What exactly does the testosterone gel boxed warning say?

Verbatim, with the label's bracketed section cross-references removed: "WARNING: SECONDARY EXPOSURE TO TESTOSTERONE. Virilization has been reported in children who were secondarily exposed to testosterone gel. Children should avoid contact with unwashed or unclothed application sites in men using testosterone gel. Healthcare providers should advise patients to strictly adhere to recommended instructions for use." It is identical on the AndroGel 1% and AndroGel 1.62% labels. Read the subject carefully: the box names children. Women are covered by the same labels in three other places — Highlights 5.1 ("Avoid unintentional exposure of women or children to AndroGel"), the section 2.2 administration instructions and Patient Counseling 17.2, the latter two reading "Children and women should avoid contact with unwashed or unclothed application site(s) of men using AndroGel 1%." — but not inside the box. Sources that describe the boxed warning as covering women and children are compressing two parts of one document into one sentence. The risk to a partner is on the label; it is simply not in the box.

Does testosterone injection have a transference risk?

No. The Depo-Testosterone label, read in full on 2026-09-20, contains no boxed warning section of any kind, the string "transfer" appears zero times in it, and the only occurrence of "secondar" anywhere in the document is the phrase "secondary sex characteristics" in its clinical pharmacology section. This is not a case of one route being safer by degree — the mechanism does not exist. An intramuscular depot is inside a muscle, and there is no treated skin for anyone to touch. That is the single clearest reason to choose an injection over a gel, and for a man with a toddler in the house it is close to decisive on its own.

Are AndroGel 1% and AndroGel 1.62% interchangeable?

No, and both labels say so in their own words: "The application site and dose of AndroGel 1% are not substitutable with other topical testosterone products." and "The application site and dose of AndroGel 1.62% are not substitutable with other topical testosterone products." They differ on nearly everything a switch would need to hold constant. Starting dose: 50 mg against 40.5 mg. Milligrams per pump press: 12.5 against 20.25, which is 62% more drug from an identical gesture. Permitted sites: the abdomen is allowed on the 1% and named in the prohibition list on the 1.62%. Wait before water: at least 5 hours against a minimum of 2. Titration: a 50/75/100 mg ladder against "the normal range" on one, 20.25 mg steps against a 350–750 ng/dL pre-dose window on the other. The 1.62% carton puts it plainly: "Topical testosterone products may have different doses, strengths, or application instructions that may result in different systemic exposure."

How many milligrams of gel equal my injection dose?

No label, guideline or trial cited on this page states a conversion, and this page will not invent one. Neither the Depo-Testosterone label nor either AndroGel label mentions the other route at all — not as a switch, not as an equivalent, not as a comparison. The two are not even measuring the same thing: an injection is an oil depot absorbed slowly over two to four weeks, and a gel is a daily applied dose of which the absorbed fraction is not something you control. What a prescriber actually does when switching is start the new product at its own labelled starting dose and titrate on your levels, which is what both labels describe and the only approach either document supports.

How do I stop testosterone gel transferring to my family?

The label gives a specific sequence, and the cases of virilisation it reports include ones where the sequence was not followed — it records that "The risk of transfer was increased in some of these cases by not adhering to precautions for the appropriate use of the topical testosterone product." Apply only to the sites your own product permits. Wash your hands with soap and water immediately afterwards. Let the site dry, then cover it with clothing — the area should stay within what a short-sleeved t-shirt covers. Before any anticipated skin-to-skin contact, wash the application site thoroughly with soap and water. If unwashed treated skin does touch someone else, wash the area on the other person with soap and water as soon as possible. And watch for the signs: if a child in the household shows unexpected sexual development, the label directs that the gel be discontinued until the cause of virilisation is identified.

Which gives better testosterone levels, injection or gel?

This page states no answer, because neither label reports a trial against the other route and none is cited here. What can be said is what kind of curve each produces and what each label asks you to measure. An intramuscular depot is absorbed slowly from the oil phase — which is why the label permits two-to-four-week intervals — and produces a peak after the injection and a trough before the next one. A daily gel produces a flatter profile, and the AndroGel 1.62% label is specific about how to check it: a pre-dose morning level at roughly 14 and 28 days after starting or adjusting, titrated in 20.25 mg steps against a 350–750 ng/dL window. The Depo-Testosterone label sets no testosterone monitoring interval at all. A steadier level is a real difference between the routes; "better" is a claim neither document makes.

Will either one affect my fertility?

