Testosterone Gel

Route: Transdermal. No ester. The gel dries on the skin and forms a reservoir in the stratum corneum that releases testosterone into circulation over roughly 24 hours. Only about 10% of the applied dose is absorbed systemically.

Dosage (applied gel, not absorbed dose):

• Testogel / Androgel 1%: 50-100 mg/day (one to two 5 g sachets)
• Androgel 1.62%: 20.25-81 mg/day, titrated in 20.25 mg steps
• Testavan 2%: 23 mg/day (1 pump) starting, up to 69 mg/day
• Fortesta / Tostran 2%: 10-70 mg/day
• Titrate on bloodwork, not feel. Absorption varies a lot between individuals and some people are genuine non-absorbers.

Application Protocol:

• Apply once daily, ideally in the morning to mimic the natural diurnal peak
• Clean, dry, unbroken skin: shoulders, upper arms, abdomen (Testogel/Androgel), thighs (Fortesta/Tostran/Testavan)
• Never apply to the genitals
• Let it dry 3-5 minutes, then cover with clothing
• Wash hands immediately with soap and water
• Do not shower or swim for at least 2 hours (6 hours is safer)

Transfer Risk (the big one):

• Testosterone transfers to anyone you touch skin-to-skin. Documented virilisation in partners and children
• Keep the site covered, wash your hands, and shower before close contact
• This is the most common reason people abandon gels

Bloodwork Timing:

• Test after at least 14 days on a stable dose
• Total testosterone 2-8 hours after application for the peak; a pre-dose draw gives the trough
• Always record the application-to-draw interval, otherwise the result is uninterpretable
• Check DHT alongside testosterone: gels commonly push DHT high because skin is rich in 5-alpha reductase

Key Notes:

• Physiological daily rhythm and easy discontinuation are the main advantages over injectables
• Lower erythrocytosis risk than IM testosterone: often the switch of choice when haematocrit runs high on injections
• High DHT:T ratio matters if you are prone to androgenic alopecia or prostate symptoms
• Skin irritation at the site is common; rotate sites
• Same HPTA suppression as any exogenous testosterone. It is not a "milder" option hormonally, only pharmacokinetically