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Table 3 Change in serum testosterone (T) and dihydrotestosterone (DHT) when assessed by testosterone replacement therapy (TRT) administration route

From: Cardiovascular risks and elevation of serum DHT vary by route of testosterone administration: a systematic review and meta-analysis

   Testosterone DHT
Route of administration Number of studies Pre-treatment T (nmol/L) (95% CI) Post-treatment T (nmol/L) (95% CI) Pre-Post treatment fold increase in T (95% CI) Pre-treatment DHT (nmol/L) (95% CI) Post-treatment DHT (nmol/L) (95% CI) Pre-Post treatment fold increase in DHT (95% CI)
Intramuscular 8 9.27 (5.68 to 12.85) 23.11 (15.38 to 34.72) 2.91 (2.19 to 3.86) 1.02 (0.69 to 1.34) 1.62 (1.2 to 2.19) 2.20 (1.74 to 2.77)
Transdermal (patch and gel) 20 7.28 (6.09 to 8.42) 16.69 (12.62 to 21.98) 2.53 (1.83 to 3.50) 0.99 (0.78 to 1.20) 3.43 (2.37 to 4.98) 5.46 (4.51 to 6.60)
Gel 13 8.90 (7.67 to 10.13) 18.3 (15.18 to 23.12) 1.98 (1.70 to 2.30) 1.19 (0.93 to 1.46) 3.81 (2.57 to 5.63) 5.12 (4.07 to 6.45)
Patch 7 4.20 (2.78 to 5.23) 9.73 (4.01 to 23.62) 4.43 (2.99 to 6.54) 0.62 (0.36 to 0.88) 2.16 (0.68 to 6.87) 6.61 (3.08 to 14.16)
Orala 4 6.66 21.88 2.80 0.90 3.92 4.46
(14.05, 2.9, 5.6, 4.1) (59.2, 5.70, 7.6, 14.96) (4.20, 2.20, 1.4, 3.6) (1.1, 1.8, 0.30, 0.41) (9.89, 3.30, 1.13, 1.35) 9.0, 1.8, 3.8, 3.3
  1. aEffects of oral TRT on T and DHT concentrations were not statistically analyzed because only four studies were identified that met our a priori inclusionary criteria, which resulted in sufficient data. For oral studies, the mean and individual values for each of the four studies are listed. Transdermal (patch or gel) TRT produces a greater elevation of serum DHT than intramuscular TRT. Means are adjusted for sample size.