Testosterone Cream vs Injection

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


If you have low testosterone, your doctor may prescribe testosterone therapy.

TRT stands for testosterone replacement therapy. It is also known as androgen therapy. The main purpose of TRT is to treat low levels of testosterone, which may occur as a result of age.

It's also becoming more popular for other uses than medical ones, such as:

  • Enhancing sexual performance
  • Achieving higher energy levels
  • Building muscle mass for bodybuilding

TRT could help you achieve these goals, according to some research. Although, there are some caveats...

Testosterone Explained

Your body produces testosterone as part of its normal sex cycle; more specifically, men assigned male at birth (AMAB) produce most testosterone while female ovaries also produce small amounts.

Testosterone is classified as an androgenic steroid which means it combines anabolic with androgenic properties; its presence contributes to secondary sexual characteristics in men like chest hair growth, deep voices, penis enlargement and increased libido.

Testosterone hormone plays an essential role in bone and muscle growth as well as red blood cell production, helping with sperm development and sexual drive for men. Testosterone levels begin increasing during puberty before declining around age 30-40; pregnant women tend to have higher levels of this hormone.

If you have low testosterone, your doctor may suggest natural methods of increasing testosterone, such as exercise or testosterone replacement therapy. They may also refer you to a urologist for further specialized treatment options.

A testosterone blood test measures the amount of testosterone present in your blood. The test can detect bioavailable or bioactive testosterone - that which your body can utilize directly - by testing bound or free testosterone levels; bound is attached to either sex hormone-binding globulin or albumin proteins while free testosterone remains free and unbound from either protein.

Low testosterone is harmful to health

Testosterone plays an essential role in maintaining sexual drive and muscle mass, maintaining mood stability and strengthening bones - but insufficient amounts may contribute to serious health conditions like anemia and bone density issues.

Millions of men experience the gradual decrease of testosterone, often known as male menopause or andropause; although some may shrug it off as just another part of aging process without seeking treatment.

However, treatment could prevent serious damage to overall health and should not be overlooked as an inevitable part of growing older.

Low testosterone levels have been linked with insulin resistance and obesity, both of which increase heart disease risk.

They've also been associated with atherosclerosis or hardening of the arteries - though more research needs to be conducted into this relationship, most cardiologists agree that maintaining optimal levels of testosterone are beneficial for heart health.

Aged adults experiencing a decline in testosterone may become susceptible to depression. This trend is most pronounced among men suffering from multiple medical conditions, such as heart disease.

Luckily, depression can be effectively managed with medication or psychotherapy treatments which could also restore normal levels of testosterone production.

Testosterone is essential to healthy blood cell production, so low testosterone levels can lead to anemia.

Loss of muscle mass also increases how many calories your body burns for energy; to combat this issue, get plenty of exercise and nutrition - supplements may increase testosterone, but without guidance from an experienced endocrinologist can lead to side effects that may negatively impact health.

Testosterone replacement therapy (TRT) explained

Testosterone is a male sexual hormone produced in the testicles and found at lower concentrations in women.

Some men who suffer from low levels of testosterone may benefit from seeing a physician to receive hormone replacement therapy, also known as TRT treatment.

Low testosterone can contribute to issues like erectile dysfunction (ED), loss of body muscle mass and depression as well as other symptoms which interfere with life quality.

Some men treated with testosterone notice an increase in energy and an improvement to their libido, as well as improved bone density and insulin sensitivity.

Although changes may take time to appear, once treatment stops these changes can often reverse themselves; so it is essential that regular blood tests and doctor appointments be scheduled while taking this medication.

Persons at risk for prostate cancer should use caution and limit long-term use. Individuals with heart disease or multiple risk factors should also stay away from this treatment, which has been shown to aggravate prostate enlargement and increase the likelihood of blood clots.

Testosterone therapy comes in many different forms. Since oral testosterone may damage liver tissue, patches or gel may be more suitable.

Orally disintegrating tablets may also be used on gums for fast action. Furthermore, some doctors also suggest injecting this form of hormone directly into their patients as this bypasses liver toxicity while offering more intense results than other methods.

