Should You Apply Testosterone Gel or Cream on Your Testicles for Best Absorption?

[Nelson Vergel]

All commercially available testosterone gels approved in the United States by the Food and Drug Administration are recommended for application on different skin areas, but none are recommended for use on testicular skin due to their alcohol content and the fact that dehydrotestosterone (DHT) conversion is higher on that application site. DHT is a metabolite of testosterone metabolism responsible for sexual drive and erectile function, but high levels can worsen hair loss on scalp and possibly increase prostate volume. In the past, there was a testosterone patch approved for scrotal application but it quickly became unpopular due to its inconvenience.

Some compounding pharmacies make liposomal creams that are not irritant to scrotal skin. Some men who have used Propecia or Proscar (finasteride) in the past to prevent hair loss or prostate inflammation were later found to have irreversible issues with low DHT and decreased sex drive and/or erectile function. These scrotal creams can help those men increase their DHT to levels that can improve sexual function.


Here is a study done in the late 80's that showed the increase propensity for scrotal skin to cause more DHT conversion.

Androgen therapy of hypogonadal men with transscrotal testosterone systems

The American Journal of Medicine
Volume 83, Issue 3 , Pages 471-478, September 1987

Abstract

The need for improved controlled delivery of testosterone to hypogonadal men stimulated the development of a self-adherent transscrotal testosterone system to provide programmed testosterone delivery through the uniquely permeable scrotal skin. In this short- and long-term efficacy trial, the responses of testosterone and its metabolites to the application of transscrotal testosterone systems of varying testosterone content were compared with the response to 200 mg of testosterone enanthate. Daily transscrotal testosterone system administration resulted in a rapid increase of testosterone and bioavailable, nonsex hormone binding globulin-bound testosterone levels to normal, peaking at two hours, followed by a slow decline over 23 hours, resembling the diurnal variation of endogenous testosterone. One year of daily transscrotal testosterone system therapy demonstrated continued reliable absorption of testosterone and suppression to normal of the luteinizing hormone in two of three patients. There was a greatly disproportionate increase of serum dihydrotestosterone (DHT) over testosterone, suggesting 5-alpha reduction at the scrotal site. The subjects reported marked subjective improvement. Thus, the transscrotal testosterone system is a novel, effective, and well-tolerated method of delivering testosterone to hypogonadal patients.

 

[BigJohn]

I use on my scrotum at least 3 times a week.

 

[GettingAnswers]

When I was on a compounded cream I applied a small portion to the scrotum a few times a week. DHT levels increased substantially doing this. No issues with irritation using the compounded cream which was not alcohol based.

 

[jpleahy]

How about applying to underarms?
http://www.axironmd.com/Pages/applying-AXIRON.aspx

 

[Nelson Vergel]

jpleahy

Yes, that is the approved application site for Axiron.

This discussion centers around the fact that the testicular sack skin is able to produce a lot more DHT than all other skin areas. Some men, specially those with low DHT induced by past long term exposure to DHT blockers, may need to bump their DHT to normal levels. Higher DHT has been linked to higher sex drive but it may also be associated with hair loss and potential prostate tissue growth. For these me, using gels on currently recommended areas by makers of Androgel, Testim, Axiron and Fortesta may not produce the needed DHT. That is why some explore applying T gels or creams on their scrotum.

Note: Androgel, Testim, Axiron and Fortesta can irritate the scrotum. If you ever decide to apply gels on that area, ensure that it is from a compounded pharmacy and that your doctor specifies a T cream with no alcohol.

 

[stcrim]

What skin areas produce the least DHT??? I have issues with testosterone cream fairly quickly causing prostate issues. May be that I over produce DHT while using insides of arms or legs as well as chest. I did follow one protocol that also reduced the effectiveness of the "T" (in the butt crack).

Any suggestions?

 

[Nelson Vergel]

We have no data on what application sites result in lowest DHT production.

Here is a study using 1 site vs 4 sites per application that showed that the 4 site arm may have a little higher T and DHT (ratio of both remained the same).



J Clin Endocrinol Metab. 2000 Mar;85(3):964-9.
Pharmacokinetics of transdermal testosterone gel in hypogonadal men: application of gel at one site versus four sites: a General Clinical Research Center Study.


