What it is

This is a clear gel that contains testosterone, the same hormone your body makes. You put it on your skin, and the testosterone passes through the skin into your blood.¹ The sachet is made for men, so you use only a small part of it each day. Your doctor sets your daily amount from your blood test, and you measure it with a syringe.

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Filling your syringe (once for each new sachet)

1. Attach the needle to the 10 mL syringe.
2. Open a new sachet and draw all the gel into the syringe. You will get about 4.5 mL, because a little gel stays in the sachet.
3. Take the needle off and close the syringe with its cap.

The nurse shows you how to do this the first time you collect your gel. Your doctor marks on your sheet how far to push the plunger each morning.

The 10 mL syringe filled from one sachet. Your doctor writes how far to push the plunger each morning.

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How to use it

• Use it once a day, every morning. Your skin releases the testosterone slowly over the whole day, so once a day is enough.² Testosterone itself leaves the blood quickly, so it must be used every day.²
• Shower first, then apply on clean, dry skin. The label advises waiting about 6 hours after applying before you shower or swim, so the gel has time to be absorbed.¹
• Push out only the amount your doctor marked, then put the cap back on.
• Spread it over the area until it is dry. You do not need to count strokes. Wait 3–5 minutes, then dress, and wash your hands with soap.^1,3
• Do not put cream or lotion on that skin first. It can stop the gel from soaking in.

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Where to apply it, and why

• Inner upper arm, inner thigh, or the back of the knee, on skin with no hair. Skin with a lot of hair turns more testosterone into DHT, the form that causes acne and unwanted hair.
• Not on the belly if you carry fat there. Fat turns testosterone into estrogen, so you get less testosterone and may have sore breasts.
• Never on the genitals. The gel contains a lot of alcohol and will sting.¹
• Not on the inside of the elbow for 3–5 days before a blood test. Blood is taken there, and leftover gel on the skin can make your result falsely high.
• Red or irritated skin? Use one of the other areas. Skin irritation is a common side effect of the gel.¹ If it is severe, stop and tell us.

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Protect children and your partner

The gel can pass to other people through skin-to-skin contact. A child who gets it can develop enlarged genitals or pubic hair.² Cover the area with clothing once the gel is dry, and wash it with soap before close skin contact. In studies of couples, covering the area with a T-shirt prevented the gel from passing to the partner.^2,3 If a child or your partner touches the area, wash their skin with soap straight away.

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The gel can catch fire until it is dry

It contains alcohol. Keep away from flames and do not smoke until the gel has dried.³

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If you miss a dose

If you remember the same day, apply your usual amount straight away. If you only remember the next day, just apply your usual amount at the usual time. Never apply a double amount, because it would push your level above your target.³

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If you stop

Your testosterone returns to your own level within a few days of stopping.¹ Please talk to us before you stop, so we can plan your follow-up.

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On blood-test days

• Have your blood taken in the morning, before you apply the gel, then apply it. This way every result shows your lowest level of the day and can be compared fairly with the last.
• Stop biotin for 3 days before the test, because it interferes with the test.

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Please stop

• Any other testosterone product. Using two products together can push your level too high, and we cannot adjust your dose safely without knowing exactly what you use.

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Tell us if you take

None of these means you cannot use the gel. Some medicines and testosterone affect each other, so knowing what you take helps us look after you more closely.

• A blood thinner taken by mouth, such as warfarin. Testosterone can change how well it works, so your doctor may check your blood clotting more often, especially when you start or stop the gel.²
• Insulin or other diabetes medicines. Testosterone can lower blood sugar a little, so your diabetes dose may need adjusting.²
• Steroid tablets or ACTH. Together with testosterone they can cause more fluid retention (swelling).²
• Estrogen tablets or the contraceptive pill. They raise SHBG, so we read your free testosterone together with your total.
• DHEA from anywhere. DHEA adds a little to the testosterone we measure, so we need to know.
• Upcoming thyroid tests. Testosterone can lower one thyroid result (total T4) while your thyroid itself is fine.²
• Any new medicine you start while using the gel, so we can check that the two work well together.

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Contact us if you notice

These can be signs that your dose is a little higher than you need. At the female levels we aim for, they are uncommon, and in trials they were mild.⁴ We tell you about them because the earlier we know, the earlier we can lower your dose, and this is part of good care.

• Oily skin, oily hair or acne. These are usually the first signs, long before anything else. Tell us at the first sign.
• More facial or body hair, or thinning hair on the top of your head.
• Swelling, pain or enlargement of the clitoris.
• Sore breasts.
• Bleeding from the vagina after menopause. This has many causes and needs a check-up with a gynaecologist; you can keep using the gel while you wait.
• A hoarse or deeper voice. Stop the gel and contact us straight away. A voice change from testosterone may not fully come back.⁵ Hoarseness often has other causes, such as acid reflux, and we will check your level to be sure.⁶
• You might be pregnant. Stop the gel and contact us straight away. Testosterone can make a baby girl in the womb develop male features.²

These symptoms usually have other causes, and we will check to be sure. Go to a hospital the same day if you have heavy bleeding from the vagina.

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How to store it

• Store below 30°C. You do not need to keep it in the fridge.
• Keep unopened sachets in their box. Use them before the expiry date on the box.¹
• Keep the filled syringe closed with its cap, and use it until it is empty before you open a new sachet.
• Keep the gel away from flames until it is dry.
• Keep it out of the sight and reach of children.

Medically reviewed by Dr. Chontirot, MD · Medical licence no. 36583 · Last reviewed: 31 October 2026

References

1. Package insert (Thailand): testosterone gel 50 mg in 5 g sachet, summary of product characteristics. Besins Healthcare.

2. Prescribing information: testosterone gel 1% for topical use. ASCEND Therapeutics US, LLC; revised 10/2025.

3. Package leaflet: testosterone 50 mg transdermal gel in sachet. Besins Healthcare (UK) Ltd; revised October 2024.

4. Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660–4666. doi:10.1210/jc.2019-01603

5. Handelsman DJ. Androgen Physiology, Pharmacology, Use and Misuse. In: Feingold KR, et al., editors. Endotext. South Dartmouth (MA): MDText.com; updated 2020.

6. Huang G, Basaria S, Travison TG, et al. Testosterone Dose-Response Relationships in Hysterectomized Women with and without Oophorectomy: Effects on Sexual Function, Body Composition, Muscle Performance and Physical Function in a Randomized Trial. Menopause. 2014;21(6):612–623. doi:10.1097/GME.0000000000000093

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