On pellets, and starting to mind the procedure — or the fact that the dose is fixed until the next one? Considering a switch to a metered spray?
A pellet is implanted once and works for months. A spray is applied each morning. The difference that matters most is not convenience — it is whether the dose can be changed after it starts.
Spray vs. pellets: what are the differences?
Testosterone Spray Rx
RxPellets
Delivery
Testosterone Spray RxMetered transdermal spray, self-applied at home. Powered by Hypospray®.
PelletsPellets implanted in the subdermal fat during a minor in-office procedure.[1]
What it involves
Testosterone Spray RxAbout ten seconds, plus a few minutes to dry.
PelletsAbout 30 minutes: the site is cleaned and numbed with lidocaine, a small incision is made, pellets are placed, and the incision is closed with a Steri-Strip.[1]
How often
Testosterone Spray RxOnce a day.
PelletsSix to ten or more pellets per implantation, a few times a year.[1][5]
Duration per administration
Testosterone Spray RxOne day.
PelletsMonths — decay depends on pellet count, BMI and baseline concentration.[5]
Changing the dose mid-course
Testosterone Spray RxAt the next daily application, on your prescriber’s instruction.
PelletsNot possible without removing the implant.
Format-specific risks
Testosterone Spray RxTransfer to others before it dries.
PelletsExtrusion and the procedure site; one series of 292 procedures reported one site infection and no spontaneous extrusions.[3]
Daily adherence
Testosterone Spray RxA daily step you have to keep.
PelletsNone between procedures — which is the case for pellets, stated fairly.
PelletsBilled in pieces: the procedure, the pellets, visits, and labs.
Product details are taken from FDA labelling and the cited literature; pellet count, procedure detail and duration vary by prescriber and protocol. Keen Testosterone Spray Rx is a compounded medication prepared by a US 503A compounding pharmacy; compounded medications are not FDA-approved. Testopel is FDA-approved. Not medical advice — a licensed clinician determines whether a spray protocol is right for you.
About Testosterone Spray Rx
Testosterone Spray Rx therapies deliver compounded hormone medication through the skin using Hypospray®, a licensed topical transdermal technology. Each actuation is a metered dose, applied to a small area of clean, dry skin.
A membership covers the full loop: lab panels, licensed clinician consultations in the app, compounded medication shipped to your door, and dose adjustments made from your results.
The men’s bottle holds 14 mL and delivers 0.20 mL per spray — a 35-day supply. Your prescriber sets the per-spray strength. Pharmacokinetics for the transdermal spray platform have been published in the peer-reviewed literature.[P]
About implanted pellets
Testosterone pellets are implanted under the skin in a minor in-office procedure and release hormone for months. Implantable pellets have been FDA-approved since 1972.[4]
Testopel pellets are 3.2 mm across and about 9 mm long, each containing 75 mg of testosterone. Six to ten or more are implanted per procedure, which takes about 30 minutes: the site is cleaned and numbed with lidocaine, a small incision is made, the pellets are placed in the subdermal fat, and the incision is closed with a Steri-Strip.[1]
In a 273-patient pharmacokinetic review, decay was modelled by pellet count, BMI and baseline concentration.[5] A single-site series of 292 implant procedures reported one implantation-site infection and no spontaneous extrusions, with 86% of patients satisfied.[3] The axis that separates a pellet from a daily dose is reversibility: an implanted pellet cannot be adjusted without removing it.
See why an adjustable daily dose beats a fixed one
One flat membership covers labs, clinicians, and medication — no per-item billing.
Pellets suit a man who is stable on a known dose and wants to stop thinking about it — and that is a real advantage. These are the three reasons people most often want something else.
ONE
A dose you can change
A daily topical dose can be adjusted at the next application. An implanted pellet cannot — if it needs to come down, the options are to wait it out or have it removed.
TWO
No procedure, no incision
No 30-minute appointment, no lidocaine, no incision to heal, and no procedure site to look after.[1]
THREE
Nothing to reverse
Stopping a spray means stopping a spray. Stopping an implant means waiting it out or a second procedure.
Keen membership
Ready for a dose you can change?
or $199/mo when you pay $599 up front for three months. No insurance needed.
A dose your prescriber can change at the next application
Nothing implanted that has to be removed to stop
Labs, clinician access, and medication in one membership
14 mL bottle, 0.20 mL per spray — a 35-day supply, with per-spray strength set by your prescriber
One procedure covers months of dosing
Nothing to remember day to day
An FDA-approved route in use since 1972[4]
Requires a minor surgical procedure and a healing site[1]
The dose cannot be changed without removing the implant
What each one includes
One published membership price on our side. On the other, a bill assembled from parts.
