TRT in Men — Testosterone Replacement Therapy Guide walkthrough.

Know your injection schedule

Most providers prescribe weekly or twice-weekly subcutaneous or intramuscular injections for stable hormone levels. More frequent, smaller doses (SubQ twice a week) maintain steadier blood levels and reduce side effects compared to large, less frequent IM injections.

Warm oil-based testosterone

Testosterone cypionate and enanthate are suspended in oil and can be thick. Warm the vial in your hands or briefly in warm (not hot) water before drawing — it flows more easily through the needle.

Follow the SubQ or IM guide

Refer to our subcutaneous or intramuscular injection guides for full technique. Use the needle gauge and length specified by your pharmacist — oil-based testosterone typically requires a slightly larger gauge (22-25g) than aqueous solutions.

Topical: choose the right site

Apply cream or gel to clean, dry skin on the scrotum (highest absorption area), inner thigh, upper arm, or shoulder as directed. Avoid the face and armpits unless specifically instructed.

Prevent transfer

Testosterone transfers easily to others through skin contact. Apply, let dry fully (3-5 minutes), then cover with clothing before contact with a partner or children. Wash hands immediately after applying.

Keep your lab schedule

Your provider will typically check total testosterone, free testosterone, estradiol, hematocrit, and PSA (if applicable) at baseline, 6-8 weeks after starting, and every 6 months once stable. Do not skip labs — elevated hematocrit (blood thickening) is a manageable side effect that requires monitoring.

Know the early changes

Improved energy, libido, and mood are often noticed in weeks 3-6. Muscle response typically emerges at 3 months with consistent exercise. Acne can occur early and usually settles — report significant acne to your provider.