Testosterone Injection vs Gel: Which Is Better?

If you're starting testosterone replacement therapy, one of the first decisions you'll face is how to take it. Injections and gels are the two most common methods—and while they deliver the same hormone, they do it very differently.

Neither is universally "better." The right choice depends on your lifestyle, your body's response, and what tradeoffs you're willing to accept. Here's what you need to know to make an informed decision.

How Each Method Works

Testosterone Injections

Injectable testosterone (typically testosterone cypionate or enanthate) is administered directly into muscle tissue—usually the thigh, glutes, or deltoid. The testosterone is suspended in oil and releases gradually over days to weeks.

Most men inject once weekly or every two weeks, though some protocols use more frequent smaller doses. After injection, testosterone levels spike and then gradually decline until the next dose, creating a "peak and valley" pattern.

Testosterone Gels

Testosterone gel (brands like AndroGel, Testim, or compounded versions) is applied daily to the skin—typically on the shoulders, upper arms, or abdomen. The testosterone absorbs through the skin into the bloodstream over several hours.

Because you apply it daily, gel provides more stable testosterone levels without the peaks and valleys of injections. However, absorption can vary significantly between individuals based on skin type, application site, and other factors.

Effectiveness: Do They Work Equally Well?

Both injections and gels are effective at raising testosterone levels and improving symptoms of low T. Research comparing the two shows similar outcomes for energy, libido, mood, and muscle mass improvements.

However, there are some differences in how they affect hormone levels. A study published in the Journal of Sexual Medicine found that both methods produce comparable increases in total testosterone and free testosterone over time. Injections tend to produce higher peak levels, while gels maintain more consistent daily levels. The clinical significance of this difference varies by individual.

Side-by-Side Comparison

The Case for Injections

Injections remain the most popular TRT method for several reasons. First, there's no transfer risk. Unlike gels, you can't accidentally expose your partner or children to testosterone through skin contact. This is especially important for men with young children or pregnant partners. Second, absorption is predictable. What you inject is what you get—there's no variability based on skin type or application technique.

Cost is another factor. Injectable testosterone cypionate is significantly cheaper than brand-name gels. A month's supply of injections might cost $30-80, while AndroGel can run $200-500 without insurance. Third, there are fewer lifestyle restrictions. You can shower, swim, and work out immediately without worrying about washing off your medication or transferring it to gym equipment.

The main drawbacks are the "peak and valley" effect (though this can be minimized with more frequent dosing) and the fact that you have to give yourself shots. For men with needle phobia, this can be a significant barrier.

The Case for Gels

Gels offer their own advantages. The biggest is more stable testosterone levels. Because you apply gel daily, your hormone levels stay more consistent throughout the week. Some men report fewer mood swings and more even energy compared to the peaks and valleys of injections.

No needles is another obvious benefit. For men who are uncomfortable with self-injection, gel removes that barrier entirely. The application process is simple—about 30 seconds in the morning. Additionally, gels may produce more DHT, which some research suggests could have benefits for libido (though more DHT also means more potential for DHT-related side effects like hair loss).

The downsides are significant though. Transfer risk requires careful management—you need to cover the application site and avoid skin-to-skin contact until it's fully absorbed (usually 2+ hours). Absorption varies significantly between individuals, which can make dosing tricky. And the cost difference compared to injections is substantial.

Which Is Right for You?

Consider injections if you have young children or a pregnant partner, you want the most cost-effective option, you lead an active lifestyle (lots of sweating, swimming), you prefer less frequent dosing, or absorption consistency is important to you.

Consider gels if you have significant needle phobia, you prefer more stable daily hormone levels, you experience mood swings on injection protocols, you don't have close contact with children or pregnant women, or cost isn't a major factor.

What About Creams?

Testosterone creams (often from compounding pharmacies) offer some advantages over gels. They typically have higher concentrations, allowing for smaller application amounts. Many men apply cream to the scrotum, which has higher absorption rates. However, creams share the same transfer risks and require the same precautions.

A Third Option: Pellets

It's worth mentioning testosterone pellets—small implants placed under the skin every 3-6 months. They offer the ultimate convenience (no daily or weekly dosing) and consistent levels, but require minor surgical procedures for insertion. They're also difficult to adjust if you need to change your dose.

The Bottom Line

Both testosterone injections and gels effectively treat low testosterone. The "best" option depends entirely on your personal circumstances—your comfort with needles, your living situation, your activity level, your budget, and how your body responds to treatment.

Many men start with one method and switch to another based on their experience. That's perfectly normal. The most important thing is getting treatment in a way that works for your life, because consistency matters more than the delivery method.

Work with your healthcare provider to choose an initial approach, then be open to adjusting based on your results and experience. The goal is optimized testosterone levels and symptom relief—not loyalty to any particular delivery method.