Abstract

Testosterone (T) in a hydroalcoholic gel has been developed as an effective and convenient open system for transdermal delivery of the hormone to men. Because the gel can be applied either to small or large areas of skin, it was important to assess whether the skin surface area on which the gel was applied was an important determinant of serum T levels. To answer this question, the pharmacokinetics of a transdermal 1% hydroalcoholic gel preparation of T was studied in nine hypogonadal men. The subjects applied in random order a 25-mg metered dose of T gel either four times at one site (left arm/shoulder) or at four different sites (left and right arms/shoulders and left and right abdomen) once daily (6-8 min) for 7 consecutive days. After 7 days of washout, each subject was then crossed over to the opposite regimen for another 7 days of treatment. Serum samples were collected for measurements of T, 5alpha dihydrotestosterone (DHT), and estradiol before, during (days 1, 2, 3, 5, and 7), and after (days 8, 9, 11, 13, and 15) application of T gel. Multiple blood samples were drawn on the 1st and 7th day after gel application; single samples were obtained just before the next T gel application on other days (24 h after the previous gel application). The T gel dried in less than 5 min, left no residue, and produced no skin irritation in any of the subjects.

Mean serum T levels, irrespective of application at one site or four sites followed the same pattern: rising to 2- to 3- and 4- to 5-fold above baseline at 0.5 and 24 h after first application, respectively. Thereafter, serum T levels reached steady state and remained at 4- to 5-fold above baseline (at the upper limit of the normal adult range) for the duration of gel application and returned to baseline within 4 days after stopping application. The application of T gel at four sites (application skin area approximately four times that of one site) resulted in a mean area under the curve (AUC0-24h) for serum T levels on the 7th day (868 +/- 72 nmol*h/L, mean +/- SEM), which was 23% higher but not significantly different (P = 0.06) than repeated application at one site (706 +/- 59 nmol*h/L). This could be due to the limited number of subjects studied (n = 9). Mean serum DHT levels followed the same pattern as serum T, achieving steady-state levels by 2 days. The mean concentration of serum DHT on the 7th day was significantly higher after application at four sites (9.15 +/- 1.26 nmol/L, P < 0.05) than at one site (6.9 +/- 0.77 nmol/L). These serum DHT levels were at or above the normal adult male range. Serum DHT:T ratio was not significantly altered by T gel application. Serum estradiol levels followed the same pattern as serum T and showed no significant difference between the one- or four-site application. We conclude that transdermal daily application of 100 mg T gel resulted in similar steady levels of serum T. The surface area of the skin to which the gel was applied had only a modest impact on serum T and DHT levels. Mean serum levels of T and DHT was higher by 23% and 33%, respectively, despite application of the gel to four times the skin area in the four sites compared with the one site group. Because of the greater dosage flexibility provided, hydroalcoholic T gel application over multiple sites seems to be an effective and nonskin-irritating method of transdermal T delivery for hypogonadal men. Dose-ranging studies are required to determine dosage regimens for T gel application as a replacement therapy in hypogonadal men.

 

[jltskfl]

Keep in mind that the absorption rate of the scrotum for almost ALL DRUGS is 24X of any other trans-dermal area of the body.

Has anyone had blood work done while using test gel on the scrotum that can provide some dosage info?

 

[Nelson Vergel]

Keep in mind that the absorption rate of the scrotum for almost ALL DRUGS is 24X of any other trans-dermal area of the body.

Has anyone had blood work done while using test gel on the scrotum that can provide some dosage info?

Pharmacokinetics of testosterone cream applied to scrotal skin

 

[lowe2sucks]

What skin areas produce the least DHT??? I have issues with testosterone cream fairly quickly causing prostate issues. May be that I over produce DHT while using insides of arms or legs as well as chest. I did follow one protocol that also reduced the effectiveness of the "T" (in the butt crack).

