Testogel pump bottles are a convenient testosterone replacement therapy prescribed for male hypogonadism on the NHS. Each standard Testogel 16.2 mg/g pump bottle contains at least 60 metered doses after priming, providing between 15 and 60 days of treatment depending on your prescribed daily dose. Understanding how many pumps you need and how long your bottle will last is essential for maintaining consistent testosterone levels and avoiding treatment interruptions. This guide explains Testogel pump dosing, correct application technique, and important safety information to help you use your medication effectively and safely.

Understanding Testogel Pump Bottles and Dosing

Testogel (testosterone gel) is a widely prescribed hormone replacement therapy used to treat male hypogonadism—a condition where the body does not produce sufficient testosterone. Available on NHS prescription, Testogel is formulated as a clear, colourless gel applied topically to the skin, where testosterone is absorbed into the bloodstream. The pump bottle formulation offers a convenient, measured dosing system designed to improve adherence and reduce dosing errors.

Testosterone replacement therapy (TRT) should only be initiated in men with confirmed hypogonadism, based on clinical symptoms (such as reduced libido, erectile dysfunction, fatigue, and low mood) and biochemical evidence of low serum testosterone on appropriately timed blood tests. The pump mechanism delivers a precise, pre-measured dose of testosterone with each actuation, eliminating the need for patients to estimate quantities from sachets or tubes. This is particularly important because testosterone replacement requires careful dose titration to achieve physiological testosterone levels whilst minimising adverse effects.

Each pump actuation of Testogel 16.2 mg/g delivers 1.25 g of gel containing 20.25 mg of testosterone. According to the UK Summary of Product Characteristics (SmPC), the recommended starting dose is 40.5 mg daily (two pump actuations), applied once daily in the morning. This starting dose is supported by NICE Clinical Knowledge Summaries (CKS) and the British Society for Sexual Medicine (BSSM) guidelines. Doses can be adjusted based on serum testosterone monitoring, ranging from one pump (20.25 mg) to four pumps (81 mg) daily, depending on individual patient response and blood test results.

Understanding your prescribed dose and the number of pumps required is essential for treatment success. Patients should never adjust their dose without consulting their GP or endocrinologist, as both under-treatment and over-treatment carry clinical risks, including cardiovascular concerns and suppression of natural testosterone production. Regular monitoring through blood tests is essential to ensure testosterone levels remain within the therapeutic range.

How Many Pumps Are in a Testogel Bottle?

A standard Testogel 16.2 mg/g pump bottle provides at least 60 metered doses after priming, as stated in the UK Patient Information Leaflet and SmPC. This provides sufficient gel for between 15 and 60 days of treatment, depending on your prescribed daily dose. The bottle is designed as a multi-dose container with an integrated metering pump that remains consistent throughout its use.

For patients prescribed the standard starting dose of two pumps daily (40.5 mg testosterone), one bottle will last approximately 30 days. Those on a lower maintenance dose of one pump daily will find the bottle lasts the full 60 days, whilst patients requiring higher doses of three or four pumps daily will need replacement bottles more frequently (approximately every 20 or 15 days respectively).

It is important to note that the first few actuations when you begin using a new bottle are priming pumps and do not count towards the 60 metered doses. The manufacturer recommends pressing the pump three times and discarding the gel before first use to ensure the mechanism is properly primed and subsequent doses are accurate. These priming actuations are separate from the 60 usable doses.

Patients should monitor their supply and request repeat prescriptions in good time, typically when approximately one week of treatment remains. Running out of testosterone replacement can lead to symptom recurrence, including fatigue, low mood, and reduced libido. Your GP surgery or pharmacy can advise on the most efficient repeat prescription system for your circumstances, whether through online ordering, telephone requests, or the NHS App.

How to Use Your Testogel Pump Correctly

Proper application technique is crucial for optimal testosterone absorption and treatment efficacy. Testogel should be applied once daily, preferably at the same time each morning, to mimic the body's natural circadian rhythm of testosterone production. The gel must be applied to clean, dry, intact skin—never to broken, irritated, or recently shaved areas.

