• Testosterone given orally is subject to extensive hepatic first-pass metabolism and is therefore most successiul as an implant, but this is superseded by testosterone esters, e.g. enanthate, which may be given orally or as depot injections; these esters do not injure the liver (see below). Skin patches are available.
• Mesterolone provides oral therapy; its molecular structure is such that its hypothalamic feedback inhibition of pituitary gonadotrophin secretion is less and it does not cause liver injury (see below).
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