What is Topical Testosterone: Uses, Dosage, Side Effects and More

Topical testosterone is a hormone replacement therapy that you apply directly to your skin as a gel, cream, or patch. It's designed to help men whose bodies don't produce enough testosterone naturally, a condition called low testosterone or "low T."

Think of it as giving your body the testosterone it needs through your skin rather than through pills or injections. The medication absorbs through your skin and enters your bloodstream, helping restore hormone levels that may have dropped due to aging, medical conditions, or other factors.

What is Topical Testosterone Used For?

Topical testosterone treats hypogonadism, which is when your body doesn't make enough testosterone on its own. This can happen for various reasons, and the symptoms can significantly impact your daily life.

Men with low testosterone often experience fatigue, reduced muscle mass, decreased sex drive, mood changes, and difficulty concentrating. These symptoms can develop gradually, making them easy to overlook at first.

Your doctor will typically diagnose low testosterone through blood tests and a review of your symptoms. The goal of topical testosterone therapy is to bring your hormone levels back to a normal range, which can help improve energy, mood, sexual function, and overall quality of life.

How Does Topical Testosterone Work?

Topical testosterone works by delivering the hormone directly through your skin into your bloodstream. This method provides a steady, controlled release of testosterone throughout the day, mimicking how your body would naturally produce the hormone.

The medication is considered moderately strong and effective for hormone replacement. Unlike testosterone pills that can stress your liver, topical applications bypass your digestive system entirely, making them gentler on your body.

Once absorbed, the testosterone travels through your bloodstream to tissues throughout your body. It helps maintain muscle mass, bone density, red blood cell production, and supports sexual function and mood regulation.

How Should I Take Topical Testosterone?

Apply topical testosterone to clean, dry skin once daily, typically in the morning. Most gels and creams work best when applied to your shoulders, upper arms, or abdomen, avoiding areas where clothes might rub off the medication.

You don't need to take this medication with food since it doesn't go through your digestive system. However, timing your application consistently each day helps maintain steady hormone levels.

Here are the key steps for proper application:

• Wash your hands thoroughly before and after applying
• Apply to completely dry skin at least 2 hours before showering or swimming
• Let the medication dry completely before putting on clothes
• Avoid contact with others, especially women and children, until the area is covered by clothing
• Rotate application sites to prevent skin irritation

Always follow your doctor's specific instructions, as different brands may have slightly different application requirements. Never apply more than prescribed, as this won't speed up results and may increase side effects.

How Long Should I Take Topical Testosterone For?

Most men need to use topical testosterone long-term, often for years or even permanently, since the underlying condition causing low testosterone typically doesn't resolve on its own. Your treatment duration depends on what's causing your low testosterone levels.

You'll typically start noticing improvements in energy and mood within 2-4 weeks, while changes in muscle mass and sexual function may take 3-6 months. Your doctor will monitor your progress through regular blood tests and symptom assessments.

Some men may be able to stop treatment if their low testosterone was caused by temporary factors like certain medications, stress, or weight gain that has since been addressed. However, most men with age-related or medical condition-related low testosterone will need ongoing therapy.

What Are the Side Effects of Topical Testosterone?

Most men tolerate topical testosterone well, but like any medication, it can cause side effects. Understanding what to expect can help you use the medication safely and know when to contact your doctor.

Common side effects that many men experience include:

• Skin irritation, redness, or itching at the application site
• Acne or oily skin, especially on the face and back
• Increased body hair growth
• Mild headaches during the first few weeks
• Changes in mood or increased irritability

These common side effects are usually mild and often improve as your body adjusts to the medication. However, you should still mention them to your doctor during follow-up visits.

Less common but more serious side effects require immediate medical attention:

• Chest pain or shortness of breath
• Swelling in your legs, ankles, or feet
• Sudden severe headaches or vision changes
• Signs of liver problems like yellowing of skin or eyes
• Difficulty urinating or changes in urination patterns

Rare but serious complications can include blood clots, heart problems, or prostate issues. Your doctor will monitor you regularly through blood tests and physical exams to catch any potential problems early.

Who Should Not Take Topical Testosterone?

Topical testosterone isn't safe for everyone, and certain medical conditions make it unsuitable or require special monitoring. Your doctor will carefully review your medical history before prescribing this medication.

You should not use topical testosterone if you have:

• Prostate cancer or a history of prostate cancer
• Male breast cancer
• Severe heart, liver, or kidney disease
• Untreated sleep apnea
• High red blood cell count (polycythemia)

Certain conditions require extra caution and close monitoring, including heart disease, diabetes, high blood pressure, or enlarged prostate. Your doctor may still prescribe testosterone but will watch you more closely for complications.

Women and children should never use topical testosterone, as it can cause serious developmental problems and unwanted masculine characteristics. Always keep the medication away from family members and wash your hands thoroughly after each application.

Topical Testosterone Brand Names

Several brand names are available for topical testosterone, each with slightly different formulations and application methods. The most common brands include AndroGel, Testim, Fortesta, and Axiron.

AndroGel and Testim are popular gel formulations that many men find easy to apply and well-tolerated. Fortesta offers a different gel consistency, while Axiron comes in a unique pump applicator that some men prefer.

Your doctor will choose the best brand based on your lifestyle, skin sensitivity, and insurance coverage. All FDA-approved brands are equally effective when used properly, so don't worry if you need to switch between them.

Topical Testosterone Alternatives

If topical testosterone isn't right for you, several other treatment options can help address low testosterone. Your doctor can help you explore these alternatives based on your specific needs and preferences.

Injectable testosterone is a common alternative that requires shots every 1-4 weeks, depending on the formulation. Many men prefer injections because they don't have to remember daily applications, though some dislike needles.

Testosterone pellets implanted under your skin last 3-6 months and provide very steady hormone levels. Nasal gels offer another option for men who can't use skin applications, though they may cause nasal irritation.

For some men, addressing underlying causes like sleep problems, stress, or weight gain can naturally improve testosterone levels without hormone replacement therapy.

Is Topical Testosterone Better Than Testosterone Injections?

Both topical testosterone and injections are effective treatments, but they work differently and suit different lifestyles. Neither is universally "better" – the best choice depends on your personal preferences and medical situation.

Topical testosterone provides more consistent daily hormone levels, avoiding the ups and downs that can occur with injections. You apply it at home daily, giving you more control over your treatment schedule.

Injections may be more convenient for men who don't want to remember daily applications or worry about skin-to-skin contact with family members. However, some men experience mood or energy fluctuations as hormone levels rise and fall between injections.

Your doctor will help you choose based on factors like your lifestyle, skin sensitivity, needle comfort, and how your body responds to each method.