Application sites for Testogel 16.2 mg/g pump are the shoulders and upper arms only, as specified in the UK SmPC. Do not apply to the abdomen or genital area. Rotate application sites daily between shoulders and upper arms to prevent skin irritation. To apply, depress the pump fully to dispense the gel into the palm of your hand, then immediately spread it thinly over a large area of skin. Allow the gel to dry for 3–5 minutes before dressing.

Wash your hands thoroughly with soap and water immediately after application to prevent accidental transfer to others. This is particularly important because testosterone can be transferred through skin-to-skin contact, posing risks to women and children. The MHRA has issued specific warnings about secondary exposure, which can cause virilisation in women (unwanted hair growth, voice deepening) and premature sexual development in children.

Key safety measures to prevent transfer include:

• Covering the application site with clothing once the gel has dried

• Waiting at least 2 hours after application before bathing or showering

• Washing the application area with soap and water before anticipated close skin contact if the site is not fully covered by clothing

• Washing the application area with soap and water if direct skin contact with another person occurs accidentally

If you miss a dose, apply it as soon as you remember on the same day. If you remember the following day, skip the missed dose and continue with your regular schedule—never double up doses. Consistent daily application optimises steady-state testosterone levels and symptom control.

For dose titration, your doctor will typically check your serum testosterone level 2–4 hours after application to assess whether your dose needs adjustment. This timing is important for accurate measurement of testosterone absorption from the gel.

Storage, Safety and Monitoring Information for Testogel

Store Testogel pump bottles at room temperature (do not store above 25°C) in a secure location, away from direct heat sources and sunlight. The medication must be kept out of sight and reach of children and pets, as accidental exposure can cause serious harm. Consider using a locked cabinet, particularly in households with young children or vulnerable individuals.

The pump bottle should be stored upright to maintain the integrity of the dispensing mechanism. Do not refrigerate or freeze Testogel, as this may affect the gel's consistency and the pump's functionality. Once opened, the bottle remains stable for the duration of its use, provided it is stored correctly. Check the expiry date printed on the packaging and do not use the product beyond this date.

Disposal of used bottles should follow local pharmaceutical waste guidelines. Return empty or partially used bottles to your community pharmacy, which operates NHS medicine return schemes. Never dispose of testosterone products in household waste or wastewater, as this poses environmental risks. If you discontinue treatment, return all unused medication to your pharmacy for safe disposal.

Fire hazard warning: Testogel contains alcohol and is flammable. Keep away from naked flames, cigarettes, and other ignition sources until the gel has completely dried on your skin. Do not smoke or go near flames during and immediately after application.

Regular monitoring is essential for safe and effective treatment. Your doctor will typically arrange:

• Serum testosterone measurement 2–4 hours after application, initially after starting treatment and following any dose changes, then periodically

• Full blood count (FBC) and haematocrit at 3–6 months, then annually; if haematocrit rises above 54%, your doctor may reduce or stop treatment and investigate the cause

• Prostate-specific antigen (PSA) and digital rectal examination (DRE) at baseline and periodically, with referral to urology if results are abnormal

• Lipid profile and liver function tests as clinically indicated

When to contact your GP:

• If you develop skin reactions (severe redness, rash, or persistent irritation) at application sites

• If you experience signs of excessive testosterone (aggression, mood changes, severe acne, or fluid retention)

• If you notice symptoms of low testosterone despite regular use (persistent fatigue, low mood, reduced libido)

• If you suspect accidental exposure of a partner or child to the medication

• If you develop signs of polycythaemia (headaches, dizziness, visual disturbances)

Caution is advised if you are taking anticoagulants or corticosteroids, as testosterone may interact with these medicines. Testosterone can cause fluid retention, which may affect the management of certain conditions.

Reporting side effects: If you experience any side effects, talk to your doctor or pharmacist. You can also report suspected side effects directly via the MHRA Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Reporting helps provide more information on the safety of medicines.

Frequently Asked Questions