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Topical testosterone (creams/gels)

Hypogonadism, a condition where the body doesn't produce enough testosterone naturally, is treated by using testosterone topical. This is only done if the cause of their hypogonadism is a disorder of the pituitary (a small brain gland) or hypothalamus.

Before you start using testosterone topical, your doctor will order tests to determine if the testosterone levels are low. 

This medicated gel is made up of testosterone. This gel is used to replace the hormone when men are not producing enough testosterone.

This medicine enters the bloodstream through your skin and helps you reach your normal testosterone levels.

This 1978 study suggests that daily aplication of testosterone cream can enlarge a micropenis.

This type of testosterone is ideal for those who aren't comfortable with injectious or subcutaneous pellets which are inserted under the skin around the buttocks or lower back.

Testosterone cream side-effects

The misuse or abuse of testosterone may cause serious side-effects such as cardiovascular disease including heart attacks, stroke and liver diseases.

Other effects include mental/mood disorders, abnormal drug seeking behavior, or incorrect bone growth in adolescents.

You should not use the drug in excess or more frequently than prescribed.

If you stop taking testosterone suddenly, you might experience withdrawal symptoms such as depression or irritability.


The topical application of testosterone can cause adverse effects on people who come into contact with the skin where the gel or solution was applied.

If they touch the skin of a child or woman who has used testosterone topical products, it is likely that they will be affected.

A woman's baby can be injured if she touches the skin of a woman who has used topical testosterone products.

Women shouldn't use this medication if they may be pregnant or breastfeeding. The baby may be harmed by testosterone.

Take precautions so that no one else comes into contact with the testosterone gel or solution on your skin.

You should wait a few moments for the testosterone solution or gel to dry before putting on clothing. This will prevent anyone from touching your skin.

After applying the medication to your hands, wash them with soap and warm water.

Avoid letting anyone touch the skin where you have applied testosterone gel or solution.

You should always wash your skin with soap and warm water before you have any contact with someone else.

Anyone who touches skin that is covered in testosterone gel or solution, but has not been cleaned with soap and warm water should do so as soon as they can.

Tell others not to touch your clothes, bedding, or any other items that might contain testosterone gel or solution.

Women and children who touch the skin treated with testosterone-containing products may experience certain symptoms.

Women who have been exposed to testosterone should consult their doctor if they develop any of the following symptoms: new hair growth on the body, or acne.

You should contact your child's doctor if you notice any of these symptoms in a child that may have been exposed to testosterone: increased sexual desire or aggression, increased erections and pubic hair growth, enlarged genitals.

The majority of these symptoms will disappear once the child has stopped contacting testosterone. However, in some cases genitals can remain larger than usual.

Children who are exposed to testosterone topical can experience a faster bone maturation than normal.

It means that children could stop growing earlier than expected, and have a shorter adult height than expected.

These children's bones could remain mature even if they are no longer exposed to testosterone topical products.

Testosterone injections 

Testosterone injections are injections of isolated testosterone. This hormone is present in both males and females, but the levels are naturally higher in males. 

Many males prefer this type of therapy over the other forms. If there are any complications with testosterone therapy, the long duration of action can be a problem.

Injecting testosterone into a muscle. Injections are usually administered every 2 to four weeks.

Only a health care professional should administer testosterone injections. Misuse of testosterone can cause serious side effects and even death.

Treatment duration will vary depending on the condition that is being treated.

You will be required to have frequent blood tests while receiving this medication.

Testosterone injection side-effects 

This treatment can have unwanted side effects in addition to its intended effects.

As your body adapts to the medication, these side effects may disappear.

The misuse or abuse of testosterone may cause serious side-effects such as heart disease including heart attacks, stroke, liver diseases, mental/mood disorders, abnormal drug seeking behavior, or improper growth in adolescents' bones.

You should not use the drug in excess or more frequently than prescribed.

If you stop taking testosterone suddenly, you might experience withdrawal symptoms. The symptoms can last for weeks or even months.