Both will, and both labels say so — in different sections and different words, which is why it is easy to miss. The Depo-Testosterone label states that "At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH)", and its precautions add "Oligospermia may occur after prolonged administration or excessive dosage." The AndroGel Highlights carry it as Warnings and Precautions 5.8: "Potential for Adverse Effects on Spermatogenesis: Exogenous administration of androgens may lead to azoospermia". Route makes no difference to this; exogenous testosterone suppresses the pituitary signal whichever way it arrives. If you may want children, raise it with the prescriber before the first dose.

Head to head

Testosterone injection vs gel

Most of this comparison is preference. One part of it is not: a gel leaves drug on skin that other people touch, and that risk is a boxed warning. An injection has no such risk at all.

Reviewed September 2026

The short answer

One difference on this page is not a trade-off and should decide the question before any of the others are considered. The testosterone gel labels open with a boxed warning: "Virilization has been reported in children who were secondarily exposed to testosterone gel. Children should avoid contact with unwashed or unclothed application sites in men using testosterone gel. Healthcare providers should advise patients to strictly adhere to recommended instructions for use." The Depo-Testosterone label has no boxed warning of any kind, and the word "transfer" does not appear in it anywhere. An injected depot sits inside a muscle; a gel sits on skin that a child can lean against. If there are young children in the house, that is the comparison, and everything below it is detail.

Read who the box actually names, because almost every secondary source gets this wrong. It says children. Women appear repeatedly on the same labels — Highlights 5.1 says "Avoid unintentional exposure of women or children"; the administration instructions and Patient Counseling 17.2 both say "Children and women should avoid contact with unwashed or unclothed application site(s) of men using AndroGel 1%." — but they are not inside the box. The risk to a partner is real and labelled; it is simply labelled somewhere else, and saying so precisely costs nothing.

The second thing worth knowing is that "testosterone gel" does not name one product. AndroGel 1% and AndroGel 1.62% are the same molecule from the same marketer and they disagree on three things a reader would assume were facts about testosterone. The abdomen is a permitted application site on the 1% and is named in the prohibition list on the 1.62%. One press of the pump is 12.5 mg on one and 20.25 mg on the other — 62% more drug from an identical gesture. You must wait at least 5 hours before swimming on one and a minimum of 2 on the other. Both labels close the door themselves: "The application site and dose of AndroGel 1% are not substitutable with other topical testosterone products."

Everything else is a genuine preference. The injection is an event every two to four weeks with peaks and troughs between; the gel is a daily habit with steadier levels and no needle. The injection cannot be forgotten in the way a morning routine can, and cannot be washed off. The gel cannot be hurried, cannot be applied to the chest or the genitals, is flammable until it dries, and requires washing the site before skin-to-skin contact. Neither label claims to work better than the other, and no head-to-head trial is cited here because this page found none to cite.

4 of 15 dimensions are materially the same. They are marked below rather than dressed up as differences.

Testosterone injection

Depo-Testosterone · testosterone cypionate · testosterone enanthate

An oil depot given deep into muscle every two to four weeks. No boxed warning, no transference risk, and a dose nobody can accidentally receive from you.

Dosing protocol →

Testosterone gel

AndroGel 1% · AndroGel 1.62% · Vogelxo

A hydroalcoholic gel applied to the skin every morning. Steadier levels, no needle — and a boxed warning about the people who live with you.

Dosing protocol →

Side by side

Every row carries how well supported it is. A claim that only reflects common practice is labelled as such rather than presented as fact.

