By Dr. Jennifer Frangos, D.O., DABOM. Published October 2026.

Both work, and both are prescribed off-label. Cream is the easy option: you rub it into your skin once a day, with no needles. Our clinic also offers small weekly injections. A measured dose does not establish that injections are more effective or safer than skin-applied treatment. Many women come to us after cream did little for them.

On cream and feel no different? Book a free consultation.

Women stretching their arms together in a green park

Cream vs injections at a glance

	Cream	Injections
How you take it	Rubbed into the skin of your thigh or calf	A small shot just under the skin
How often	Every day	Once a week
How exact the dose is	It varies. What you absorb depends on your skin and the cream.	The injected amount can be measured; blood levels and response still vary.
Adjusting the dose	Possible, but harder to measure	Simple, in small precise steps
Can it rub off on others?	Yes. Keep the area covered and away from children.	No
Effort	The least	About a minute a week, once you have learned it
Research in women	Skin-applied testosterone is the most studied	Less studied, and guidelines are cautious
Our verdict	Good, and the easiest place to start	An option our clinic uses, with individualized discussion and monitoring

Whichever form you choose, the goals are the same. Women come to us for a better sex drive, a steadier mood, more energy and more strength. Sex drive is the benefit with the strongest research behind it. The others are less proven, which is one more reason to track how you feel and not only your lab number.

For what the research shows on each goal, see how to get testosterone prescribed as a woman.

Why cream is the easy choice

Cream asks almost nothing of you. No needles, no supplies, no learning curve. You rub a small measured amount into your skin once a day, usually on the outer thigh or the back of the calf, and get on with your morning.

It suits women who dislike needles, and women who want to start gently and see how they feel.

Two things to know:

It is usually custom-made. No testosterone product is made for women in the US, so creams for women are typically mixed by a compounding pharmacy.
It can rub off. Testosterone on your skin can transfer to someone who touches it. The FDA requires its strongest warning on testosterone gels for this reason, after children were affected by skin contact. Let it dry, keep the area covered, and wash your hands.

Why cream often falls short

The weakness of cream is that nobody can be sure how much of it gets in.

Skin is not a precise doorway. Different preparations are absorbed at different rates, and custom-made creams can vary in strength. Two women using the same cream can end up with very different levels.
Low doses without labs. Some women are handed a low-dose cream and never have their level checked. If nobody measured, nobody knows whether the cream failed or the dose was simply too low.

We often hear from new patients that they used a cream for months and felt nothing.

Why our clinic sometimes uses injections

An injection provides a measured dose, but its effects still require monitoring.

The dose is exact. The amount administered can be measured; that does not guarantee a particular blood level or clinical response.
Nothing is lost on the way in. There is no skin barrier to cross.
It is easy to fine-tune. We check your level with labs, then move the dose up or down in small, precise steps.

You should know where the guidelines stand. The leading guideline on testosterone for women recommends the skin-applied form and advises against injections, because injections can push levels well above the normal female range. We know of no study that compares cream and injections head to head in women.

Our view comes from treating patients. When injections are used, dose selection and monitoring need particular care. Labs and symptom review help guide adjustments but cannot guarantee that side effects will not occur. Our weekly injection guide walks through how it is done.

Are injections hard to do?

This is the part most women worry about, and the part they get over fastest.

It is a short, thin needle that goes just under the skin, not deep into muscle. It takes about a minute, once a week. We show you how, and it soon becomes routine.

That is the real trade. Cream requires daily application and transfer precautions. Injections require injection training and monitoring. Neither form should be judged by convenience or dose measurement alone.

Book a free consultation

On cream and feel no different? Or trying to decide where to start? Begin with a free call. Here is how it works at Amazing Meds.

Free consultation. Our care team listens to what is going on, answers your questions, and explains the care process and next steps. Coverage and out-of-pocket costs depend on your insurance plan.
Labs. If you want to move forward, we book your lab work right then, at a lab near you. Testosterone always starts with labs. Labs are billed to your insurance.
Provider visit. We book your visit to go over your results, choose cream or injections with you, and set your dose. Visits are billed to your insurance.

We work with Aetna, Cigna, TRICARE, Blue Cross Blue Shield, UnitedHealthcare and other major plans, and we treat patients by telehealth in all 50 states. Medication is self-pay.

Book a free consultation

Cream not working? What to check before you switch

Before you give up on testosterone, run through five questions.

Was your level ever checked? The guideline calls for a blood test three to six weeks after starting. Without it, you are guessing.
How long has it been? Give it a fair trial. The guideline’s cutoff is six months with no real improvement.
How are you applying it? Where you put it, and whether it has time to dry, changes how much gets in.
What were you hoping it would fix? Sex drive has the strongest evidence. Mood, energy and strength are changes many women notice too, but they are less proven.
Is something else going on? Estrogen, thyroid, sleep and other medications can all cause the same complaints.

If cream is not helping, ask your clinician to review the diagnosis, formulation, application, treatment duration and monitoring before deciding whether to change treatment. Do not increase the dose on your own.

What about pellets?

Pellets are placed under the skin every few months. The catch is that once they are in, the dose cannot be changed. The guideline advises against them, partly for that reason. We compare them in pellets vs injections.

Side effects with either form

Side effects depend on more than a single blood result. Acne and hair growth can occur within the reference range; excessive levels increase concern for androgenic effects. Formulation also matters, including skin-transfer risk with topical treatment and higher peaks with some injectable regimens.

Both symptoms and labs matter when monitoring treatment. Long-term safety, beyond about two years, has not been established for either.

For the full list, see testosterone side effects in women.

What it costs

Testosterone is self-pay, and it is inexpensive. Your provider visits and labs are billed to your insurance. Insurance rarely covers testosterone for women in any form, because it is prescribed off-label. More in Does insurance cover testosterone for women?

Frequently asked questions

Are testosterone injections better than cream for women?

Injections have not been established as superior to skin-applied testosterone in women. Guidelines favor transdermal treatment. Discuss the evidence, formulation-specific risks and monitoring with a qualified clinician.

How long does testosterone cream take to work?

Your level should be checked three to six weeks after you start. How you feel can take longer. If there is no real improvement by six months, the guideline says to stop or rethink the plan.

Where do women apply testosterone cream?

The guideline suggests the back of the calf or the upper outer thigh. Follow the instructions that come with your prescription.

Can I switch from cream to injections?

A change may be considered after your clinician reviews your response, risks and monitoring. It is not an automatic next step when cream has not helped.

Do the injections hurt?

Expect a small pinch. The needle is short and thin and goes just under the skin.

Do I need labs for cream?

With us, yes. Testosterone always starts with labs, whatever the form, and labs are how the dose is checked afterward.

Still deciding between cream and injections?

You do not have to work it out alone. Book the free consultation, tell us what you have tried, and we will tell you whether we can help and what the next step would be.