicles. It is usually reversible after stopping, but recovery takes months, cannot be guaranteed, and takes longer after a long-acting preparation. Raise it before the first dose if you may want children \u2014 fertility-sparing alternatives exist.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is long-term testosterone injection therapy safe?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It is prescribed for confirmed deficiency with symptoms, and it is monitored throughout: haematocrit, testosterone level, PSA and a prostate assessment before starting and at intervals afterwards. The largest safety trial, TRAVERSE, found no increase in heart attack, stroke, prostate cancer or prostate enlargement. Two of its adverse findings reached statistical significance \u2014 erythrocytosis, by a wide margin the clearest, and a roughly 43% rise in clinical fractures in the fracture subtrial. Atrial fibrillation, pulmonary embolism and acute kidney injury were numerically higher but did not reach significance, and should not be described as established harms. The trial showed the absence of the harm that was feared rather than a benefit, which is why monitoring is part of the treatment.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Book an Appointment<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees men\u2019s health and testosterone patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital, Chonburi \u2014 Urology department <a href=\"tel:0880221445\">088-022-1445<\/a>. Diagnosis comes first: testosterone deficiency means a low level confirmed on two early-morning blood tests together with real symptoms. Questions about cost are answered by the hospital rather than by Dr. Soarawee \u2014 for Bangkok Hospital, by email to <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This article is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is educational only, is not medical advice, and does not create a doctor\u2013patient relationship. It gives no doses or intervals: those are set by the prescribing doctor. Do not start, stop or change a prescribed treatment on your own. Availability of individual preparations differs by country. No diagnosis, prescription or individual medical advice is given through personal messaging channels or social media, and Dr. Soarawee operates no public social media account \u2014 any account offering private consultation in his name is fraudulent. Always consult a qualified healthcare professional before starting any medical treatment.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/04\/15\/testosterone-replacement-therapy-2\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2022\/04\/15\/testosterone-replacement-therapy-2\/\",\n      \"name\": \"Short-Acting vs Long-Acting Testosterone Injection: How the Choice Is Made\",\n      \"description\": \"How shorter-acting injectable testosterone and long-acting testosterone undecanoate differ on steadiness of levels, reversibility, clinic attendance and safety, and why only one of them can ever be self-administered.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2022-04-15\",\n      \"dateModified\": \"2026-08-29\",\n      \"lastReviewed\": \"2026-08-29\",\n      \"specialty\": \"https:\/\/schema.org\/Urologic\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/04\/15\/testosterone-replacement-therapy-2\/#trt\" },\n      \"disambiguatingDescription\": \"Comparison of injectable testosterone preparations for men with confirmed testosterone deficiency. No doses or dosing intervals are given: preparation, dose and interval are set by the prescribing clinician. Long-acting testosterone undecanoate must be administered in a medical setting with observation and is never self-injected. Testosterone replacement at Bangkok Hospital Headquarters is provided as a transdermal gel or as an injection; pellets, nasal gel and oral testosterone capsules are not offered. CORRECTION 29 August 2026: an earlier version stated that the TRAVERSE trial found more atrial fibrillation, pulmonary embolism and acute kidney injury without noting that none of those differences reached statistical significance. The findings that did reach significance were erythrocytosis, by a wide margin the clearest, and a roughly 43% increase in clinical fractures in the fracture subtrial.\"\n    },\n    {\n      \"@type\": \"MedicalTherapy\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/04\/15\/testosterone-replacement-therapy-2\/#trt\",\n      \"name\": \"Injectable testosterone replacement therapy\",\n      \"description\": \"Testosterone replacement by intramuscular injection, using either a shorter-acting ester such as testosterone enanthate or long-acting testosterone undecanoate. Shorter-acting preparations may be self-administered after in-person training; long-acting testosterone undecanoate is administered in a medical setting with a period of observation afterwards.\",\n      \"indication\": {\n        \"@type\": \"MedicalIndication\",\n        \"description\": \"Symptomatic testosterone deficiency confirmed on two early-morning serum testosterone measurements. Not indicated for men with normal testosterone and not a performance enhancer.\"\n      },\n      \"contraindication\": {\n        \"@type\": \"MedicalContraindication\",\n        \"description\": \"Men currently seeking to conceive should not start testosterone; clomiphene citrate, hCG or an aromatase inhibitor are used instead. Untreated erythrocytosis, untreated obstructive sleep apnoea and untreated prostate cancer require assessment first. Long-acting testosterone undecanoate must never be self-administered.\"\n      },\n      \"seriousAdverseOutcome\": [\n        { \"@type\": \"MedicalEntity\", \"name\": \"Pulmonary oil microembolism after long-acting testosterone undecanoate\", \"description\": \"Cough, urge to cough, breathlessness, chest tightness or dizziness within minutes of injection. 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The adverse effect most clearly demonstrated in the TRAVERSE trial, and harder to manage with a long-acting preparation because the dose cannot be withdrawn.