Dimension	Testosterone injection	Testosterone gel	Basis
Boxed warning	None — the label has no boxed warning section	WARNING: SECONDARY EXPOSURE TO TESTOSTERONE	labelThe whole comparison, in one row. Verbatim from both AndroGel labels: "Virilization has been reported in children who were secondarily exposed to testosterone gel. Children should avoid contact with unwashed or unclothed application sites in men using testosterone gel. Healthcare providers should advise patients to strictly adhere to recommended instructions for use." The Depo-Testosterone label has no boxed warning at all. Read who the box names — children. Women are covered by the same labels at Highlights 5.1, in the section 2.2 administration instructions and at Patient Counseling 17.2, all of which read "Children and women should avoid contact with unwashed or unclothed application site(s) of men using AndroGel 1%." — but not inside the box.
Can it reach another person?	No. The dose is inside a muscle	Yes, from unwashed or unclothed treated skin	labelThe word "transfer" appears zero times in the Depo-Testosterone label, and the only occurrence of "secondar" in that document is "secondary sex characteristics". This is not a smaller risk on an injection; it is an absent one. The AndroGel labels require washing hands with soap and water immediately after applying, covering the site with clothing once dry, and washing the site "thoroughly with soap and water prior to any situation where skin-to-skin contact of the application site with another person is anticipated".
What secondary exposure looks like	Not applicable	Virilisation — and the label says to stop until the cause is found	labelIn children the AndroGel labels describe inappropriate changes in genital size, development of pubic hair, increased erections and libido, aggressive behaviour and advanced bone age; in women, changes in hair distribution and acne. Most cases regressed when exposure stopped, but the label records that in some the genital enlargement did not fully return to age-appropriate size and bone age stayed ahead. It adds that "The risk of transfer was increased in some of these cases by not adhering to precautions for the appropriate use of the topical testosterone product."
Labelled dose	50 – 400 mg every two to four weeks	50 mg daily (1%) or 40.5 mg daily (1.62%)	labelDepo-Testosterone, verbatim: "For replacement in the hypogonadal male, 50 - 400 mg should be administered every two to four weeks." AndroGel 1%: "The recommended starting dose of AndroGel 1% is 50 mg of testosterone (4 pump actuations, two 25 mg packets or one 50 mg packet), applied topically once daily in the morning". AndroGel 1.62%: "The recommended starting dose of AndroGel 1.62% is 40.5 mg of testosterone (2 pump actuations or a single 40.5 mg packet)", adjustable between 20.25 mg and 81 mg. These are not comparable numbers: one is a depot, the other a daily application of which an unstated fraction is absorbed.
Conversion between the two routessame	Not stated on the label	Not stated on the label	labelNeither label mentions the other route, a switch, or an equivalent dose, and no guideline this page could open states one. They are not even the same kind of quantity — a depot released over weeks from oil against a daily applied dose with an unstated absorbed fraction. If you are switching, the new product's own labelled starting dose is the only number any document will give you.
Route and frequency	Intramuscular, deep in the gluteal muscle, every two to four weeks	Topical, once daily in the morning, to clean dry intact skin	labelDepo-Testosterone, verbatim: "DEPO-Testosterone Injection is for intramuscular use only. It should not be given intravenously. Intramuscular injections should be given deep in the gluteal muscle." A dose you cannot forget on a Tuesday against a dose you can — and a dose you can wash off against one you cannot.
Where on the body	Gluteal muscle	Depends which gel — and the two disagree about the abdomen	labelThe clearest illustration that "testosterone gel" is not one product. AndroGel 1% is applied to "the right and left upper arms/shoulders and/or right and left abdomen", and "Do not apply AndroGel 1% to any other part of the body including the genitals, chest, armpits (axillae), knees, or back." AndroGel 1.62% goes on the upper arms and shoulders only: "Do not apply AndroGel 1.62% to any other parts of the body including the abdomen, genitals, chest, armpits (axillae), or knees." Permitted on one label, prohibited by name on the other.
How much is one dose unit	Millilitres of a stated concentration, drawn into a barrel	12.5 mg per press (1%) against 20.25 mg per press (1.62%)	labelThe second contradiction, and the one most likely to cause a real dosing error. AndroGel 1%, section 3: "Each pump actuation delivers 12.5 mg of testosterone in 1.25g of gel." AndroGel 1.62%, section 3: "Each pump actuation delivers 20.25 mg of testosterone in 1.25 g of gel." Same volume of gel, same-looking canister, 62% more drug per press. A new pump must also be primed with 3 actuations that are discarded before the first real dose.
Wait before swimming or showering	Not applicable	At least 5 hours (1%) against a minimum of 2 hours (1.62%)	labelThe third contradiction. AndroGel 1%: "The patient should be advised to avoid swimming or showering for at least 5 hours after the application of AndroGel 1%." AndroGel 1.62%: "The patient should avoid swimming or showering or washing the administration site for a minimum of 2 hours after application." Neither figure transfers to the other product, and neither replaces the separate instruction to wash the site before anticipated skin-to-skin contact.
Can you switch products at the same milligrams?	Esters differ — the label names one it must not be swapped with	No. Both gel labels forbid reasoning across products	labelAndroGel 1.62%, verbatim: "The application site and dose of AndroGel 1.62% are not substitutable with other topical testosterone products." — with the mirror sentence on the 1% label. The 1.62% carton adds: "Topical testosterone products may have different doses, strengths, or application instructions that may result in different systemic exposure." On the injection side the caution is narrower and specific: "Testosterone cypionate should not be used interchangeably with testosterone propionate because of differences in duration of action."
Diagnosis required before startingsame	Two low morning measurements	Two low morning measurements	labelIdentical, and it is the requirement most often skipped. Depo-Testosterone, verbatim: "confirm the diagnosis of hypogonadism by ensuring that serum testosterone concentrations have been measured in the morning on at least two separate days and that these serum testosterone concentrations are below the normal range." Both routes carry the same indications — primary hypogonadism and hypogonadotropic hypogonadism — and both state that safety and efficacy in "age-related hypogonadism" have not been established.
Labelled monitoring schedule	Haematocrit periodically; no fixed testosterone interval	Pre-dose morning testosterone at about 14 and 28 days (1.62%)	labelThe gel is the more prescriptive of the two here, and only at one concentration. The AndroGel 1.62% label titrates in 20.25 mg steps against a 350–750 ng/dL pre-dose window measured at roughly 14 and 28 days after starting or adjusting. The 1% label is looser — increase from 50 to 75 to 100 mg if the level is below range, and discontinue if it consistently exceeds the normal range at 50 mg daily. The Depo-Testosterone label states that "Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration" and sets no testosterone interval at all.
Effect on your own sperm productionsame	Suppressed — stated in the label's own mechanism section	Suppressed — section 5.8 names azoospermia	labelNeither route protects fertility, and the labels say so in different words. Depo-Testosterone: "At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH)", with "Oligospermia may occur after prolonged administration or excessive dosage" in its precautions. AndroGel Highlights 5.8: "Potential for Adverse Effects on Spermatogenesis: Exogenous administration of androgens may lead to azoospermia". If children are still a plan, raise it before starting either.
Flammability	Not applicable	Avoid fire, flames and smoking until the gel has dried	labelAn unglamorous row that belongs on the page because it is on the label and on no comparison article. The AndroGel products are alcohol-based — the 1% is 67.0% ethanol — and both labels instruct the patient to "Avoid fire, flames or smoking until the gel has dried". Oil in a vial carries no such instruction.
Which works bettersame	Not established against the other route	Not established against the other route	labelPrinted rather than omitted, because a missing row and an unobtainable answer look identical on a page. Neither label reports a trial against the other route, and this page cites none. What the labels do separate them on is everything above — exposure risk, application rules, monitoring cadence and how a dose is measured.

