Development of a men’s Preference for Testosterone Replacement Therapy (P-TRT) instrument

Figures & data

Table 1 Sample characteristics of males using testosterone replacement therapy

	All participants n = 58	Preference* n = 24 (41.4%)
Mean age ± SD (range)	55 ± 10.0 (22–69)	55 ± 7.8 (42–68)
Days of TRT therapy ± SD	175.5 ± 299.2	299.8 ± 429.9

Note:

* Participants using TRT > 1 month; experience with more than one product formulation or mode of administration.

Abbreviations: SD, standard deviation; TRT, testosterone replacement therapy.

Table 2 Response rate (%) of participants for major themes of the saturation grid

Items*	Responses n = 58, (%)
Ease of use	56.9
Energy level	39.7
Libido	34.5
Odorless or only a slight odor	22.4
Fast or quick drying time	13.8
Convenience	12.1
Feel better	10.3
Muscle tone, shape, fat redistribution	10.1

Note:

* Participant mention of the reported items and phrases had to be ≥10%.

Table 3 Results for participants using testosterone replacement therapy for more than 1 month and having experience with more than one product

ID	Age	Days	TRT experience	Comparison	Preferred	Current use	Endpoint
1	48	90	Effective: pleased with product; apply by myself; no transportation to doctor’s office.	2 other products	TG	Yes	Feel better, more energy; convenience
2	66	120	Effective; pain to put it on everyday; some burning sensations; wait time to dry.	I	TG	Yes	Energy; worked as well as injections
3	50	270	Positive: Both about the same.	Another TG	TG	Yes	More energy; decrease mood swings
4	54	365	I used another product where I had to do the injection into the muscle, and the gel is easier because there is no sticking and blood, etc. But the injection more potent; lasts longer.	I	TG	Yes	More sex drive; more energy; but skin looks like it’s peeling at times
5	46	180	Yes it is the gel, and I apply topically to the inner thigh and I really can’t really tell if it’s working or not because I am on so many other meds, can’t tell any difference.	TG and oral tablets	Patch	Yes	Patch; quicker; more convenient
6	64	90	It worked.	Another TG	TG	Switched to another TG	Increased testosterone
7	54	365	Helped as far as my energy level. I don’t know if it has helped with regard to erectile dysfunction, I don’t know which part was mental and physical.	Another TG	TG	Yes	Increased energy; sexual desire; outcomes about the same
8	47	120	First I found it very expensive; my insurance didn’t cover it at all. I did find that it worked fine. I almost liked it better than the shot; it gave me a normal feel. The shots really hype you up, puts you almost on a cocaine buzz.	Another TG and I	TG	Discontinued; TG - high cost	More natural
9	55	365	I don’t use the gel anymore. I didn’t like having to wash my hands every time.	TG	Patch	Switched to a different product	Slept better; lost weight
10	45	113	Not effective: I really was expecting like a boost of energy or some type of extra, sexual stamina/ strength or something. I couldn’t really feel much of anything.	I and TG	TG	Discontinued	No efficacy
11	68	90	Not very effective: Ease of use was good, no odor but it didn’t work very well. Experienced a boost for a little bit.	Another TG	TG	Discontinued	No efficacy
12	66	90	I didn’t like it at all. I was rather annoyed with working with it. Well I didn’t like the time that it take to dry. And then I was running into rash and problems with itching. Never saw results with topical gel.	Two different TGs	I	Switched to injection	Less frequency with injections
13	61	42	I put it on. I’m not sure what you want? Don’t know of any side effects. Personally I think that it’s sub therapeutic the dose they have me on. I haven’t used it long enough to get a testosterone level.	TG	I	Yes	Injection: lower cost
14	42	90	Overall I guess it would be a fair experience. Well as opposed to injections and other products I’ve used, I guess the gel’s downfall is that you had to wait for it to dry. It wasn’t a noticeable boost, the boost was more gradual.	TG	I	Yes	Injection: better outcomes
15	57	365	It’s a product that I plan on continue to use. I will be at the doctor’s office in 3 months in March. The last time I had a testosterone level check my levels were at almost a thousand. So I was very pleased with that.	I	TG	Yes	No pain; ease of use
16	62	1460	Very good. It gives you the energy you need.	Another TG	TG	Yes	Okay with all of them
17	48	1825	Efficacy: Mixed – the gel works and sometimes it doesn’t. My testosterone level has fluctuated, I had had better results with injecting myself, but it is a painful and longer process. Patch leaves giant red marks; topical gel was less robust than injection.	Injection and patch	TG	Yes	Ease of use; more energy; weight loss
18	59	270	Well it works very well, it seems to do very well, I have had it tested for my levels and it seems to work well.	Another product	TG	Yes	Improved stamina, energy, and sex drive; no odor
19	45	180	Overall, it’s decent, it irritates the skin but other than that it works well.	2 other products	TG	Yes	Best one so far
20	59	180	Good, but it's not where I wanted it. Supposed to help with erectile dysfunction but it didn’t really help.	Injection	TG	Plans to go back to topical gel	More energy; felt better, but did not appear to help erectile dysfunction
21	57	45	I found that it did not reliably keep my testosterone levels up. It just didn’t have the same effect as the other gel. I wasn’t getting the results for sexual drive and energy.	Another TG	TG	Yes	Smooth texture, odorless, clear, quick absorption, no stain
22	46	90	It was fine for small doses, 2 squirts per leg. But then my doctor prescribed me to shots because 6 squirts got to be a lot to rub in.	Another TG	I	Switched to injection	Inconvenience; needed a larger dose
23	61	210	Well, as compared to the other one it applies much better. It doesn’t leave the same kind of sticky or uncomfortable feeling as the other one does. The overall effect from using it seems to be satisfactory.	Another TG	TG	Yes	Increased energy; sex drive; no negative effects
24	59	180	I started taking it because I always seemed tired all the time, when you lose testosterone you lose your sex drive, and it has improved a little.	Both I and TG	Both	Yes	Increased sex drive and energy

