Compounded creams on the scrotum are typically absorbed very well with less aromatization and do increase DHT to super physiological levels.
I’ve been on cream only for 3.5 months (switched from pellets) and am switching to injections +low dose cream, just waiting on meds to be delivered.
Positives of cream:
Easy to apply and titirate dosage, quickly absorbed, less aromatization, generally very good for libido due to DHT increases.
Have to apply 1-2 times a day, must time around showers, sweating, sex, etc to get full absorption and no transference issues. Super physiological levels of DHT will increase hair loss in those predisposed to it. Also, conflicting studies on very high DHT and prostate issues, BPH, CVD, etc. One observational study I found suggested mid levels of DHT are associated with reduced risk of CVD compared to low or high levels.
Why I’m switching from cream only:
I’ve been on 100mg a day which give me 7-800 TT at peak and FT at 75% from
top of the range. For reference, I was at 1300TT on pellets. On cream, I’ve experienced significant heart palpations when lifting between sets as my heart rate comes down. It did not happen on 50mg of cream but that dose was too low for me. I do not believe it’s due to high levels as they were much higher on pellets and I did not have palpitations. Additionally, I’ve had increased irritability on the cream and tend to get pretty red faced when lifting, BP and hematocrit are not issues. Also don’t have the joint pain relief I had on pellets, I’m a low aromatizer with mid-high SHGB and need more estrogen. I’ve switched docs and he believes the sides are related to excess DHT so we are going to try 100mg test C a week (split) and 50mg of cream daily to start and go from there.