label: Stated on the FDA label
guideline: Clinical practice guideline
literature: Published literature
practice: Common practice, not documented

Which one

Choose Testosterone injection if

Anyone in your household is a young child, or could be. This is the one criterion on the page that is a boxed warning rather than a preference, and an injection removes the risk rather than managing it.
You would rather deal with it once every one to four weeks than every single morning, and you are not troubled by a needle.
Your skin, your job or your sport makes a daily topical impractical — showering within a few hours, contact sport, shared bedding, or a partner who is pregnant or trying to be.
You want the product with the fewest product-specific rules. One oil, one route, one dose range, and nothing that changes because the pharmacy dispensed a different strength.

Choose Testosterone gel if

You will not inject, and that is a real and sufficient reason — the treatment you actually take beats the one you avoid.
You want steadier day-to-day levels rather than the peak and trough of a depot given every two to four weeks.
You live alone, or everyone in the household is an adult who understands the washing and covering rules and will follow them every day.
You want the more prescriptive monitoring schedule: the AndroGel 1.62% label titrates against a pre-dose morning level measured at about 14 and 28 days, where the injection label sets no interval.

Two warnings that apply whichever you choose. First, the gel figures on this page are tied to a specific product and do not travel: the 1% and the 1.62% disagree on whether the abdomen is allowed, on how many milligrams come out of one press of the pump, and on how long to wait before swimming — and both labels say in their own words that their "application site and dose… are not substitutable with other topical testosterone products". Read the carton in front of you, not the number you remember. Second, neither route preserves your own sperm production. The injection label describes spermatogenesis being suppressed "through feedback inhibition of pituitary follicle stimulating hormone (FSH)"; the gel Highlights state that "Exogenous administration of androgens may lead to azoospermia". If fertility matters, that conversation belongs before the first dose, not after the first six months — and the only agent in this space with an FDA-approved male indication for it is hCG.

