Summarize this article:

Buccal testosterone is taken orally through a lozenge. The lozenge dissolves in your mouth. It is normally taken twice a day, in the morning and night. This approach is an efficient way to dose testosterone in men. However, the lozenges have a bitter taste and can cause mouth irritation. Transdermal testosterone gel is a commonly used approach. It is a gel that is applied on the body which mimics a dose that would normally occur. The gel is applied to the shoulders, upper arms, chest, or belly. Make certain you wash your hands after application. The gel is applied once a day at the same time, usually in the morning by about eight a.m.  The cost of the gel can be high. You have to make certain the areas are dry before coming into contact with women (especially pregnant women) or children. There is a risk of transferring the testosterone if the gel isn’t dry. The transdermal testosterone patch is another skin-dosing approach, which mimics a dose that would normally occur. Some of the patches may be applied onto the scrotum, though they may be placed on the arms or back as well. The patch is applied once a day at the same time, usually in the morning by about eight a.m.  When you remove the patch, make certain no one else is exposed to the testosterone. Dispose of the patch immediately. The cost of the transdermal patch is high as well. Testosterone replacement therapy (TRT) is only done under the care of a physician. No matter which method you use, it is important to get regularly checked to make certain enough testosterone is entering your blood to be effective.  Before beginning testosterone therapy, your doctor must perform a digital rectal exam and PSA blood test should be measured. If these are abnormal (suggesting an enlarged prostate), then therapy should not be started and further testing should be done. Three months after starting testosterone, the same tests should be performed. If there is concern for enlarged prostate or prostate nodules at that time, then testosterone should be stopped. The Endocrine Society generally recommends TRT if the tested levels of testosterone are lower than 300 ng/dL and there are symptoms of low testosterone.  Testosterone pills are available, but are not useful, as taking plain testosterone by mouth has no effect because the liver metabolizes it too rapidly. Modified forms of testosterone pills were made that prevented the testosterone from being metabolized in the liver, but it was shown that these forms can cause damage to the liver.
Try buccal testosterone. Take transdermal testosterone gel. Consider transdermal testosterone patch. Talk to your doctor before starting any testosterone replacement therapy.