Testosterone Creams vs. Injections- Pro's and Con's

On September 12, 2016 In Testosterone 0

When responsibly and appropriately engaging in a testosterone optimizing program, individuals often must decide along with their prescribing doctor, the most appropriate route of administration due to various factors, concerns and goals on the table. Anyone that cares about their long term health and wellness (as you should) know that paying attention to their cardiovascular, heart and liver health is critical to long term success on a program. But what about results you may ask? Well, yes this is obviously important too as we want to strive to be much better that just “normal” but rather, optimized in all areas of our hormones and health! The goal is to look at all factors and make the most informed decision as to how to nicely optimize our testosterone levels and look and feel our best while simultaneously preserving our health long term. Assuming you’re a forward thinking, responsible person you would agree, right?

The goal with this article is to help explain in simple laymen’s terms the differences, pros and cons of the two most common and popular routes of administering; testosterone creams and testosterone injections and why one may be best to have over the other in one's quest to optimize their testosterone levels to desired but safe, zones.

Factors The Doctor and Patient Must Consider with TRT

Areas of wellness to have a keen eye towards when engaging in Testosterone Replacement Therapy (TRT) include but are not limited to; liver enzymes ALT & AST, PSA, hemoglobin, hematocrit, RBC’s, blood pressure and cholesterol counts. As many seasoned HRT doctors and men engaging in TRT programs know, elevating one’s testosterone sometimes may pose a risk to elevating these markers to unhealthy levels. This of course should not be ignored or left to get out of control if any of it applies to the patient. After all, one of the primary goals of TRT and optimizing hormones is to look and feel our best in the most effective and healthy way, right? If it comes at sacrificing our long term health, then it doesn’t end up making a whole lot of sense long term.

There are often many things to consider and discuss when a new client is coming on with a program for their first time or, revisiting to start back up after a long intermission if they happened to “fall off the bandwagon” to engage in a less than healthy lifestyle for a while. Sometimes, there are imbalances that are partly due to lifestyle habits such as excessive sugar intake and bad eating habits that have affected one’s cholesterol negatively. Other times, individuals over indulge in alcohol or other medications that contribute to liver stress and sometimes signs of damage, therefor affecting its ability to play roles in supporting the intentions of TRT programs. Often times, due to a combination of hereditary and lifestyle habits just mentioned together, some individuals may express all of the concerns above along with high blood pressure. Periodically, a case may come in with a long term user of TRT that has not had the right “care” and their hemoglobin, hematocrit and RBC’s have been neglected and are high with signs of polycythemia present (see blog:

Aside from health concerns and lab markers, there are preferences of the patient that come into play as well. Due to various outside concerns such as being in contact with young children, one who may travel a lot or someone with needle phobia, there are many things to consider as to the best route of administration of testosterone and the most suitable overall Hormone Replacement Therapy program.

Testosterone Injections: The Pros and Cons

Testosterone injections have always been a “go to” method of administration for most men through the years, and for good reason. Very effective at getting one’s testosterone levels up without the need of a surgical procedure with pellets every few months or applying gel or cream daily is a nice selling point to many. Injections come in different forms as well. 

The most common injectable form here in the states is testosterone cypionate, which is enanthate’s cousin. Unlike propionate, this one is more of a nice, slower releasing testosterone with more of a “bell curve” and more stable levels of T in the body. This often shows less aromatization (conversion) of T into estrogen as well without the strong peaks and valleys.

The Pros

Testosterone injections are a nice choice for men who have no present health or lab marker concerns on the table and want to “inject it and forget it” while on TRT week to week. With injections, there is no worry about waiting to apply after a shower, two times a day.  Injections pose no risk of contact with children or women whom the male user may be in constant physical contact with.

Some men who may be in contact with kids may not want the risk of any T creams coming in contact with them, although this is very hard to do when applied appropriately to discreet places like the back of the knees! One case of a wrestling coach comes to mind, which was a very valid one where he was often on the mat with the kids wrestling with and coaching them several days a week.

The Cons

Some of the undesired drawbacks of injections will vary from person to person. The most common complaint is the unpleasant feeling of painfully injecting one’s self with needles. In order to best stabilize and benefit, injections should to be done a couple times a week. Scar tissue may sometimes build up at injection sites over time. Many men who travel for business find it inconvenient to have to check bags with syringes and needles versus taking a simple carry on with testosterone cream.