Drug interactions can alter the way your medication works or increase the risk of serious side effects. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist.

You should not stop taking any medication or alter the dosage without consulting your doctor.

The following products may interact with this medication:

  • Blood thinners (such as Warfarin)

The benefits and risks of testosterone replacement therapy 

Health benefits

The goal of testosterone replacement therapy is to restore hormone levels within the normal range for young adults.

It should, in principle, approximate natural endogenous hormone production.

It produces and maintains physiological serum concentrations, including active metabolites, of the hormonal hormone. 

Benefits include, most importantly, positive effects on mood and energy levels, patients' well-being and sexual function, lean muscle mass and strength, erythropoiesis, bone mineral density (BMD), cognitive abilities and certain benefits for cardiovascular risk factors. 

It is known that testosterone helps with libido and other factors such as mood, erythropoiesis and cognition.

Possible risks

Risks of testosterone replacement therapy vary depending on age, lifestyle, and other medical conditions.

The risk of prostate cancer, as well as worsening of symptoms such as benign prostatic hypertrophy and liver toxicity, is present.

Other symptoms include sleep apnea, congestive cardiac failure, gynecomastia and infertility.

Rarely, testosterone treatment has been associated with psychotic symptoms, aggression and excessive libido, as well as physical and mental dependence. Withdrawal syndromes and physical and psychological dependency have also been reported.

It is a benign side effect of testosterone therapy. The cause is the aromatization (conversion) of testosterone to estradiol by peripheral fat tissue and muscle. The ratio of testosterone to estradiol is usually normal.

The downregulation of gonadotropins is responsible for the diminution of testicular size during testosterone replacement therapy and reduced fertility.

Transdermal testosterone-replacement therapy is associated with a variety of skin reactions, mainly erythema or pruritus, which are more common with patches than with gel preparations.

Injections of testosterone intramuscularly can cause localized pain, bruising or swelling, as well as erythema.

It is also anabolic and will cause some water, sodium, and nitrogen retention. Patients with preexisting renal, hepatic, or cardiac disease may experience worsened oedema. Rarely has hypertension been reported.

A female who was using testosterone gel was diagnosed with hyperandrogenism. 

Men who want to father a child should not undergo testosterone replacement therapy because exogenous testosterone will suppress the HPT-axis.

Ongoing TRT monitoring 

Before and during treatment, laboratory parameters such as PSA, hematocrit and lipid profiles should be monitored.

The patient should be checked for signs of edema and gynecomastia. They should also be tested for sleep apnea symptoms, lower urinary symptoms, as well as low BMD.

The Endocrine Society has developed clinical guidelines for the monitoring of patients who receive TRT.

At baseline, the PSA level, the digital rectal examination, the hematocrit (BMD), the lipids and the liver function test should be performed.

The patient will then be evaluated 3 and 6 month after the treatment begins and annually thereafter to determine whether the symptoms have improved and if there are any adverse effects.

Three months after starting testosterone therapy, it is important to monitor the levels of testosterone.

It is important to measure the total serum testosterone levels in the morning. For older men, a target range between 400 and 500 ng/dL (14.0-17.5 nmol/L), is recommended.

If there is no response to the treatment, it may be necessary to increase the dose.

The serum testosterone level can be determined between injections of injectable testosterone.

The serum level of men who have been treated with transdermal testosterone patches should be determined 3 to 12 hours following the application.

The serum level of patients who are receiving oral testosterone tablets should be checked immediately prior to the application of any new system.

After a week, patients on testosterone gel can have their levels tested.

The bioavailable testosterone level should be checked in all cases as testosterone therapy reduces SHBG.

Testosterone creams vs injections

The testosterone replacement therapy is not a one-size-fits all treatment.

Both methods are extremely effective in optimizing hormone levels.

Both approaches will provide the same benefits:

  • Muscle mass gain
  • Cognitive Enhancement
  • Greater energy levels
  • Sexual performance and function improved

Some men see better results with cream, while others with injections.

