At The Men’s Health Clinic, we believe in tailoring Testosterone Replacement Therapy (TRT) to the individual, ensuring hormonal stability, symptom relief, and long-term safety.

While there are multiple TRT delivery methods available, our clinical experience has shown that microdosing testosterone — combined with human chorionic gonadotropin (hCG) — provides the most physiological, effective, and well-tolerated approach to hormone optimisation.

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Traditional TRT Options – What You Need to Know

There are several ways to administer TRT, each with its own advantages and limitations. The choice of TRT method should always be guided by a thorough discussion with your doctor.

1. Injectable Testosterone

Intramuscular Injections

This is the most widely used method of delivering testosterone. However, traditional dosing schedules (weekly or biweekly injections) can lead to hormonal peaks and troughs, resulting in mood swings, energy crashes, and increased testosterone to oestrogen conversion.

Subcutaneous Injections

This has become increasingly popular as it is perhaps more effective from a patient compliance perspective. Injections are typically painless compared to intramuscular injections, and there is a decreased rate of testosterone to oestrogen conversion.

Testosterone Esters

Short Acting: Testosterone Propionate

This fast-acting ester is typically unsuitable for TRT due to its pharmacokinetic properties meaning it is metabolised too quickly to achieve healthy stable testosterone levels.

Medium Acting: Testosterone Cypionate & Testosterone Enanthate

These medium-acting esters are utilised by most clinics as the dose and injection regime can easily be adjusted to effectively titrate the dose of testosterone according to response, thus minimising side effects.

Long Acting: Testosterone Undecanoate (Nebido^®)

Testosterone Undecanoate is a slow-release injectable that usually lasts 10–14 weeks per dose. While it is convenient, many men experience hormonal instability, particularly in the weeks following an injection as testosterone levels peak and then gradually decline.

Mixed: Sustanon^®

Sustanon is a mix of four testosterone esters, intended to reduce injection frequency. However, the short-acting Propionate ester requires frequent injections, while the long-acting Decanoate ester causes an extended washout period, making stable levels harder to maintain.

2. Transdermal Gels & Patches

Gels and patches offer a non-invasive option, but absorption is unreliable, leading to inconsistent symptom relief. Skin irritation is also a common issue, and there is a significant risk of testosterone transfer to partners, children, or pets.

3. Testosterone Cream

Some clinics promote testosterone cream as an alternative to injections, but we do not recommend it due to:

• Unpredictable absorption, leading to hormonal instability.
• Increased Dihydrotestosterone (DHT) conversion, which may seem advantageous due to reports of increased libido and mood, but excess DHT has been linked with cardiovascular disease.
• High risk of transference, making it unsuitable for men with partners or families.

4. Testosterone Implant

Testosterone pellets provide a long-term option, but require a minor surgical procedure, the dose is fixed and the release of testosterone is inconsistent casing unstable levels.

5. Oral Testosterone

Oral testosterone is rarely used due to concerns over liver toxicity and poor bioavailability.

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Why We Recommend Microdosing Testosterone with hCG

At The Men’s Health Clinic, we have refined our TRT protocols to minimise side effects and optimise hormone balance for both enhanced symptom relief and long-term physical and psychological health.

Through our clinical experience, we have found that microdosing testosterone via frequent, low-dose subcutaneous or intramuscular injections – combined with hCG – provides the most stable and effective approach to TRT.

Stable Hormone Levels

By injecting smaller amounts more frequently, we avoid the peaks and crashes associated with traditional dosing.

Lower Oestrogenic & Androgenic Side Effects

Large spikes in testosterone increase oestrogen conversion, leading to anxiety, feeling emotional, water retention, mood swings, and gynecomastia. Microdosing helps prevents this.

Improved Haematocrit Control

High-dose injections can elevate red blood cell production excessively, increasing cardiovascular risk. Smaller doses help mitigate this issue.

Better Symptom Management

Our patients report enhanced energy, cognitive function, mood stability, and libido when on a microdosing protocol.

HCG for Testicular Function & Fertility

Microdosing alone can suppress natural testosterone production, potentially leading to testicular shrinkage and infertility. hCG mimics luteinizing hormone (LH), and to a degree Follicle Stimulating Hormone (FSH) helping to maintain:

• Testicular size and function
• Endogenous testosterone production
• Fertility and sperm production
• A more balanced hormonal profile

HCG is a critical component of TRT for men who wish to preserve testicular function while benefiting from optimised testosterone levels.

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The Future of TRT is Microdosing Testosterone with hCG

At The Men’s Health Clinic, we are committed to providing the most effective, evidence-based approach to TRT.

Our experience has consistently demonstrated that microdosing testosterone, in combination with hCG, is superior to traditional dosing methods, offering improved symptom relief, fewer side effects, and better long-term health outcomes.

If you are considering TRT or are currently on a traditional protocol and experiencing instability, we encourage you to contact our specialist doctors to explore how microdosing with hCG can optimise your treatment.