TRT Delivery Methods: Injection, Cream, Pellets & Oral

Testosterone is FDA-approved in several forms: weekly injection, daily topical cream, implanted pellets, and oral capsules. Elevra offers weekly injection and topical cream. Each method differs in dosing cadence, side-effect profile, and monitoring, not in whether it can work when dosed correctly by a licensed provider following your labs.

Compare

Four delivery methods, side by side.

Figures below come from FDA-approved product labeling and the Endocrine Society's clinical practice guideline. Sources are listed under the table.

 Weekly injectionTopical creamPelletsOral
Offered by ElevraYesYesNoNo
Typical dosing cadenceElevra's protocol: weekly (label range 50–400 mg every 2–4 weeks, individualized)1Daily2Every 3–6 months, implanted3Twice daily4
How it's takenIntramuscular or subcutaneous injectionApplied to skin, absorbed transdermallySmall pellets inserted under the skin in-officeSwallowed capsule, absorbed into the intestinal lymphatic system, bypassing first-pass liver metabolism6
Notable side-effect considerationInjection-site reactions; hematocrit is monitored per labelSkin irritation; risk of transferring testosterone to others through skin contactMinor in-office procedure; possible pellet extrusionFDA label warning for blood pressure increases (Warnings and Precautions, updated July 2025)4
MonitoringHematocrit and PSA per FDA label and Endocrine Society guideline1,5Hematocrit and PSA per FDA label and Endocrine Society guideline2,5Hematocrit and PSA per Endocrine Society guideline3,5Hematocrit, PSA, and blood pressure4,5

This table describes FDA-approved product categories generally. It is not a superiority ranking; the right method for you is a clinical decision made with your provider based on your labs, lifestyle, and goals.


What Elevra offers, and why

Elevra prescribes weekly injectable testosterone and topical testosterone cream. Both are FDA-approved delivery methods with an established monitoring plan; your provider recommends between them based on your labs, your comfort with injections, and how consistently a daily topical application fits your routine.

Weekly injection

Intramuscular or subcutaneous testosterone (such as testosterone cypionate) is dosed weekly under Elevra's protocol. FDA labeling for testosterone cypionate allows a broader, individualized range of 50 to 400 mg every two to four weeks1; the Endocrine Society's 2018 guideline recommends monitoring hematocrit and, in the first year, prostate-specific antigen, with a urology referral if PSA rises more than 1.4 ng/mL above baseline.5

Topical cream

Topical testosterone is applied daily to the skin. FDA labeling for topical products includes a specific warning about the risk of transferring testosterone to another person through skin contact, alongside the same hematocrit and PSA monitoring used for injection.

Pellets and oral testosterone (not offered by Elevra)

Testosterone pellets are inserted under the skin in a brief in-office procedure and are FDA-labeled for redosing roughly every three to six months. Oral testosterone undecanoate, a newer FDA-approved option, is absorbed into the intestinal lymphatic system, bypassing the first-pass liver metabolism that limited older oral testosterone products6, but it carries an FDA label warning that it can increase blood pressure (Warnings and Precautions, updated July 2025), which requires blood-pressure monitoring in addition to hematocrit and PSA. Elevra does not currently offer either method.


Sources

Where these figures come from.

  1. FDA-approved prescribing information, testosterone cypionate injection: accessdata.fda.gov.
  2. FDA-approved prescribing information, testosterone topical gel/cream (Vogelxo): accessdata.fda.gov.
  3. FDA-approved prescribing information, testosterone pellets (Testopel): DailyMed (NLM/FDA).
  4. FDA-approved prescribing information, oral testosterone undecanoate (Jatenzo), including its Warnings and Precautions section on blood pressure (the boxed warning that appeared in earlier versions of this label was removed in July 2025; blood pressure is now addressed in Section 5.4): accessdata.fda.gov.
  5. Bhasin S, et al. "Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline." Journal of Clinical Endocrinology & Metabolism, March 2018.
  6. Goldstein I, Chidambaram N, Dobs A, et al. "Newer formulations of oral testosterone undecanoate: development and liver side effects." Sexual Medicine Reviews, 2025;13(1):33-40.
Questions

Delivery methods, answered

Which TRT delivery methods does Elevra offer?
Elevra offers weekly injectable testosterone and topical testosterone cream. Elevra does not offer testosterone pellets or oral testosterone. Your provider recommends between the two offered methods based on your labs, lifestyle, and goals.
Is one TRT delivery method more effective than another?
FDA-approved testosterone products across injection, topical, pellet, and oral routes are each labeled to raise testosterone into a target range when dosed correctly. The formulations differ in dosing frequency, side-effect profile, and monitoring, not in whether they can work; the right one depends on your biology and preferences.
Why doesn't Elevra offer testosterone pellets or oral testosterone?
Elevra has chosen to offer weekly injection and topical cream. Pellets require an in-office insertion procedure, and FDA-approved oral testosterone undecanoate carries an FDA label warning for blood pressure increases (Warnings and Precautions, updated July 2025) that requires additional monitoring. Ask your provider if you want to discuss options beyond what Elevra currently offers.

Updated 24 Sep 2026 · Author: Elevra Optimal Health

Get Started

Find the right delivery method for you.

Take the testosterone assessment, then talk with Elevra's team about weekly injection versus topical cream.

Take the Testosterone Assessment