Testosterone Cream vs. Testosterone Injections

Elite HRT

Written by Elite HRT on April 01, 2021

Medically reviewed by

Camille Frecking, Regulatory Affairs Specialist, MEDICAL ADVISOR

Testosterone hormone therapy can have great impacts on those with low testosterone levels. However, there are multiple ways that you can use it, which can make it hard to pick the right choice for you.

When it comes to testosterone cream, such as Androgel, and injections, each has its own pros and cons that correspond with the dose or prescription. It is best to work with your doctor to pick the right option for you, but you can start with what your goals are and what is important to you.

Keep reading to understand what testosterone is, things that can cause low testosterone levels, and the different ways that testosterone can be administered.

What is Testosterone?

Testosterone is a sex hormone that is the highest in men but also is in women in small amounts. Testosterone is also known as an androgen, or male sex hormone. Testosterone is also a steroid hormone, meaning it is made of lipids and has a 4 carbon ring structure.

Testosterone plays a role in reproductive functioning as well as muscle growth, mood, fat stores, facial hair, sex drive, bone strength, and more. Testosterone is an important hormone, especially in men, that can make a huge difference in day to day life if it is not in balance.

Excess amounts of testosterone also can cause acne, aggressive behavior, excessive hair growth such as body and pubic hair, and can even worsen sleep apnea.

Factors That Could Lead to Testosterone Deficiency

Low testosterone or testosterone deficiency can occur in many men. Low testosterone can be suspected with certain symptoms such as low hair growth, mood changes, low libido, low sperm production, and other signs, however, some men do not have symptoms at all.

To diagnose low testosterone your doctor can order urine or blood tests to determine your testosterone levels. Because testosterone levels can change throughout the day, the tests are usually collected multiple times a day to get a bigger picture of your hormone status. If you are discovered to have low testosterone, there may be a few reasons why this may be. Age, genetics, the environment, previous surgeries, and a hormonal imbalance may be to blame.

Age

Age is one of the most common factors that is associated with low testosterone levels. As men age, their testosterone levels naturally decrease resulting in unwanted symptoms.

These slow declines in hormones usually begin at age 40 in men, decrease at a rate of about 1 percent per year. This means that testosterone level changes are not usually noticeable until about your 50s or 60s. This slow decline in testosterone will accompany normal body changes including increased fat deposits around the body, decreased muscle tone, hair loss or thinning, and low sex drive.

This can be frustrating for men as they age, but there are some things that can be done to make you feel more youthful.

Genetics

Your genetics can also play a role in having low T. Certain conditions such as Klinefelter syndrome, Kalman syndrome, and hemochromatosis can cause you to have low testosterone. Klinefelter syndrome is when a male is born with XXY chromosomes, as opposed to XY.

This results in small-sized testicles that are unable to produce a large amount of testosterone, in addition, there are other changes such as low muscle mass, low hair growth, and large breasts. Kalman syndrome is a delay or absence of puberty that comes from a lack of the necessary sex hormones.

All of these conditions can be recognized by your health care provider and the symptoms can be addressed with therapy.

Environmental

Some things in the environment can also impact your ability to create testosterone.

For example, a reduction in testosterone production could occur if there was an injury to the testicles such as being hit during sports.

Another environmental cause could be exposure to a toxin or chemical such as chemotherapy or radiation from cancer treatment.

Even things that you come in contact with every day can be interrupting your body’s natural production, such as plastics, pesticides, and certain foods that could be contributing to a decline in testosterone.

While you cannot avoid all of these environmental features, keep an eye out for anything that could be reducing your testosterone levels and work to prevent injuries to and swelling of the testicles through measures such as wearing a cup during sports.

Orchiectomy

An orchiectomy is a procedure to remove one or both of the testicles. An orchiectomy may need to occur if there is testicular or prostate cancer present, if an injury to the testicles occurs, testicular torsion when the testicles spin on itself, or for gender reaffirming surgery.

