If you are someone who takes regular testosterone then you may be aware of some recent changes to the availability of Primoteston, the short-acting injectable form of testosterone, which has been removed from the PBS.
It will still be available on a private script, and the cost is about the same. The big hit will be to people who receive a subsidy for their prescriptions – pensioners and health care card holders – as they will now have to pay full price.
Primoteston is a popular form of male sex hormone which comes in 1ml vials containing 250mg of testosterone enanthate, and can be self-injected. It produces male levels of testosterone in the body, which can last up to a few weeks in some people, although typically the levels fall out of the male range after 10 to 14 days.
This compound is prescribed for transgender men to promote masculinization, and for cisgender men who are testosterone deficient, which can happen for a variety of reasons including testicular failure, pituitary disease and prior abuse of anabolic steroids.
As well as assisting with masculinization and energy levels, and increasing sex drive, having a normal amount of testosterone in the body also promotes a sense of well-being. For most men, being testosterone deficient is unpleasant, and when severe can contribute to quite significant depression, fatigue and reduced quality of life.
The loss of the PBS listing means that Primoteston, at about $38 per box of 3, may now be unaffordable for people who relied on the PBS discount due to their concession card status.
There are however alternative forms of testosterone available.
There is Sustanon, another short-acting injectable which, although not PBS listed, is about $5 cheaper than Primoteston on a private script.
The next most popular is Reandron, which is a long-acting injectable that is PBS-listed, lasting up to 14 weeks in some men. The downside is that it’s a larger volume (4ml) and needs to be injected into the gluteal muscle in your backside, so cannot be self-injected.
Not all guys like long-acting testosterone shots, but I’m a big fan in my practice treating trans men especially, as it’s easier to achieve good male levels without the highs and lows that short-acting injections tend to give.
Sometimes the high peaks that occur with short-acting shots lead to way too much testosterone in the body, which has flow-on effects for your health.
For those who don’t fancy needles, there is also testosterone gel and patches, although the popular underarm gel Axiron was recently discontinued. Gel sachets are affordably available on the PBS.
They are not preferred for gender transition, due to their very slow onset of physical changes. However they can be quite reasonable for maintenance testosterone therapy in the fully masculinized male.
I’m very disappointed by the PBS decision to delist Primoteston, as it is an excellent treatment option for many. However there are some potential alternatives so do have a chat to your doctor about your options.
Dr Fiona Bisshop specialises in LGBTI health and works at Holdsworth House Medical Brisbane. To make an appointment, call (07) 3894 0794 or visit the website here. She wants to hear from you! Send your health question to [email protected] and she’ll pick the best ones to answer in each issue of QNews Magazine. #AskDocQ is completely anonymous. No identifying information will be printed in the Doc’s reply, and your personal information stays with the Doc. And at QNews Magazine, we’ll start collating all the Doc’s answers.