Keen membership
$229/mo
or $199/mo when you pay $599 up front for three months. No insurance needed.
Included, no separate bill
Initial and follow-up lab panels
Licensed clinician consultations in the app
Compounded medication, shipped to your door
Dose adjustments from your lab results
Ongoing support, whenever you need it
Typical pellet protocol
Varies
Billed separately
Implantation procedureper procedure
The pellets themselvesper implantation
Office visits and follow-upsper visit
Lab panelsper draw
Site care and complication managementas needed
Travel and appointment timeper procedure
Care and support
With Keen
Licensed clinicians answer in the app — no phone tree, no separate visit fee. Lab panels, protocol changes, and refills all run through the same thread.
Pellets
Support depends on the provider and the plan — office visits, pharmacy calls, and lab coordination are usually handled separately from each other.
Frequently asked questions
Is the spray inhaled or nasal?
No. Hypospray® is a topical transdermal technology — the spray is applied to your skin and absorbed through it. Nothing is inhaled.
How long do pellets actually last?
Months, and the exact figure depends on how many were implanted, your BMI, and your baseline concentration — those were the variables modelled in a 273-patient pharmacokinetic review.[5] Your prescriber is the right person to ask about your own protocol.
What happens if a pellet dose is too high?
That is the trade-off pellets carry. A daily dose can be lowered at the next application; an implanted pellet cannot be adjusted without removing it.
Are pellets a worse choice?
No. Pellets have been FDA-approved since 1972,[4] one series of 292 procedures reported a single site infection and no spontaneous extrusions with 86% patient satisfaction,[3] and the Endocrine Society guideline sets no ranking between formulations.[7] This page is about what changes if you switch.
What does membership cost?
$229/mo, or $199/mo when you pay $599 up front for three months. No insurance needed. Labs, clinician visits, and medication are included.
Spray or pellets: which is right for you?
Neither route is right for everyone. A licensed clinician decides based on your labs, your history, and how you want to live with your protocol.
Consider the spray if
You are still finding the right dose and want it adjustable
You would rather not have a procedure or an incision
You want to be able to change course at the next application
A short daily step is something you will actually keep
Pellets may still suit you if
You are stable on a known dose and want to stop thinking about it
You would rather have a few procedures a year than a daily step
You know daily adherence is the thing you would not keep up
The Endocrine Society guideline sets no ranking between formulations — choice rests on preference, pharmacokinetics, burden, and cost[7]
or $199/mo when you pay $599 up front for three months. No insurance needed.
Hypospray® is a registered trademark. Keen Meds Inc. utilizes the Hypospray® topical transdermal delivery platform under license.
Keen Testosterone Spray Rx is a compounded medication prepared by a US 503A compounding pharmacy; compounded medications are not FDA-approved. Products named on this page are FDA-approved and their details are taken from their FDA labelling. This is a comparison of how each medication is administered — not a claim of clinical superiority, equivalence, or comparative effectiveness. Not medical advice; a licensed clinician determines what is appropriate for you.
Jockenhövel F, Vogel E, Kreutzer M, et al. Pharmacokinetics and pharmacodynamics of subcutaneous testosterone implants in hypogonadal men. Clin Endocrinol (Oxf). 1996;45(1):61–71. PMID 8796140PMID 8796140
Cavender RK, Fairall M. Subcutaneous testosterone pellet implant (Testopel) therapy for men with testosterone deficiency syndrome: a single-site retrospective safety analysis. J Sex Med. 2009;6(11):3177–3192. PMID 19796052PMID 19796052
McCullough AR, Khera M, Goldstein I, et al. A multi-institutional observational study of testosterone levels after testosterone pellet (Testopel) insertion. J Sex Med. 2012;9(2):594–601. PMID 22240203PMID 22240203
Pastuszak AW, Mittakanti H, Liu JS, et al. Pharmacokinetic evaluation and dosing of subcutaneous testosterone pellets. J Androl. 2012;33(5):927–937. PMID 22403285PMID 22403285
Schoenfeld MJ, Shortridge E, Cui Z, Muram D. Medication adherence and treatment patterns for hypogonadal patients treated with topical testosterone therapy. J Sex Med. 2013;10(5):1401–1409. PMID 23464534PMID 23464534
Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744. PMID 29562364PMID 29562364
[P] Chik Z, Johnston A, Tucker AT, Chew SL, Michaels L, Alam CAS. Pharmacokinetics of a new testosterone transdermal delivery system, TDS®-testosterone, in healthy males. Br J Clin Pharmacol. 2006;61(3):275–279. doi:10.1111/j.1365-2125.2005.02542.x PMID 16487220PMID 16487220doi:10.1111/j.1365-2125.2005.02542.x
