Every testosterone replacement route approved in the United States, as one table: how often you dose, what the blood level does between doses, and the main problem each label reports. The pharmacokinetic figures come from the prescribing information and a pharmacology review; the adverse-event percentages come from each product’s own label. The article: Testosterone Injections vs Gel vs Pellets: What Actually Separates Them explains what separates them.
8 routes, 2 boxed warnings
two of the 8 carry a boxed warning that is about other people or about the injection itself (secondary exposure for gels; pulmonary oil microembolism for IM undecanoate), not about the hormone.
| Routes approved in the US | 8 |
|---|---|
| Widest swing between doses | IM cypionate or enanthate every 2–4 weeks: about 1,112 ng/dL at day 4–5, about 400 ng/dL by day 14 |
| Flattest | Daily transdermal gel: in range within 1–2 days, then steady |
| Boxed warnings | 2 (gel: transfer to others; IM undecanoate: pulmonary oil microembolism and anaphylaxis) |
| Formats | CSV, JSON |
| License | CC BY 4.0, attribute Big Dick Pills |
| Checked | 24 September 2026 |
All 8 routes, side by side
| Method | Typical schedule | Level pattern | The catch |
|---|---|---|---|
| IM cypionate or enanthate | 50–400 mg every 2–4 weeks, or 75–100 mg weekly | Peak about 1,112 ng/dL at day 4–5, falling to about 400 ng/dL by day 14 | Mood and libido track the cycle; injection-site pain |
| SC enanthate auto-injector (Xyosted) | 75 mg weekly into the abdomen | Flatter than IM; dose adjusted on a trough drawn 7 days after the shot | Label reports raised hematocrit in 14.0%, hypertension in 12.7%, raised PSA in 12.0% |
| IM undecanoate (Aveed) | 750 mg, again at 4 weeks, then every 10 weeks | Peak about 813 ng/dL by day 7; trough 323–339 ng/dL at week 10 | Boxed warning for pulmonary oil microembolism and anaphylaxis; 30 minutes of observation after every dose, under a restricted programme |
| Transdermal gel (AndroGel, Testim, Fortesta, Vogelxo) | 40–100 mg daily depending on the product | In range within 1–2 days, then steady | Boxed warning for transfer to others; no swimming or showering for at least 5 hours |
| Transdermal patch (Androderm) | 2–6 mg nightly, starting at 4 mg | Peak about 765 ng/dL around 8 hours; roughly mimics the natural daily rhythm | Skin irritation in 48% of users |
| Nasal gel (Natesto) | 11 mg per dose (5.5 mg per nostril), three times daily | Peak within 40 minutes; 24-hour average about 421 ng/dL | Three doses a day forever; nosebleed, runny nose, nasal scabbing |
| Oral undecanoate (Jatenzo and similar) | 158–396 mg twice daily, with food | Absorbed through the lymphatics, bypassing first-pass liver metabolism | Ambulatory monitoring showed blood pressure up 4.9/2.5 mm Hg; useless without a fatty meal |
| Subcutaneous pellets (Testopel) | 150–450 mg implanted every 3–6 months | Peak about a month after implant, then sustained for 4–6 months | Minor surgical procedure; extrusion in about 10%; very hard to reverse if you react badly |
How we built this
Eight routes are approved in the United States. The pharmacokinetic figures below come from the published prescribing information and from a review of testosterone preparations in Translational Andrology and Urology; the adverse-event percentages come from each product’s own label. Where a figure is a label percentage it is quoted as the label states it; where it is a pharmacokinetic peak or trough it is the published value for the standard dose.
What this cannot tell you
Whether you need testosterone at all (that is a diagnosis, with two morning blood tests, per the AUA guideline), and which route your prescriber will offer, which depends on cost, insurance and monitoring as much as on this table. Not medical advice.
Use this data
The facts in this table (what a guideline says, what a label says, what a trial found) are not ours to own; repeat them anywhere. Our wording, table and layout are free to reuse, including commercially, under CC BY 4.0. Credit Big Dick Pills and link back; that is all we ask.
Sources
- Shoskes JJ, Wilson MK, Spinner ML. Pharmacology of testosterone replacement therapy preparations. Translational Andrology and Urology, 2016;5(6):834–843. Transl Androl Urol
- FDA issues class-wide labeling changes for testosterone products. U.S. Food and Drug Administration, 28 February 2025. FDA
- XYOSTED (testosterone enanthate) injection, prescribing information. DailyMed
- JATENZO (testosterone undecanoate) capsules, prescribing information, revised July 2025. FDA label
- ANDROGEL (testosterone gel), prescribing information, boxed warning on secondary exposure. FDA label
- Ramasamy R, Masterson TA, Best JC, et al. Effect of Natesto on Reproductive Hormones, Semen Parameters and Hypogonadal Symptoms: A Single Center, Open Label, Single Arm Trial. The Journal of Urology, 2020;204(3):557–563. PubMed
- Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. American Urological Association, 2018, validity confirmed 2024. AUA
- Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. New England Journal of Medicine, 2023. NEJM