Key takeaways
Estradiol gel (Divigel) and testosterone gel (Testim, AndroGel) are both topical hormone replacement therapies, but they serve different purposes. Estradiol gel is an estrogen replacement used to treat menopausal symptoms such as hot flashes and night sweats, while testosterone gel is used to treat low testosterone levels in adult males. Both medications are used off-label as part of gender-affirming hormone therapy. Estradiol gel is applied to the upper thighs, whereas testosterone gel is applied to areas like the shoulders, upper arms, or thighs, depending on the brand. Common side effects of estradiol gel include vaginal yeast infections and breast tenderness, while testosterone gel can cause skin irritation and acne. Both medications carry risks of serious side effects, such as heart attacks and strokes, but testosterone gel also has a risk of misuse and addiction due to its controlled substance status. Additionally, estradiol gel may require the use of a progestin if you have a uterus to reduce the risk of uterine cancer.
