Injections vs. Creams: Which Delivery Method is Best?

In my training at the Hormonal Health Institute, we spent a lot of time discussing pharmacokinetics—how drugs move through the body.

When a patient comes to see me in Southlake for Low T, they usually have a preference already.Some guys say, "Doc, I’m not doing shots. Give me the gel." Others say, "I heard the creams don't work. I want the injections."

The truth is, there is no "best" method. But there is a best method for you. And the difference often comes down to your lifestyle, your biology, and who you live with.

Let’s break down the two heavyweights of TRT: Intramuscular Injections vs. Transdermal Creams.

The Contender: Injections (Testosterone Cypionate)

This is the gold standard f;or a reason. It is what I use personally, and it is what the majority of my patients eventually choose.

The Pros:

100% Certainty: When you inject testosterone, you know exactly how much is getting into your system. There is no guessing game. It bypasses the skin, bypasses the liver, and goes right into the muscle reservoir.It allows for very stable levels. With a proper protocol (usually injecting twice a week), we can keep your levels perfectly optimized without the roller coaster.

The Cons:

The Needle: It involves a needle. Now, to be fair, we use tiny insulin-sized needles for shallow  injections. It’s virtually painless. But the psychological hurdle is real.

The Challenger: Transdermal Creams & Gels

These are applied to the skin daily, usually on the shoulders or thighs.

The Pros:

Needle-Free & Mimics Nature: For guys who travel a lot or just hate needles, this is a valid option. Biologically, creams can mimic the body’s natural daily rhythm. You apply it in the morning, your levels peak, and then they drop by evening.

The Cons:

The Absorption Roulette: Here is the issue I learned to watch for in my functional training. Not everyone absorbs creams well. Some guys have thick skin (literally) or sweat it off. You might apply 100mg, but only absorb 10mg. It can be inconsistent.

The Danger Zone - Transference: This is the biggest safety warning I give. If you use cream, you have to be incredibly careful about transference. If you apply the cream and then hug your wife, or pick up your kids, or let your dog lick your arm, you can transfer testosterone to them. This can cause virilization in women and children (hair growth, voice deepening). It is rare if you are careful, but it is a risk.

Why I Don't Use Pellets (Usually)

You might have heard of pellets (BioTE, etc). I am trained in them, but I rarely recommend them as a first line. Why? Because you can't adjust the dose. Once I surgically implant pellets in your glute, they are there for 4 months. If your dose is too high and you feel anxious, or too low and you feel tired, I can't fix it. I prefer methods where we have total control.

The Magnolia Protocol

When you come to Magnolia Functional Wellness, we start with a conversation about your life.

• Do you have young kids? We probably avoid creams to prevent transference.
• Do you travel for work? Maybe pre-filled syringes are easier, or maybe a cream is less hassle.
• Are you looking for the highest possible stable levels? Injections usually win.

We are data-driven. We can start with one method, check your labs in 6 weeks, and if the absorption isn't there, we pivot.

The Verdict

The "best" method is the one you will actually do consistently.Testosterone therapy is a commitment. It doesn't work if you miss doses.My job is to find the delivery system that fits seamlessly into your morning routine so you can stop thinking about your hormones and start living your life.