Abbreviations: I, injection; TG, topical gel; TRT, testosterone replacement therapy.

Figure 1 Final conceptual model for testosterone replacement therapy product preference.

Table

Directions: Please either mark or circle the number that best describes to what extent each of the following items influences your preference for a testosterone replacement product?
Please tell us how each of the following items influences your preference for a testosterone replacement product	Not influential	Somewhat influential	Influential	Very influential	Extremely influential
Location of product application	1	2	3	4	5
Drying time when applied to skin	1	2	3	4	5
Convenience	1	2	3	4	5
No skin rash	1	2	3	4	5
Skin not itchy	1	2	3	4	5
Impact on muscle tone	1	2	3	4	5
Effect on sex drive	1	2	3	4	5
Sexual desire	1	2	3	4	5
No product odor	1	2	3	4	5
Texture is not greasy	1	2	3	4	5
Absorption rate	1	2	3	4	5
Impact on exercise	1	2	3	4	5
Impact on stamina	1	2	3	4	5
Impact on others (friends, spouse, partner, family)	1	2	3	4	5
Impact on energy levels	1	2	3	4	5
Attitude about self	1	2	3	4	5
Product does not have to be injected	1	2	3	4	5
Product works	1	2	3	4	5
Product use met expectations	1	2	3	4	5
Liking the product	1	2	3	4	5
Weight loss from product use	1	2	3	4	5
Feel better	1	2	3	4	5
Easy to apply	1	2	3	4	5
Not sticky	1	2	3	4	5
Prefer this product over other TRT options	1	2	3	4	5
Prefer this product over injections	1	2	3	4	5
Impact on testosterone levels	1	2	3	4	5
No skin irritation from use	1	2	3	4	5
No discomfort	1	2	3	4	5

Abbreviation: TRT, testosterone replacement therapy.