#26andtrans

Whats wrong with testapel? I am on it. Just honestly curious.

Hey, 

I was on it for a while but am officially Testopel free! One of my major complaints is that Testopel was never formally studied as a drug by the FDA! Pretty BS, yeah? 

Here’s how that happened: In 1972, fused crystalline subcutaneous testosterone pellet implants were officially approved for use in the USA… but the formulation lay dormant until a re-rendering of the recipe (called Testopel) hit the market for the first time ever in 2008. When the re-engineered product hit the market, no new studies were done- thus no FDA approved pharmacokinetic studies exist for Testopel in its current formulation… and, as a result, Testopel lacks “specific information as to the mechanism of dissolution, the recommended dosing, the insertion technique, the dosing recommendations, and the data on the dosing frequency.” Talk about horrifying! 

Testopel prescribers are just batting in the dark with regard to dosages and dosing cycles. Literature from the original 1972 formulation recommends 4 pellets per implant but actual and more recent studies that I’ve stumbled upon also make reference to 6-9 pellets or 10-12 pellets per dosing cycle which is supposedly every 4-6 months . I was on 10 pellets every 3 months… and that was barely enough to keep my levels in line. By month 3, my T levels were barely in the 200s… and even immediately after implant, my T levels barely surpassed 600. 

In addition to dosages, dosing cycles, and level woes, Testopel has some very real and serious side effects that are significantly more intense than the usual injectable T/ creams/ gels that most people are prescribed! My doctor and the medical literature I received for Testopel barely made reference to the possibility of pellet EXTRUSION. Pellet extrusions aren’t some rare adverse side effect, they are the highly probable reality! Looking at studies, the likelihood of pellet extrusion is anywhere between 0.3% to 40%… which is a horrifying range. Some studies claim that the rate of extrusion increases per implant over time, other studies claim that no extrusions occurred. To me, this mixed bag of statistics and hodgepodge of  data is demonstrative of how understudied Testopel is as a drug. 

Which brings me to another point: Testopel made me feel like a lab rat. I’d go in a Urology Office every 3 months for implants. Each appointment, I’d deal with 3 medical professionals at a minimum (receptionist, nurse and urologist). I’d go in and each visit I was required to pee in a cup. Once in the exam room, I’d get naked from the waist down, get injected with a topical numbing agent, get cut open with a scalpel, implanted, and steri-stripped back up. I’d go in for blood tests even more regularly. The whole experience was supposed to minimize my contact with Testosterone, but instead it maximized the medicalization of my identity… and it didn’t feel good. 

Nor did my butt!!! For 1-2 weeks post-implant, I’d have to bum around and take it easy. I’d hobble to and fro and was required to keep my activity to a minimum. It was recommended that I ice and take Tylenol… and even then, I’d feel sore. Sitting was unusually uncomfortable and, at my worst points, it was unbearable. Additionally, there was always a major bruise on my butt post-implant, like sometimes my whole cheek would turn black and blue! Recently, as in the last 2 or 3 implants, I started getting blood blisters at the implant site. That was annoying and physically uncomfortable…  and the blood blisters looked pretty unsightly! When I brought my blood blistered butt to the attention of my doctor, my concerns weren’t really addressed. The doctor would tell me to be mindful of infection… because apparently that’s a very real concern with Testopel. Each time you get implanted, you’re undergoing “surgery,” and with each “surgery,” the risk of infection increases… another aspect of Testopel that is minimized! 

Ultimately, what happened to me was pretty predictable. My butt started extruding pellets and got infected. I ended up with a gaping hole and wound on my butt that was open for about 2 months… just sitting there, exposed to air and bacteria and other icky shit because the Testopel had decimated my ass. I had to have part of my butt surgically excised to remove the damaged tissue and close the wound. And it was hella crappy. I just got my stitches removed today and am only beginning to feel better… 

Which brings me to my final mix of thoughts: I wouldn’t be so aggro about the whole situation if there was some sort of transparency… but Testopel is a pharmaceutical drug and the pharmaceutical industry is all about the bank! The lack of recent studies regarding the current Testopel formulation is because of the money hungry industry! Patients currently on Testopel are actively being used as Testopel test subjects. Lastly, inserting foreign bodies into your body and hoping for the best really isn’t a sound method of hormone replacement therapy… especially for trans and gender nonconforming peepz.