Some results have shown that the cream is more potent because it helps to increase good cholesterol and DHT levels.

Many people also prefer the cream because it eliminates the need for injections, which is often the final straw. The benefits of either option will speak for themselves.

It's less invasive, as you won't need to inject yourself for the rest of your days, which will reduce scar tissue formation.

Anyone looking for a testosterone optimization therapy that is faster and painless should give it a try.

The cream offers a slight increase in the levels of dihydrotestosterone, which improves erectile function and sexual performance.

It makes sense, as DHT is essential to a man’s libido. The trans-scrotal lotion has the edge over intramuscular shots.

The increase in DHT, and possibly PSA, is only temporary (and this is why you should work with a doctor that is experienced in using transdermal systems in his or her practice).

It is possible to keep your testosterone levels stable by using cream daily.

Trans-scrotal cream has only one real drawback: it can be accidentally wiped off by mistake.

For maximum testosterone absorption, you will need to avoid certain activities (such as working out and showering) for 90 minutes.

The creams and injections are very similar in their results, if they are used under the supervision of a physician who is progressive.

Both methods will result in the same physiological effects: increased muscle mass, improved cognition, more energy, and endurance.

This study confirms previous findings that different T formulations have variable adverse effects rates.

In particular, T pellets and gels have higher rates of erythrocytosis and E compared to injectable T formulations. This may be due to the fact that their T mean and peak levels are higher.

PSA levels do not seem to be affected by the T formulation. Similarly, inconsistent variations in lipid concentrations occur.

Is there an alternative option? 

Military Muscle Safely Increases Testosterone Levels

Military Muscle is an ideal supplement that will safely increase testosterone levels while catering to soldiers' specific needs.

Not only is it owned and run by military personnel themselves, but they offer an unrivalled money back guarantee with thousands of satisfied customers worldwide already using this supplement!

This supplement offers a natural alternative to steroids by using natural ingredients to achieve similar results without risk or side effects. It features 14 vitamins, minerals and extracts with strong clinical evidence supporting their effectiveness.

Zinc deficiency has been known to decrease testosterone levels so this supplement provides essential zinc supplementation while simultaneously decreasing inflammation levels.

Urtica dioica root extract has been shown to be an effective anti-inflammatory, as well as aiding with testosterone conversion into estrogen in the body, helping reduce any negative side-effects that could include bloating, water retention or fat accumulation.

Furthermore, Boron has shown great promise as having a significant impact on testosterone and relieving inflammation.

Iron is another key component to help combat the normal decline of testosterone seen as men age, helping you feel energised throughout the day and more alert than before.

Military Muscle's creator conducted extensive research to ensure that every supplement included is proven effective and safe, at doses which will benefit users.

Unlike many products on the market which hide behind proprietary blends for ingredients used to formulate them, Military Muscle clearly lists each of their daily capsule ingredients.


The most popular method for treating low testosterone is to use creams and gels. These are easy to use and reliable.

Transdermal gels and creams should be applied first thing in morning. The areas of application are the shoulders, upper arm and scrotum. Gels, creams and lotions are usually available in concentrations between 1,2,5, and 10%.

Testosterone Injections is another commonly prescribed treatment for low testosterone . It is preferred by doctors because it can provide stable and predictable levels of testosterone within the body

The effectiveness of the treatment is dependent on the type and frequency of injections of testosterone. The two main ways to administer testosterone injections is subcutaneously.

It's not really a matter of choosing between testosterone gels or creams.

TRT is not a one-size fits all treatment. However, each of the methods is effective in improving symptoms associated with low testosterone.

Your specific circumstances will determine which method you prefer.

Gels and creams are easy to use, but they do have their drawbacks. Gels and creams can be affected by heavy sweating or friction.

In the same way, there is also a high chance of transferring the preparation to others when in contact.

It can be especially problematic if you are in contact with women who are pregnant or trying to conceive.

Injections of testosterone are the most reliable treatment.

The blood testosterone levels are predictable and minimally interfere with your lifestyle.

Many people are afraid of needles and will not use them.

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