An orchiectomy causes low testosterone because the testicles are the primary location for testosterone production. Usually, there is testosterone replacement therapy after an orchiectomy so that the person continues to have adequate testosterone hormones.

However, in the case of orchiectomy for gender reaffirming, testosterone replacement is not common. So, an orchiectomy can cause low testosterone levels, but testosterone replacement is usually initiated after the surgery.

Ways That Testosterone Can Be Administered

Testosterone replacement therapy can be administered in a variety of ways including injection, patch, cream, pill, and implant. Each method has its own pros and cons, so they must be weighed carefully to make the best decision for you.

Injection

Testosterone injections are one of the most common and preferred ways for the administration of testosterone. There are three forms of testosterone that can be used for injection including testosterone enanthate, testosterone cypionate, and testosterone propionate. Each form has its own pros and cons including how slow or fast it is released into the body.

The injections are beneficial because they are inexpensive and can be released into the entire body relatively quickly. The negative side to injections is that you have to have frequent injections that can be uncomfortable, and the levels of testosterone begin to decrease as you get closer to needing another injection.

Cream

Testosterone gel and creams can be applied to various parts of the body depending on the brand and instructions. Some of the most common places for this type of androgen therapy are the front of the thighs, the shoulders or arms, and the abdomen. You should not apply it to the penis or scrotum.

After you apply you have to wait for it to dry before putting clothes on over it. The creams are usually well tolerated by the skin and are easy to apply.

On the other hand, they can be expensive and can be easily transferred from the skin of one person to another. You must be very careful that women and children do not come in contact with the product or they could begin developing masculine features.

Side effects of testosterone cream include but are not limited to difficulty breathing, shortness of breath, chest pain, dizziness, nausea or skin irritation.

Patch

A testosterone patch is like a sticker with a packet of testosterone attached to it that slowly releases testosterone hormone onto the skin. Some of the patches are applied to the scrotum and some are applied to other areas of the skin such as the arm. 

For scrotal patches, the patch is applied to a scrotum that has been shaved so that there is no hair. These are generally non-irritating and others do not know that you are wearing them. 

For non-scrotal patches, it is easy to apply them and the release of hormones is similar to the natural release pattern of testosterone. The negative side to non-scrotal patches is that they can cause irritability to the skin.

Pill

Pill forms of testosterone are available, such as Androderm, but this is not usually the preferred method of administration. 

While pill forms of testosterone may be easy to take and remember to take there are negative side effects that outweigh the benefits. 

One major side effect is its interaction with warfarin, a blood clot medication, because it can multiply the blood thinner effect, making you bleed more easily. 

This makes the pill form one of the last forms to be chosen and is not usually prescribed.

How To Pick the Best Administration for You

To pick the best administration of testosterone for you you should take the time to list out your symptoms and what is important in medication for you. 

You can then bring that to your doctor and work together to choose testosterone that will fit your needs and help you the most. It’s important to be transparent about your medical history such as history of liver disease, stroke, and heart attack as testosterone therapy is not appropriate for everyone. 

Since each form of testosterone has its own pros and cons you will have to decide that the pros outweigh the cons, especially if you are looking to treat specific issues like erection dysfunction or enlarged prostate. 

Conclusion

Testosterone creams and injections are only two of many options for testosterone replacement therapy. While testosterone injections are less expensive, they may be inconvenient to receive. 

Testosterone creams are easy to apply, but you must take care that others do not come in contact with the medication and they can be relatively more expensive. 

Testosterone therapy is something that should be considered if you have low levels of testosterone, related to any condition or factor. 

To do this you should work with your healthcare provider or Elite HRT, and let them know your concerns so that you can get the best treatment possible.

Resources

Testosterone, aging, and the mind | Harvard Health

Klinefelter syndrome – Symptoms and causes | Mayo Clinic

Testosterone Treatments: Why, When, and How? | American Family Physician