Any suggestions?

where you have no hair follicle... most hairless area (shaven ballsack doesnt count for some reason)..
shoulders, forearms and scrotum are most androgenic (a lot of dht conversion)

 

[Nelson Vergel]

The aim of this study was to define the pharmacokinetics of testosterone delivered via the scrotal skin route. The study was a single‐center, three‐phase cross‐over pharmacokinetic study of three single doses (12.5, 25, 50 mg) of testosterone cream administered in random sequence on different days with at least 2 days between doses to healthy eugonadal volunteers with endogenous testosterone suppressed by administration of nandrolone decanoate. Serum testosterone, DHT and estradiol concentrations were measured by liquid chromatograpy, mass spectrometry in extracts of serum taken before and for 16 h after administration of each of the three doses of testosterone cream to the scrotal skin. Testosterone administration onto the scrotal skin produced a swift (peak 1.9–2.8 h), dose‐dependent (p < 0.0001) increase in serum testosterone with the 25 mg dose maintaining physiological levels for 16 h. Serum DHT displayed a time‐ (p < 0.0001), but not dose‐dependent, increase in concentration reaching a peak concentration of 1.2 ng/mL (4.1 nm) at 4.9 h which was delayed by 2 h after peak serum testosterone. There were no significant changes in serum estradiol over time after testosterone administration. We conclude that testosterone administration to scrotal skin is well tolerated and produces dose‐dependent peak serum testosterone concentration with a much lower dose relative to the non‐scrotal transdermal route.

"The bioavailability of testosterone via the scrotal skin is striking higher than for abdominal skin. Using the same testosterone cream and steroid LC‐MS assay measurements, in this study a Cmax (4.6 ng/mL, 16.0 nm) was achieved with the lowest dose (12.5 mg) applied to the scrotal skin whereas applying 100 mg testosterone cream to the abdominal skin produced a Cmax of 16.3 nmol/L (4.7 ng/mL). This suggests an about eightfold increase in testosterone bioavailability, using the scrotal compared with abdominal skin routes. "

"Testosterone administration to the scrotal skin also produced a marked rise in serum DHT following each testosterone dose, but neither the time of peak nor the peak DHT concentration were dose dependent."

Source:
Pharmacokinetics of testosterone cream applied to scrotal skin
R. Iyer
Andrology. Volume5, Issue4
July 2017
Pages 725-731

 

[Nelson Vergel]

Case Study: Absorption of Testosterone Cream via Scrotal Delivery

 

[madman]

where you have no hair follicle... most hairless area (shaven ballsack doesnt count for some reason)..
shoulders, forearms and scrotum are most androgenic (a lot of dht conversion)

Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels

Ronald S. Swerdloff, Robert E. Dudley, Stephanie T. Page, Christina Wang, and Wael A. Salameh



Skin

Skin possesses all of the requisite steroidogenic capabilities to ensure local homeostatic control of steroid hormones, suggesting an important paracrine role for T, DHT, and estradiol within the skin, the function of which is poorly understood (143). Likewise, skin contains metabolizing pathways (e.g., glucuronidation; sulphation) that inactivate DHT (144). Consequently, localized mechanisms in skin maintain concentrations of DHT that are not meaningfully influenced by circulating DHT levels, probably due to the fact that the DHT concentration gradient favors secretion into blood (143, 145). In men, androgen levels are highest in the scrotal skin followed by pubic skin and then thigh skin, a pattern paralleled by 5a-reductase and low 5a-reductase activity (and thus tissue DHT) (146). In women, skin DHT concentrations are highest in the labia majora and clitoris followed by pubic skin and then thigh skin (147).

 

[eli]

Case Study: Absorption of Testosterone Cream via Scrotal Delivery

Can one apply Testosterone gel or cream on feet and then wear socks? Sounds like a good area

 

[Elbert56]

Keep in mind that the absorption rate of the scrotum for almost ALL DRUGS is 24X of any other trans-dermal area of the body.

Has anyone had blood work done while using test gel on the scrotum that can provide some dosage info?

After 1 month of using tostran gel on the scrotum, only 10 mg a day, my testosteron rise from 4 to 24. So it really works.

 

[Nelson Vergel]

New Atrevis Hydrogel Based Testosterone Cream from Empower: Surprising Results!

After a month of using the new hydrogel cream from Empower Pharmacy at 1 ml per day (4 clicks of 0.25 mg each) my testosterone increased dramatically higher than it was even on 200 mg per week of injectable testosterone cypionate. and this was after using the cream plus pregnenolone 100 mg...

www.excelmale.com