How To Inject Testosterone: What are the steps?

Elite HRT

Written by Elite HRT on June 04, 2021

Medically reviewed by

Camille Frecking, Regulatory Affairs Specialist, MEDICAL ADVISOR

If you have been prescribed injectable testosterone or are considering your options, it is important at some point to know about the process of injecting testosterone. Many people’s only interaction with injections is when you get a vaccine administered by a healthcare provider, so it is natural not to know about the process of injection. 

It is not as difficult as you may think, but you do need to be prepared so that you do it correctly to prevent any damage and to get the best results from your injection. 

Also, keep in mind that it may be easier to ask a family member or friend to inject testosterone for you. Sometimes it can be difficult to inject yourself physically and to get past the mental block of not wanting to prick yourself. 

Keep reading to learn more about testosterone, how to inject it, where you get testosterone, and more. 

What is Testosterone?

Testosterone is a hormone in the body that is most well known as being the male sex hormone, or androgen. Testosterone is produced in men in the testicles and is important for a wide variety of functions. 

Concerning sexual functioning, testosterone is important for producing sperm and balancing sex drive. It also has other functions in the body including increasing muscle mass, decreasing body fat, maintaining body hair, and others. 

Testosterone is also present in women, but not in as high of an amount. In women, testosterone is made in the adrenal glands. 

Overall, the testosterone hormone is important in ensuring the body functions properly, so if you do not have enough natural testosterone, supplemental testosterone may be helpful.  

Forms of Testosterone

Testosterone levels can naturally decrease in men as they age, so hormone replacement therapy may be suggested by your healthcare provider. Testosterone injections are some of the most common forms of hormone replacement therapy. 

However, there are actually multiple forms of testosterone including a patch, oral tablet, injections, cream, and gel. Each form of testosterone has its own pros and cons that need to be outweighed by you and your healthcare provider. Intramuscular injections (IM injections) of testosterone are definitely one of the most common forms of testosterone administrations. 

Supplies Needed

Just like with any process you will need to gather your supplies first. Your supplies will likely be given to you by your healthcare provider, but you may need to purchase it separately if it is not given to you. 

Before beginning, you will want to have all of the supplies in reach so that you do not have the process interrupted. 

The first supply is your testosterone vial. Your vial may be single-use, meaning you use it once and then throw it away, or multi-use meaning you can use it multiple times until it expires or you have finished it. 

The other supplies you will need are a needle, a syringe, an alcohol wipe, and a small band aid. You may have a needle that is already attached to a syringe or you may need to use a separate one. If using a separate needle and syringe, you can also choose to use an access device for removing the medicine from the vial. 

The size of the syringe may change based on the dose of the medication. The size of the needle can also vary based on the size of the person. However, typically you can use a 22-23 gauge needle that is 1 to 1.5 inches long. If you are a slim person, a 1-inch needle would be more appropriate, and if you have more body fat, a 1.5-inch needle would be a good choice. Additionally, your provider may supply you with an 18 gauge needle for drawing the solution out of the vial.

Also, if you have someone else inject the testosterone for you, they may want to wear gloves. 

Preparing for the Injection

The first step in preparing for the injection is to gather all of your supplies and wash your hands. Before beginning to draw up the medication you always want to ensure that the medication is correct. You will check that it is the right medication, the correct dose, the right time to take it, and the right route. 

So, check the vial for the name, expiration date, and dosage. After all of these precautions are taken you can move on to drawing up the medication. 

First, you will remove the lid from the vial and wipe the rubber stopper with an alcohol wipe. While the rubber is drying you can prepare your needle and syringe by attaching them if necessary. 

You will then draw air into the syringe in the same amount as your dose. For example, if you need to pull up 1 mL of testosterone, you will pull up 1 mL of air into the syringe. 

Next, with the vial flat on the table, you will pierce the rubber stopper and inject the air from the syringe into the vial. With the needle in the vial, flip the vial upside down so that the vial is above the needle and syringe. You can then pull back on the plunger to take out the correct amount of medication. Remove the needle from the vial.

Ensure that there are no air bubbles. If there are, tap the table to move the air to the top of the syringe — them, you can “prime” the needle by pushing very slowly and gently so that just the air bubble comes out, and only a very tiny solution follows. 

If you are planning to use this needle versus swapping it out for a smaller size, you should ensure that it does not touch any surfaces. At this point, you should be ready to inject the testosterone. 

Injecting the Testosterone

You will want to choose an appropriate site for injecting the testosterone. Your healthcare provider will likely tell you their preferred site for injection, but the two most common sites are in the thigh and the buttocks. 

The thigh site is the vastus lateralis muscle and is the outer third of the thigh. The buttocks site is the ventrogluteal site. It is the part of the buttocks close to the hip. Your doctor will be able to provide you with a demonstration of how to locate this spot to ensure you do not hit any nerves, and the solution goes directly into the muscle tissue as intended. 

After you choose an injection site you should wipe the site with an alcohol prep pad. Let the site air dry, then you can insert the loaded syringe at a 90-degree angle (straight in) into the muscle. You can use your thumb and index finger to do a reverse pinching motion and stretch out the skin, making it more taut and less painful to puncture. 

Before you insert the medication into the muscle you should pull back on the plunger to see if there is blood in the syringe. If there is the blood that returns this means the needle is in a blood vessel and you should remove the needle from the body. You would need to replace the needle and try again. If there is no blood return you can go ahead and inject the medication into the muscle. Gently pull the needle straight out just as you put it straight in initially.  

Remove the needle from the muscle and cover with a cotton ball or gauze if there are any extra drops of blood. It should not bleed more than a few drops, if any. Engage the anti-needlestick safety device to prevent any needlestick injuries. Then place your needle and syringe into a sharps disposal bin. 

How Often Should you Take Testosterone Injections?

The dose and frequency of testosterone injections vary based on a variety of factors. Your current hormone levels, age, the intensity of symptoms, and sex are just some of the factors that can impact the amount and how often you get an injection. 

However, the most common dose is 1 mL of 200 mg/mL depo-testosterone every 2 weeks. There are also different types of injectable testosterone including testosterone cypionate, testosterone enanthate, and testosterone propionate that can differ in the dose as well. 

Throughout your course of testosterone treatment, you may also change the dose based on how well you are responding to the treatment. 

Conclusion

Beginning injectable testosterone therapy may seem intimidating at first, but with time and practice you will gain confidence and it will be like second nature. When beginning treatment you should pay close attention to the effects of the medication and if any of them are not expected or are causing your discomfort. 

If you notice any unwanted side effects you should report them to your healthcare provider so they can determine the best course of action. If this is the case they may decide to reduce your dose, change the administration route, or stop it all together. 

Testosterone injections are a reliable way to get hormone replacement therapy, and when taken under the instruction of your healthcare provider or a provider like Elite HRT, you can feel confident that you have the best people on your side with great intentions to help you reach your health potential. 

Resources

Comparison of Testosterone Replacement Therapy Medications in the Treatment of Hypogonadism

How to give a Testosterone Intramuscular (IM) Injection

Testosterone therapy: Potential benefits and risks as you age