Testogel®

Key points about Testogel®

  • Testogel® is a testosterone-containing gel.
  • It has a few uses including testosterone replacement therapy in cisgender men and gender affirming hormone therapy.
  • Find out how to use Testogel® safely and possible side effects.
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Testogel® is a testosterone-containing gel that's applied to your skin.

  • Testogel® comes in a container with a metered dose pump, which means that each pump gives the same amount of gel and the same dose.
  • One pump gives 1.25 g of gel with 20.25 mg of testosterone.
  • In Aotearoa New Zealand, Testogel is available in the 1.6 % strength. 

 


Testogel® is used as:

  • testosterone replacement therapy (TRT) for people with testosterone deficiency
  • testosterone-based gender affirming hormone therapy.

Read more about these uses below.

Testosterone replacement therapy (TRT) are medicines used to treat the symptoms of testosterone deficiency or low testosterone levels in men. This condition is also called hypogonadism.

  • TRT is not for everyone. You need to have blood tests, a full discussion with your doctor, and ongoing monitoring to see if it’s right for you. Read more about low testosterone levels.
  • Testogel® replaces natural testosterone if your body doesn't make enough testosterone. Read more about testosterone replacement therapy (TRT).


Dose

  • The usual dose is 1 or 2 pumps applied once daily, preferably in the morning.
  • Your doctor may adjust your dose depending on your response to treatment, up to a maximum of 4 pumps in 24 hours.
  • Missed dose: If you forget to apply a dose, apply it as soon as you remember. If the next dose is almost due, then just apply 1 dose. Don't apply a double dose to make up for a forgotten dose.
  • Read more below about how to apply Testogel®.

Testosterone gender affirming hormone therapy (T-GAHT) is when testosterone is used by some transgender and non-binary people to help align their body with their gender.

  • T-GAHT can be used by trans men or non-binary people for gender masculinizing effects such as increased body hair growth (chest, back, arms, legs), facial hair, deeper voice, etc
  • Testosterone gel is applied to your skin and absorbed. It can cause more gradual changes than injectable testosterone. Read more about T-GAHT.


Dose

  • The starting dose is 1 pump applied once daily, preferably in the morning. 
  • Your doctor will adjust your dose doctor depending on your individual needs and blood levels. The usual dose is 2 pumps in 24 hours and the maximum dose is 4 pumps in 24 hours.
  • Missed dose: If you forget to apply a dose, apply it as soon as you remember. If the next dose is almost due, then just apply 1 dose. Don't apply a double dose to make up for a forgotten dose.
  • Read more below about how to apply Testogel®.

Wash your hands with soap and water before and after applying Testogel®.

Your doctor will tell you how many pumps of the gel you need to get the correct dose for you.


Using the pump for the first time

  • When using the Testogel pump for the first time, you'll need to prepare it for use.
  • Remove the cap and press the plunger down 3 times, collecting the gel on a tissue.
  • Don't use the gel from the first 3 pumps. Throw away the used tissues carefully to avoid transfer to other adults, children or pets.
  • Your pump is now ready to use.
  • Note: You will only need to do this the first time you open a new pump. 


Apply Testogel® to the skin on your shoulders and upper arms

  • Apply Testogel® as a thin layer to the skin on your shoulder and upper arm.
  • Using your fingers, gently spread the gel evenly across 1 shoulder and upper arm.
  • If your dose is 2 pumps of gel, then apply the second dose to the other side. 
  • If you're using 3 or more pumps, apply up to 2 pumps to the first shoulder and upper arm and up to 2 pumps to the other shoulder and upper arm.
  • Don't apply the gel to the upper chest, genitals or abdomen or to inflamed, broken and irritated skin.
  • Allow the gel to dry completely for at least 3 to 5 minutes before dressing.
  • Wait at least 2 hours after gel application before you bath, shower or swim.

Image credit: Testogel® CMI, Medsafe


Avoid transfer to other people

If other people come into contact with testosterone gel for long periods of time, they can develop masculine features. Testosterone may be transferred to others through skin-to-skin contact where you applied the gel. To avoid transfer to others it's important to:

  • wash your hands straight after applying the gel
  • put on clothing over the area once the gel has dried on your skin
  • wear gloves if you're helping to apply testosterone gel to another person.

It's okay to have skin-to-skin contact with others where there is no Testogel®.

Here are some things to know when you're using Testogel®. Other things may be important as well, so ask your healthcare provider what you should know about.


You may need regular blood tests

Before you start Testogel®, and while you're using it, you may need blood tests to check your testosterone levels. The blood test is best done in the morning before you apply that day’s gel, OR 4 to 6 hours after you applied the gel. Also, blood tests should be taken from the opposite arm from the one you apply the gel to if you only apply to one side.


Testogel® may cause skin irritation, burning and dryness

Testogel® contains alcohol (ethanol) which can cause skin irritation. Tell your doctor if this continues.

Some people experience mood swings, sleep problems (insomnia) and impatience. If these things happen to you, contact your doctor for advice.

Testogel®(external link) Consumer Medicine Information (CMI), Medsafe


References

  1. Testosterone and esters(external link) New Zealand Formulary
  2. Testogel®(external link) Testogel, UK

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland; Dr Rona Carroll, FRNZCGP, PGDip, Wellington

Last reviewed: