testosterone injections
Since the 1950’s testosterone has been primarily administered by intramuscular injection for men. Yet, there has been increasing evidence and support that testosterone can be given by subcutaneous injection, rather than by intramuscular injection. Benefits of subcutaneously injecting testosterone include less discomfort and pain, smaller needle size, and possibly lesser dosage of testosterone needed to sustain steady state levels of serum testosterone. Furthermore, subcutaneous injection of testosterone weekly was able to maintain testosterone levels within the normal reference range.
what is a subcutaneous injection?
An injection that places the medication in the subcutaneous tissue right below the skin (instead of the muscle layer), this allows the medication to absorb more slowly than an intramuscular injection.
the benefits of subcutaneous injection
Ease of administration and less discomfort
Well tolerated
Minimal testosterone peak and trough fluctuations
Less chance of venipuncture
Less bruising
how often do I need to inject testosterone subcutaneously?
Subcutaneous testosterone can be injected weekly or 2x a week similar to the IM route of testosterone injection. While some clinics may have advised patients to inject a low dose of testosterone daily, the majority of studies investigated the efficacy of subcutaneous testosterone injection weekly or twice a week.
needles size and what to use
A 18-gauge needle is used to draw the testosterone solution into a 1cc or 3 cc syringe to the prescribed amount. The needle is removed and replaced with a fine 25- or 27-gauge 5/8”-inch needle. Commonly used sites for subcutaneous injection of testosterone include the abdominal fat or the thigh.
how to prepare your syringe
Don’t let the needles touch any surfaces.
The first time you use the vial, remove the cap (the cap gets thrown away) on the vial to reveal the rubber stopper.
Wipe off the rubber stopper of medication vial with alcohol and allow it to air dry.
Open the syringe and screw the needle onto it.
Pull back the safety (or cap). This is needle dependent and your needle may or may not have a safety.
Put the needle into the vial and turn the vial upside down.
Pull back the plunger to the medication amount, check for bubbles, and tap the syringe to remove them.
Turn the vial right side up, and remove the needle from the vial. Put the safety back on the needle if applicable.
Remove the needle from the syringe and place it in the sharps container.
Put a new needle on the syringe. Don’t touch the end!
how prepare your injection site
Option A: Abdomen*
Option B: Top of thigh*
*Be sure to rotate sites
Option A: Abdomen
Select an area at least one inch away from your belly button, but not above your belly button.
Wipe your skin with an alcohol pad and allow it to air dry.
Pinch your skin and insert the needle at either a 45 or 90 degree angle
Push the plunger to inject the medication and pull the needle out of your skin.
Option B: Top of thigh
Select an area in the upper third of your thigh.
Wipe your skin with an alcohol pad and allow it to air dry.
Pinch your skin and insert the needle at either a 45 degree or 90 degree angle
Push the plunger to inject the medication and pull the needle out of your skin.
Disposal after injection:
Dispose of the needle and syringe in the sharps container, and apply your a band-aid.
When the vial is empty, place it in the sharps container.
When the sharps container is full, tape the lid and take it to your pharmacy for proper disposal and to get a new container.
tips for reducing pain
Never reuse needles.
Use separate drawing up and injecting needles.
Let your skin dry fully from the alcohol wipes before injecting.
Ice the area before applying alcohol wipes to numb the area.
Keep the muscle in the injection area warm and relaxed.
Inject the medication when it’s at room temperature.
Break through the skin quickly with the needle.
Insert the needle straight into the skin and pull it out again without wiggling or changing its direction.
common side effects from injection
Pain or pinching
Bruising and Other skin irritations or lumps
Red ness or warmth or swelling at injection site
Product discharge or bleeding
Skin Infections- can be avoided with proper preparation- If you do develop you can use polysporin at the fist sign of an infection if develops longer see your family doctor.
Itching- Can be a reaction to the ester (oil) in the testosterone or the needles- please contact the pharmacy for options
still have questions?
For those who choose to do a Intermuscular injection –IM Dr. Brown has created an instructional video for intramuscular injections:
If you have any questions or concerns regarding injections please follow up with your pharmacy for more information.
