How to Administer a Testosterone Injection — Low-T Injection Guide

Posted by Dr. Michael White, Updated on February 28th, 2024
Reading Time: 6 minutes

Testosterone injections are one of the most popular forms of testosterone therapy available today.

In fact, low-t injections were the first treatment available for testosterone deficiency. Initially, testosterone was injected daily, but as recombinant biomedical techniques have advanced, most patients only require one injection every 10-14 days.

As of today, Testosterone Cypionate is the most popular form of testosterone HRT injection in the United States.

Most typical testosterone shots are comprised of an ester compound melded with bio-identical testosterone to provide a slow and steady supply of testosterone over an extended period. The following injection protocol applies to all testosterone ester injections.

Remember, only use recombinant testosterone with a prescription from a licensed physician, and always follow the instructions of your doctor to the letter!

Testosterone therapy can produce surprising results for patients with clinically diagnosed low-t, but it should always be treated with respect.

Ensure that You're Administering the Correct Testosterone Dosage

The first step to injecting testosterone is to check and make sure that you are using the right dosage, as prescribed by your doctor.

In the United States, Testosterone Cypionate is the most popular, but Testosterone Enanthate is also widely prescribed. The ideal testosterone dosage is generally in the range of 100-200 mg/mL.

There is always the chance that you were given the wrong prescription, and taking more or less testosterone than prescribed will either inhibit the benefits of treatment or increase the risk of testosterone side effects, respectively.

Clean the Surface Where You Will Perform the Injection

Before you gather your supplies, find a firm, flat area where you can engage in testosterone injection prep.

Disinfect the area so that you minimize the risk of contamination. Having a mirror available can also be beneficial to make it easier to inject specific muscle tissues.

Gather Testosterone Injection Equipment, Ensuring Sterility

Wash your hands thoroughly and gather up all of the supplies that you'll be using to perform the injection.

Place them on your designated administration site. You'll need your testosterone equipment, as well as sterilized gloves, alcohol swabs, and a SHARPS container, or another suitable disposal container that is thick enough to prevent the needle from piercing through the vessel.

Never reuse a syringe or needle. This is highly dangerous and vastly increases your risk of contracting an infection or blood-borne diseases.

Your needle should be capped, sealed, and clean until the time for injection.

Also, most patients opt to use two separate needles during the injection process. A wide-bore needle makes it easier to draw the testosterone into the syringe because bio-identical testosterone is quite oily and viscous.

Unfortunately, a larger needle also leads to more pain. For this reason, you'll likely trade out needles before injection, to a smaller needle that vastly reduces the pain associated with the injection.

If the needle or syringe is ever dropped or contaminated during the low-t injection process, throw away the contaminated equipment and start over.

Clean Hands and Put On Gloves

Before administering your testosterone dose, wash your hands thoroughly with water and antibacterial soap.

After your hands are clean and dry, put on clean medical gloves. From this point forward, you should only touch safe and decontaminated surfaces. Change gloves if you make contact with any other surfaces or objects.

Draw Dosage into Syringe

Every testosterone prescription has a specific recommended dosage. Always be sure to inject the correct low-t therapy dose every time.

Always do the math and make sure you'll have the intended dose. Dependent on the density of the testosterone serum, the total volume of testosterone that you'll need will differ.

The first thing that you should do from this point is to take your syringe and draw back the plunger until the volume of air in the syringe equals your intended dosage. It's important to inject air into the medication vial before drawing testosterone because it vastly increases the ease at which the viscous testosterone serum is drawn.

Proceed to clean the penetrable lid of the testosterone vial with an alcohol wipe, then pierce the cap with the needle.

Pump the air from the syringe into the bottle, then flip the vial and syringe carefully, so that the needle is entirely submerged in the low-t serum. Drawback the plunger until your syringe reads the correct testosterone dosage.

Switch to a Smaller-Gauge Needle

At this point, you will change to a thinner needle to make the injection much more tolerable. Flip the syringe so that the needle points toward the ceiling. Pull the plunger slightly to let a slight amount of air into the syringe, so that no testosterone spills. Press the cap back onto the needle and unscrew the needle from the syringe carefully.

Set the needle aside, or otherwise safely dispose of it, then take the smaller needle and carefully twist it onto the syringe, then uncap the new syringe.

Aspirate the Syringe

For your immediate safety, you'll need to evacuate any bubbles from the syringe.

If bubbles of air enter your bloodstream as a result of poor injection practices, this can lead to a dangerous and potentially fatal condition known as an embolism.

To prevent this from happening, you'll look at the syringe as it's held with the needle pointing up. Tap on the side of the syringe so that any bubbles which are clinging to the wall of the syringe float to the top.

After all of the air is concentrated at the needle tip, carefully push the plunger until all air is evacuated and a small curve of the Testosterone Serum rounds off the edge off of the tip of the needle.

Sterilize the Testosterone Injection Site

As we mentioned previously, the majority of testosterone shots are delivered intramuscularly.

The two most common sets of muscles to administer a low-t injection are the glutes and the vastus lateralis.

In layman's terms, those are your butt cheeks and the upper area of the outer thigh, respectively. The deltoids of the upper arm are often chosen as an injection site as well.

In general, the best places to perform an injection are the larger muscles with less subcutaneous fat between the skin and the muscle tissue because this minimizes the pain associated with the dose.

It's crucial to choose an injection site carefully, to both reduce pain and vastly reduce the risk of puncturing a blood vessel or damaging a nerve.

At your designated injection site, sterilize the skin with an alcohol pad in the area where you will administer the injection. This eliminates skin bacteria, mitigating the risk of infection.

It's important to note that there are blood vessels and nerves in the gluteal region, so the best place to inject testosterone into the glutes is on the upper, outside corner of the muscle.

Inject the Bio-Identical Testosterone

Now comes the time for injection. Tilt the syringe at a right angle to your designated injection site. When ready, dart the needle into the skin in a careful and steady, yet quick, manner.

Pull back the plunger very slightly to make sure that you didn't accidentally knick a blood vessel. If you see blood enter the syringe, then immediately withdraw the needle and choose a different location.

If you did not see blood, depress the plunger at a measured and constant rate until the medication is entirely dispensed. Pull out the needle quickly, yet carefully.

During injection, you might experience mild burning, pressure sensation, stinging, or discomfort. This is nothing to worry about.

If you experience shooting pain, this means that you might have struck a nerve, and you should cancel the injection and contact your doctor. If the pain becomes worse over time, you should also give your doctor a call.

Clean the Injection Site

After you've completed the injection, set aside the needle, and check for bleeding. If you are bleeding, use a sterilized bandage or cotton ball to protect the site of injection. After you've completed the injection process, throw away the syringe, needle, and any other contaminated products into their appropriate containers.

Never throw away needles and other bio-hazard products into the trash can. Return them to your physician or a pharmacy for disposal. It's also important to never throw away excess testosterone or other medications into the trash or down the drain.

It is okay, however, to throw away empty testosterone vials and bottles usually.

Remember to always talk to your doctor if you experience any symptoms or side effects that you believe may be related to your testosterone therapy!

Testosterone Injections are Easier and Simpler Than They May Appear

In this article, we've attempted to explain the process of how to inject intramuscular testosterone thoroughly. This information should only be considered for informational purposes, and you should always follow your doctor's instructions precisely.

Once you've learned how to inject testosterone, it becomes a simple and easy process, but you should always take the time to thoughtfully and deliberately perform the steps involved to ensure safety!


Testosterone Intramuscular Injection video


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