Other, and more important concerns are lab markers previously mentioned. YOUTH-RX has been in business for over 13 years (as of fall 2016) with over 2,500 clients which equates to quite a bit of case studies and lab reports over the years. In numerous amounts of these case studies, it has been seen time and time again that injections have a much more noticeable negative impact on cholesterol in such a way that it decreases HDL (good) cholesterol and increases LDL (bad). Injections also tend to have a faster negative impact on hemoglobin, hematocrit and RBC’s with how much it elevates them (this makes blood “thick” and hard on heart) in some individuals sensitive in this area. This route of administration sometimes may show a correlation with elevations in liver enzymes and its overall health also as the ester that makes it “time released” is cleaved off at the liver. One last con with going the injection rout; they shut down LH and FSH ( your production of testosterone and sperm) faster in comparison to creams, making the need for more frequent reboots to keep leydig cell function relevant, to be incorporated for best long term health and receptiveness.

Testosterone Creams: The Pros and Cons

The Pros

The pros of testosterone cream are many to most men showing a disruption in their endocrine systems and in the area of their testosterone levels. Often, hormones including testosterone have gotten out of control due in part to less than stellar lifestyle practices which show up on lab reports. Often with scenarios similar to this, when other areas of the body are stressed or “beat up” such as with elevated blood pressure and cholesterol or high liver enzymes, the cream route is the healthier and, better choice by far. In comparison to injections, the creams are the much more “gentle” approach on these important health markers in our hundreds upon hundreds of case studies within YOUTH-RX’s client base through the years. This is critically important for both the patient and the doctor to consider as we should never want to sacrifice our long term health from a TRT program. If there are current concerns on any important health markers on lab results, creams are often the better choice as to not exacerbate them to make them any worse like injections often do. The goal is to look and feel our best now and, year after year moving (or charging) forward!

Other pros of creams are the ease of application. Whether simply applying to the inside of the elbow or the more popular and discreet application behind a knee or the top of your foot, this is painless and takes less than 60 seconds in the morning and evening. This can easily be taken while traveling without the need to take needles, syringes and vials. Also, testosterone levels are more stable from day to day without any “saw” or “bell curve” levels of testosterone going on in the body. This is turn enables the body to easier manage related areas such as DHT and estrogen conversion. Healthy, steady and smooth is a good way to be.

How Effective Are Creams?

Good question here and, a valid one! Testosterone creams and gels come in many different strengths on the market for many different reasons which we won’t get into those details here. In short, if the appropriate dose is used for your needs, the answer to this headlining question is: Very effective!

Let’s try to understand the vast differences between the most common gels and creams most know of and the ones many aren’t familiar with. Most men have heard of those well marketed, big pharma gels we have seen on all those commercials and radio ads, right? Most of these gels or creams typically only come in 1-1.62% or if you’re lucky, up to 5% potency. What does this equate to in milligrams of testosterone? Not much to be simple but essentially, 10-20mg of testosterone per gram. This usually requires a large daily “slathering” of lotion on the skin in a few different areas to get a decent amount.

Unfortunately, in too many cases men get a slight elevation in their T levels from these weak cream or gel solutions that are just enough to slow down their own endogenous production. It’s like taking 2 steps forward only to take 2 back.  Our doctors here at YOUTH-RX understand quite well the difference between just having "normal" versus nice optimal levels of testosterone (and other hormones) to where we look and feel our best and respond appropriately to programs.

In a majority of cases here at YOUTH-RX, our male clients due to lab results and their clinical needs, will receive up to a 20% cream preparation that is compounded specifically for them. This equates to a nice “manly dose” of up to 200mg of testosterone per ml of cream. This in turn doesn’t require so big of an application (it’s very small) but yet the positive results and the impact are amazing and yield “just what the doctor ordered”: Healthy, vibrant and optimized levels of testosterone.

The Cons

For some, the inconvenience of taking the 60 seconds to apply a little bit of cream in the morning and at night poses a challenge from time to time due to forgetting, distractions or other various reasons. In less than >1% of cases there may be a slight allergic reaction. But again, this is extremely rare to ever hear about. They are a bit more out of the pocket book up front. When prescribed and taken appropriately with an optimized dose of testosterone, there aren’t many drawbacks or, cons to creams.


When done correctly and responsibly, men can look their best and feel the way they deserve to while having healthy, optimized testosterone and be as healthy as possible.

You are here visiting us today for a reason. You are likely a bit ahead of most in regards to addressing and wanting to take care of your health and well-being. Looking for and finding the right answers can be quite a task but we are here to assist you with finding the right solution to look and feel your best. Fill out our health history form today and let one of our heavily experienced consultants know a good time to discuss the process and more. Shortly, you can be well on your way to a new you! 

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