Testosterone topical cream (which is actually more gel-like) is used to treat men whose bodies don’t make enough natural testosterone, which is called hypogonadism. Testosterone is a hormone that triggers the growth and development of men’s sex organs and maintains their secondary sex characteristics, such as a deep voice, muscle mass and a relatively hairy body. Testosterone cream/gel is available only via a doctor’s prescription and precautions need to taken while applying it.
Choose your product.
Once it’s been established by your doctor (via blood tests) that your body is producing less testosterone than it should, talk with your doctor about what product (and strength) is most appropriate for your situation. Androgel and Fortesta are both available in individual packets and multi-dose pumps. Vogelxo is available as individual packets, multi-dose pumps and tubes.
If you are using a pump for the first time, prime it before measuring out your first dose by holding it over the sink and pushing the pump all the way down at least three times for the Androgel and Vogelxo pumps or eight for the Fortesta pump.
The individual packets (Androgel, Fortesta and Vogelxo) are more convenient to use because they are pre-portioned and easy to access — you just have to tear the packet open.
Measure out the correct dose.
Once you’ve primed the gel pump, place the palm of your hand under the pump and push down the recommended number of times as prescribed by your doctor. The strength of the gel and the number of pumps needed are based on what your base testosterone levels are and how large a person you are. If you’re using a tube of Vogelxo gel, then simply measure out the recommended amount into your hand — typically about the size of a 50 cent piece.
AndroGel is available in two dosage strengths: 1% and 1.62% concentrations. Both are applied to the skin, but in different amounts.
The recommended starting dose of Androgel 1% is 50 mg applied once daily to your skin.
If you are using the individual foil packets, tear the packet open along the perforated margin and squeeze the entire contents either into the palm of your hand or directly onto your skin where your doctor recommended applying it.
Apply the cream/gel to your body.
Apply the testosterone cream/gel to clean, dry skin somewhere on your shoulders, upper arms or abdomen (stomach) — unless your doctor recommends a different location. The stronger concentration of AndroGel (1.62%) is usually applied to the shoulders and upper arms only. In general, the cream/gel is applied to areas that can be covered by clothes easily to prevent children, women and pets from coming into contact with it.
Fortesta gel/cream is typically applied to the front or inner skin of the thighs (upper legs).
In contrast, Vogelxo gel/cream is only applied to the shoulders or upper arms, but not the abdomen or stomach.
Testosterone cream/gel is never applied to the scrotum or penis. Don’t apply it to skin that has any cuts or scrapes.
Wash your hands before and after applying it.
As soon as you finish applying the testosterone cream/gel to your clean, dry skin, it’s important to wash your hands with warm water and soap immediately afterwards. The potential danger is transferring some of the hormone to a child, woman or pet before it completely absorbs into the skin of your hands.
Although testosterone is beneficial for men (within reasonable doses), it can disrupt the hormone balance in children, women and pets, such as dogs and cats.
Don’t touch anyone or any pet immediately after applying testosterone cream/gel. Thoroughly wash and dry your hands (with a clean towel) before doing anything else.
Cover the application area with clothes.
After you’ve washed and dried your hands, it’s time to put on clothes in order to cover the area of application. Doing so is more for the protection of others (and pets) than anything else. Allow the testosterone cream/gel at least 10 minutes to absorb into your skin before putting on shirts, pants or shorts.
Depending on the health and hydration of your skin, it may take less than 10 minutes for most of the gel to absorb, or it might take as long as 20 minutes.
It’s best to wear cotton garments that are breathable so that the testosterone gel can continue to absorb into your skin once your clothes are on.
Don’t shower for at least two hours or more.
Just to be on the safe side, it’s recommended that you don’t get your skin wet for at least two hours after applying the testosterone gel. More specifically, wait for at least two hours if you apply either AndroGel 1.62%, Fortesta or Vogelxo, but closer to five hours if you apply AndroGel 1% before showering, bathing or swimming in a pool.
You should also avoid lots of vigorous exercise for a few hours after applying the testosterone gel if the exertion makes you sweat a lot.
Although the gel/cream may look like it’s completely absorbed into your skin after 10 minutes or so, it actually takes longer for it to penetrate all the layers of your skin and reach your bloodstream.
See your doctor at regular intervals.
It’s important to schedule regular visits with your doctor (every few months or so) so they can check your progress, take blood samples and see if the testosterone medication is working as expected. It can take three to six months of daily application of testosterone gel for hormone levels to become normal — sometimes longer.
Sign and symptoms that your testosterone levels may be too low include: low sex drive, trouble getting an erection, hair loss, lack of energy, loss of muscle mass, increase in body fat and mood changes (depression).
Testosterone gel/cream should not be used treat the symptoms of low testosterone in men who have low testosterone due to normal aging.
Keep it away from women and children.
Although testosterone medication can make significant health improvements in men who have abnormally low levels, the hormone can be harmful to women and children. For females, it can create a hormone imbalance with estrogen and trigger more masculine secondary sexual characteristics to develop — deeper voice, more hair growth, etc. For young boys it can over-stimulate their development or make the sexual characteristics appear prematurely.
Testosterone therapy may cause birth defects in pregnant women who come in contact with the medicine.
In reality, rubbing up against the skin of someone who’s just applied the gel is not especially dangerous, but repeated exposure to testosterone can certainly cause problems in women, fetuses and children — as well as pets.
Children and women should also avoid contact with the unwashed clothing of someone who uses testosterone gel.
Recognize negative side effects.
Testosterone is a steroidal hormone and applying it to your skin for long periods of time (many months or years) increases the risk of negative side effects. More common side effects include blood in the urine, difficulty urinating and frequent urination because hormone therapy can affect the prostate gland in men. Report any noticeable side effects to your doctor immediately.
Other relatively common side effects include: bloating and swelling around the body (face, hands, feet), acne on the face and back, blurred vision, feeling dizzy, flushed face, headache, aggressive behavior, sweating, hair loss and faster heartbeat. If you have sleep apnea it may worsen and you may need to speak with your doctor about treatment with a CPAP machine.
Men using testosterone cream are also at risk for deep vein thrombosis and pulmonary embolism due to the increased red blood cell count that results from testosterone therapy. You may want to talk to your doctor about screening for this and keep an eye out for leg/calf pain or shortness of breath.
Taking testosterone medication typically causes your testicles to get smaller due to atrophy (not working as hard producing natural testosterone).
On the other hand, testosterone gel therapy can enlarge the penis in men and clitoris in women.