Frequently asked questions

What exactly does the testosterone gel boxed warning say?: Verbatim, with the label's bracketed section cross-references removed: "WARNING: SECONDARY EXPOSURE TO TESTOSTERONE. Virilization has been reported in children who were secondarily exposed to testosterone gel. Children should avoid contact with unwashed or unclothed application sites in men using testosterone gel. Healthcare providers should advise patients to strictly adhere to recommended instructions for use." It is identical on the AndroGel 1% and AndroGel 1.62% labels. Read the subject carefully: the box names children. Women are covered by the same labels in three other places — Highlights 5.1 ("Avoid unintentional exposure of women or children to AndroGel"), the section 2.2 administration instructions and Patient Counseling 17.2, the latter two reading "Children and women should avoid contact with unwashed or unclothed application site(s) of men using AndroGel 1%." — but not inside the box. Sources that describe the boxed warning as covering women and children are compressing two parts of one document into one sentence. The risk to a partner is on the label; it is simply not in the box.
Does testosterone injection have a transference risk?: No. The Depo-Testosterone label, read in full on 2026-09-20, contains no boxed warning section of any kind, the string "transfer" appears zero times in it, and the only occurrence of "secondar" anywhere in the document is the phrase "secondary sex characteristics" in its clinical pharmacology section. This is not a case of one route being safer by degree — the mechanism does not exist. An intramuscular depot is inside a muscle, and there is no treated skin for anyone to touch. That is the single clearest reason to choose an injection over a gel, and for a man with a toddler in the house it is close to decisive on its own.
Are AndroGel 1% and AndroGel 1.62% interchangeable?: No, and both labels say so in their own words: "The application site and dose of AndroGel 1% are not substitutable with other topical testosterone products." and "The application site and dose of AndroGel 1.62% are not substitutable with other topical testosterone products." They differ on nearly everything a switch would need to hold constant. Starting dose: 50 mg against 40.5 mg. Milligrams per pump press: 12.5 against 20.25, which is 62% more drug from an identical gesture. Permitted sites: the abdomen is allowed on the 1% and named in the prohibition list on the 1.62%. Wait before water: at least 5 hours against a minimum of 2. Titration: a 50/75/100 mg ladder against "the normal range" on one, 20.25 mg steps against a 350–750 ng/dL pre-dose window on the other. The 1.62% carton puts it plainly: "Topical testosterone products may have different doses, strengths, or application instructions that may result in different systemic exposure."
How many milligrams of gel equal my injection dose?: No label, guideline or trial cited on this page states a conversion, and this page will not invent one. Neither the Depo-Testosterone label nor either AndroGel label mentions the other route at all — not as a switch, not as an equivalent, not as a comparison. The two are not even measuring the same thing: an injection is an oil depot absorbed slowly over two to four weeks, and a gel is a daily applied dose of which the absorbed fraction is not something you control. What a prescriber actually does when switching is start the new product at its own labelled starting dose and titrate on your levels, which is what both labels describe and the only approach either document supports.
How do I stop testosterone gel transferring to my family?: The label gives a specific sequence, and the cases of virilisation it reports include ones where the sequence was not followed — it records that "The risk of transfer was increased in some of these cases by not adhering to precautions for the appropriate use of the topical testosterone product." Apply only to the sites your own product permits. Wash your hands with soap and water immediately afterwards. Let the site dry, then cover it with clothing — the area should stay within what a short-sleeved t-shirt covers. Before any anticipated skin-to-skin contact, wash the application site thoroughly with soap and water. If unwashed treated skin does touch someone else, wash the area on the other person with soap and water as soon as possible. And watch for the signs: if a child in the household shows unexpected sexual development, the label directs that the gel be discontinued until the cause of virilisation is identified.
Which gives better testosterone levels, injection or gel?: This page states no answer, because neither label reports a trial against the other route and none is cited here. What can be said is what kind of curve each produces and what each label asks you to measure. An intramuscular depot is absorbed slowly from the oil phase — which is why the label permits two-to-four-week intervals — and produces a peak after the injection and a trough before the next one. A daily gel produces a flatter profile, and the AndroGel 1.62% label is specific about how to check it: a pre-dose morning level at roughly 14 and 28 days after starting or adjusting, titrated in 20.25 mg steps against a 350–750 ng/dL window. The Depo-Testosterone label sets no testosterone monitoring interval at all. A steadier level is a real difference between the routes; "better" is a claim neither document makes.
Will either one affect my fertility?: Both will, and both labels say so — in different sections and different words, which is why it is easy to miss. The Depo-Testosterone label states that "At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH)", and its precautions add "Oligospermia may occur after prolonged administration or excessive dosage." The AndroGel Highlights carry it as Warnings and Precautions 5.8: "Potential for Adverse Effects on Spermatogenesis: Exogenous administration of androgens may lead to azoospermia". Route makes no difference to this; exogenous testosterone suppresses the pituitary signal whichever way it arrives. If you may want children, raise it with the prescriber before the first dose.

Sources

Next steps

Compare online TRT providersWhich platforms prescribe injections, which prescribe gels, and what monitoring each includes.TRT — how it works and what it costsWhat gets tested before a prescription, what the routes are, and what a year of it actually costs.

Other comparisons

Educational reference, not medical advice. Which medication suits you is a decision for your prescriber.