Testosterone injections vs cream vs pills

Testosterone comes in three main forms online: injections, gels or creams rubbed into the skin, and capsules or troches taken by mouth. They contain the same hormone, but they differ in how often you take them, what can go wrong, how much FDA review stands behind them and what they cost. Injections are the cheapest online, gels carry a boxed warning about transfer to children, and oral capsules need regular blood pressure checks.

The three forms at a glance

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Each label measured success against its own “normal range” with its own assay, so the percentages describe each product, not a ranking between them. Prices are monthly with the medication included and any required membership added.

Injections

Testosterone cypionate is the form most online clinics prescribe. The Depo-Testosterone label gives 50 to 400 mg every two to four weeks, injected deep into muscle, and puts its half-life at about eight days. Several clinics split that into smaller doses: Rex MD lists cypionate as a twice-weekly injection, and Maximus describes weekly at-home injections. Xyosted, an enanthate autoinjector, goes under the skin of the abdomen once a week, starting at 75 mg; in its 52-week study, 90% of 150 men were in the normal range at week 12.

Injections suit men who don’t mind needles and want the lowest price. Online they cost $79 to $183 a month at the clinics that publish a price, as of October 2026: PeterMD ($79 on a 12-month plan billed upfront), TRT Nation and Maximus ($99.99), MangoRx ($149 with labs) and Hone Health ($28 plus the $155 Premium membership). Generic cypionate is FDA-approved, but Hone Health, Maximus, MangoRx and TRT Nation say theirs is compounded. Rex MD uses FDA-approved generic cypionate inside its $250 to $299 program. See testosterone injections and the injection price list.

Gels and creams

FDA-approved topical testosterone comes as gels and a topical solution. AndroGel 1.62% starts at 40.5 mg once a day on the shoulders and upper arms, adjusted between 20.25 mg and 81 mg from morning levels at about 14 and 28 days. In its label study, 146 of 179 men (81.6%) reached the normal range by day 112. It is also the product used in TRAVERSE, the 5,246-man heart-safety trial, which found major heart events in 7.0% on testosterone and 7.3% on placebo (Lincoff et al.).

The catch is transfer. Gels carry a boxed warning: children have developed signs of early puberty after touching skin where testosterone gel was applied. The label says to wash your hands, cover the site, and keep children and women from contact with unwashed skin. Gels are also flammable until dry.

Creams sold online are compounded. Hone Health ($60 plus its membership, $215 a month with Premium), Maximus ($99.99 on a 6-month plan) and Fountain TRT ($199 with video visits) offer creams; Rex MD prescribes FDA-approved testosterone gel 1.62% in its program. A compounded cream is lawful when a pharmacy prepares it for your prescription and it differs meaningfully from approved gels, but it isn’t FDA-approved, and strength can vary by pharmacy. See testosterone gel or cream.

Oral capsules and troches

Three oral testosterone undecanoate capsules are FDA-approved, with no generic. Kyzatrex starts at 200 mg twice a day with food and runs from 100 mg once a day to 400 mg twice a day; in its label study, 88% of 139 men were in the normal range at day 90. Tlando is 225 mg twice a day, with 80% of 95 men in range at day 24.

All three labels dropped their boxed warning on blood pressure in 2025, according to the label change histories, but blood pressure remains a warning: measure it periodically, and don’t use oral testosterone with uncontrolled high blood pressure. The labels also warn about azoospermia, blood clots, swelling in people with heart, kidney or liver disease, sleep apnea and lipid changes, and the Kyzatrex label asks for a hematocrit check about every 3 months. It also says Kyzatrex is not a 17-alpha-alkyl androgen and is not known to cause liver side effects.

Online, Henry Meds charges $179 a month for Kyzatrex, with visits, labs and shipping included, though not in California. Compounded options cost more: Hone Health’s troches are $60 plus its membership ($215 a month with Premium). See oral testosterone.

How each form is monitored

Each label sets its own schedule for checking that the dose is right, which is worth knowing because the follow-up labs cost money if your clinic doesn’t include them:

• Xyosted: a trough testosterone level, taken 7 days after a dose, once you have had 6 weeks of injections, then periodically.
• AndroGel 1.62%: a pre-dose morning level at about 14 and 28 days, with the dose adjusted up or down.
• Kyzatrex: a level 7 days after starting or changing the dose, taken 3 to 5 hours after the morning capsule, then periodically, plus hematocrit about every 3 months.

Clinics that include repeat labs in the monthly price, such as Rex MD and MangoRx, take this cost off your hands.

What every form shares

Every form is testosterone, so the core warnings travel with it. Labels warn about higher blood pressure, a rise in red blood cell count (hematocrit), blood clots, lower sperm production and worsening of an enlarged prostate. They call for periodic checks of testosterone, hematocrit and, on the gel and oral labels, PSA and lipids.

Every form is also a Schedule III controlled substance. Online clinics can prescribe any of them without an in-person exam under a DEA and HHS temporary rule (90 FR 61301) that runs through December 31, 2026. And every form can suppress your own testosterone and sperm production; if you want to keep fertility, read enclomiphene vs TRT.

How to choose

Weigh these with your clinician:

• Needles. If you won’t inject, a gel, cream or capsule is the alternative.
• Children and partners at home. Gel or cream means guarding against skin-to-skin transfer every day.
• Routine. Injections are weekly to every few weeks; gel is daily; capsules are twice a day with food.
• Blood pressure. Every form can raise it, and the oral labels put particular weight on regular checks.
• FDA approval. If you want an approved product, ask for generic cypionate, an approved gel or Kyzatrex by name; many online creams, troches and injections are compounded.
• Cost. Injections run $79 to $183 a month online and are usually the cheapest; Kyzatrex is $179 at Henry Meds, as of October 2026.

Several clinics let you change form inside the same plan. Hone Health prescribes injections, cream and troches, and Maximus injections, cream and enclomiphene. Compare them on our best online TRT clinics list.

The bottom line

Injections are the lowest-cost form online at $79 to $183 a month, gels and creams avoid needles but can transfer to children, and FDA-approved oral capsules avoid both but need twice-daily dosing and blood pressure checks, as of October 2026. All three are Schedule III, all need labs before and during treatment, and many online versions are compounded. Start at our testosterone hub and choose the form with a licensed clinician.