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Treatments8 min read

Types of TRT: Injections, Gels, Creams and Pellets

Compare the main types of testosterone replacement therapy - injections, gels, creams and pellets - including the trade-offs in convenience, cost and monitoring.

TTWritten by Top TRT Editorial TeamUpdated September 14, 2026

Key takeaways

  • The main TRT formats are injections, topical gels, creams and long-acting pellets, each with distinct trade-offs.
  • No single format is best for everyone; the right choice depends on lifestyle, cost, and how your body responds.
  • All formats are prescription-only and require ongoing monitoring, regardless of how convenient they seem.

How the formats differ

Testosterone can be delivered to the body in several ways. They differ in how often you use them, how steady the resulting hormone levels are, cost, and practical considerations like skin transfer or clinic visits. This guide is educational - it does not cover doses or technique, which are decisions for you and your clinician. For a broader primer, start with what TRT is.

Injections

Injectable testosterone is among the most widely used formats. Depending on the specific medication, injections are given on a schedule ranging from weekly to less frequent. Many telehealth programs support at-home injections after appropriate instruction.

  • Pros: often the most affordable option; well established; flexible scheduling
  • Cons: some men dislike self-injection; levels can rise and fall between doses depending on the interval

Our comparison of injections versus gel goes deeper on this choice.

Gels and creams

Topical testosterone is applied to the skin daily. It offers steady levels and avoids needles, which appeals to many men.

  • Pros: needle-free; daily application produces relatively stable levels
  • Cons: risk of transferring testosterone to partners or children through skin contact, so care with application and washing is essential; must remember to apply every day; can be more expensive than injections

The skin-transfer risk is a genuine safety point. Clinicians give specific guidance on covering the area and avoiding contact until it dries.

Pellets

Testosterone pellets are small implants placed under the skin during a brief in-office procedure. They release testosterone slowly over a period of months.

  • Pros: long-acting and low-maintenance between placements; nothing to do daily
  • Cons: requires a minor procedure; the dose cannot be easily adjusted once placed; possible site issues such as infection or extrusion

Because pellets are not easily reversible mid-cycle, clinicians often reserve them for men who have already responded well and tolerated testosterone in another format.

Choosing with your clinician

The best format is the one that fits your life, budget and biology - and that you will actually stick with. A clinician weighs your preferences against practical factors and your monitoring needs. Whichever you choose, the fundamentals hold: it is prescription-only, and it needs regular follow-up bloodwork.

Telehealth providers differ in which formats they offer and how they price them. Compare options on our TRT clinic comparison, check availability where you live via Online TRT by State, or read our provider reviews.

This article is general information, not medical advice. A licensed clinician should evaluate your symptoms and testosterone levels and decide whether TRT is appropriate for you.

Ready to compare TRT clinics?

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Sources & medical references

Treatment facts on this page are grounded in regulatory guidance and peer-reviewed research. Pricing and plan details come from each provider's published information. This content is for information only and is not medical advice - always consult a licensed clinician before starting treatment.

  1. 1.Testosterone Levels Test - MedlinePlus, U.S. National Library of Medicine (NIH)
  2. 2.Hormones (health topic) - MedlinePlus, U.S. National Library of Medicine (NIH)
  3. 3.Testosterone Information - U.S. Food & Drug Administration