\" },\n        { \"@type\": \"MedicalEntity\", \"name\": \"Clinical fracture\", \"description\": \"Statistically significant increase of approximately 43% in the TRAVERSE fracture subtrial, despite improved bone mineral density on imaging.\" }\n      ],\n      \"adverseOutcome\": [\n        { \"@type\": \"MedicalEntity\", \"name\": \"Suppression of sperm production, commonly to azoospermia; usually but not always reversible, and slower to reverse after a long-acting preparation\" },\n        { \"@type\": \"MedicalEntity\", \"name\": \"Worsening of obstructive sleep apnoea\" },\n        { \"@type\": \"MedicalEntity\", \"name\": \"Gynaecomastia, acne, mood changes, fluid retention, testicular atrophy\" },\n        { \"@type\": \"MedicalEntity\", \"name\": \"Peak-and-trough symptoms before the next dose with shorter-acting preparations\" },\n        { \"@type\": \"MedicalEntity\", \"name\": \"Atrial fibrillation, pulmonary embolism and acute kidney injury (numerically higher in the TRAVERSE trial but NOT statistically significant; these should not be described as established harms of testosterone)\" }\n      ],\n      \"followup\": \"Haematocrit, testosterone level, PSA and prostate assessment before starting and at intervals during treatment. Observation after each long-acting testosterone undecanoate injection. Preparation, dose and interval are changed by the prescribing doctor, not by the patient. Emergency assessment the same day for chest pain, breathlessness on reduced exertion, unilateral calf pain or swelling, stroke symptoms, or infection at the injection site. In Thailand the emergency number is 1669.\"\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/04\/15\/testosterone-replacement-therapy-2\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/04\/15\/testosterone-replacement-therapy-2\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What is the difference between short-acting and long-acting testosterone injections?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Shorter-acting esters such as testosterone enanthate are given every few weeks and can be self-administered after in-person training, with levels rising and falling more between doses. Long-acting testosterone undecanoate is given every few months, gives steadier levels, and must be administered in a medical setting with observation afterwards. 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Anyone offering to supply it for home use should be refused.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Which testosterone preparation should a patient choose?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is a clinical decision made with the patient from blood results, other conditions, fertility plans and how easily they can attend, rather than a choice from a menu. 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This applies to men with a confirmed deficiency; testosterone is not a performance enhancer for men whose levels are normal.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Does testosterone injection affect fertility?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Yes, with either preparation. Sperm production commonly falls to zero because treatment suppresses the brain signal driving the testicles. It is usually reversible after stopping, but recovery takes months, cannot be guaranteed, and takes longer after a long-acting preparation. Men who may want children should raise it before the first dose; fertility-sparing alternatives exist.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Is long-term testosterone injection therapy safe?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is prescribed for confirmed deficiency with symptoms and monitored throughout with haematocrit, testosterone level, PSA and prostate assessment. The largest safety trial, TRAVERSE, found no increase in heart attack, stroke, prostate cancer or prostate enlargement. Two adverse findings reached statistical significance: erythrocytosis, by a wide margin the clearest, and a roughly 43% rise in clinical fractures in the fracture subtrial. Atrial fibrillation, pulmonary embolism and acute kidney injury were numerically higher but did not reach significance and should not be described as established harms. The trial showed the absence of the harm that was feared rather than a benefit.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>Two injectable testosterone preparations, two quite different propositions. Dr. Soarawee Weerasopone explains how short-acting and long-acting testosterone injections differ, why only one of them can ever be given at home, and why the choice is a clinical decision rather than a menu.<\/p>","protected":false},"author":185281453,"featured_media":10107,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Short-acting versus long-acting testosterone injection compared by a urologist \u2014 steadiness of levels, clinic visits, why long-acting testosterone undecanoate must be given with observation, and what monitoring both require.","jetpack_seo_html_title":"Short-Acting vs Long-Acting Testosterone Injection | Dr. Pom","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1363],"tags":[1532,1563,1573,1564],"class_list":["post-4916","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mens-health","tag-men-health","tag-testosterone","tag-testosterone-injection","tag-testosterone-replacement-therapy"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-1hi","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/TRT-Comparison.jpg?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts\/4916","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/comments?post=4916"}],"version-history":[{"count":28,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts\/4916\/revisions"}],"predecessor-version":[{"id":11779,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts\/4916\/revisions\/11779"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/media\/10107"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/media?parent=4916"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/categories?post=4916"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/tags?post=4916"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}