TRT Injections
Proper technique and adherence to safety guidelines are crucial for a successful injection.
Prior to drawing your medication, make sure you understand your dose and identify how much medication you will be drawing into the syringe.
How To Read A 1mL Syringe
Syringes can vary by brand.
If using the 1mL the syringe below, each line will indicate 2 units.
This can make some doses difficult (for example: 0.35mL ). In this case it is usuallt best to round down to 0.34mL.
Some syringes do provide per unit measurements, making doses like a 0.35mL (or 25 units) very easy to identify.
How To Read Dosing on a 3mL Syringe (Not commonly used)
3mL syringes are NOT commonly used in TRT anymore due to the potential for dosing errors.
However, we see this question frequenctly asked online, so we thought we would provide this information.
A detailed step-by-step guide on how to administer testosterone using the Intramuscular injection (IM) method:
- You’ll Need:
- Testosterone vial: Ensure it is properly stored, NOT refridgerated.
- Syringe and needles: Preferably 5/8″ to 1 & 1/4″ 23-25 gauge needle with a 1mL syringe.
- Alcohol swabs to sterilize the injection site and vial top.
- Sharps container or equivalent proper container for safe needle disposal.
- Preparing the Injection Site:
- Choose the injection site: Common sites include the gluteal muscle (upper outer quadrant) and the vastus lateralis muscle in the thigh.
- Clean the injection site with an alcohol swab in a circular motion and allow it to dry.
- Drawing the Testosterone:
- Remove the cap from the testosterone vial and clean the rubber stopper with an alcohol swab.
- Assemble the syringe and needle, ensuring they are well fastened.
- Pull back the plunger of the syringe to draw air into it equal to the desired testosterone dosage.
- Insert the needle into the vial, turning the vial upside down, and inject the air into the vial.
- While keeping the vial upside down, draw the required testosterone dosage into the syringe, ensuring no air bubbles are present.
- Administer the Injection:
- Hold the syringe like a dart.
- Insert the needle into the muscle at a 90-degree angle.
- Slowly push the plunger to inject the testosterone do not push the plunger in quickly. The idea here is to NOT squirt the medication inside you. This is a common cause of injection pain.
- Once the dose is administered, withdraw the needle from the muscle.
- Immediately Post-Injection:
- Apply place your alcohol pad over the injection site and apply gentle pressure with your fingers to the injection site, and apply a small circular masasaging motion.
- Dispose of the used needle and syringe in the proper containner.
- If necessary, use a band-aid or sterile adhesive to cover the injection site.
- Observe the injection site for any swelling or bleeding.
There may be some mild discomfort and minor swelling present, (which is normal), however, persistant pain, swelling tat expands beyond the injection site, and heat could be a sign of an infection. *Never store your injectable medications and injection supplies in a bathroom.
Pros:
- You can administer a large dose of Testosterone at one time.
Cons:
- You must use a longer and thicker needle if you’re injecting into muscle.
- Some literature indicated that repeated and long term IM injections in the same location can cause scar tissue.
Subcutanaeous TRT Injections (SQ) also referred to as “SubQ”
How To Read Dosing on an Insulin Syringe
This technique involves injecting testosterone into the fatty tissue just below the skin. Here is detailed step-by-step guidance on how to administer testosterone using the Subcutaneous injection (SQ) method.
Prior to drawing your medication, make sure you understand your dose, and identify how much medication you will be drawing into the syringe.
Here is a detailed step-by-step guide on how to administer testosterone using the Subcutaneous injection (SQ) method:
- Gather Supplies:
- Testosterone vial: Ensure it is properly stored, and not refrdgerated.
- Syringe and needle: Use an insulin needle for SQ injections. These are typically 31 gauge 5/16″ needles with 50 or 100 unit syringes.
- Alcohol swabs: Sterilize the injection site and vial top.
- A proper container for safe needle disposal.
- Prepare the Injection Site:
- Choose the injection site: Common sites for SubQ injections include the abdomen, upper thigh, deltoid, glute, triceps, or upper outer arm
- Clean the injection site with an alcohol swab in a circular motion and allow it to dry.
- Draw the Testosterone:
- Remove the cap from the testosterone vial and clean the rubber stopper with an alcohol swab.
- Pull back the plunger of the syringe to draw air into it equal to the desired testosterone dosage.
- Insert the needle into the vial, turning it upside downt, and inject the air into the vial.
- While keeping the vial upside down, draw the required testosterone dosage into the syringe.
This step might feel time consuming, but as you can see in the video below it can be done in under 1 minute.
- Administer the Injection:
- Hold the syringe like a pencil with a comfortable grip.
- With your other hand, pinch a fold of skin at the cleaned injection site.
- Insert the needle directly into the subcutaneous tissue.
- Slowly push the plunger to inject the testosterone.
- Once the dose is administered, withdraw the needle from the subcutaneous tissue.
- Release the pinched skin fold.
- After your Injection:
- Grab your alcohol pad, place it on the injection site and using your 2 fingers apply gentle pressure in a circular motion.
- Dispose of the used needle and syringe in a sharps container or equivalent.
- If necessary, use a band-aid or sterile adhesive to cover the injection site.
- Observe the injection site for any adverse reactions or bleeding. *Never store your injectable medications and injection supplies in a bathroom.
SQ injections are perfect for more frequent doses of smaller amounts of Testosterone. It is also ideal for those that are too immobile to actually reach the muscle tissue on their body. Modifyuing your injection frequency is not always a personal preference and should be addressed with your physician.
Pros
- Generally no pain at all.
- Rarely leaves a bruise or lump.
- You have more accessible injection sites, such as abdomen, upper thigh, glute, triceps, deltoids etc.
Cons:
- You are limited as to the amount of Testosterone you can administer. Typically injections exceeding 25 units of oil based medciation may cause a small lump.
- This may require more frequent injections to get the weekly dose you need.
Can be slow to draw the medcation into the needle. See video here:
Are You Using The Right Size Needle ?
The pharmacys usually provides a ⅝” or 1″ needle length for intramuscular testosterone injections.
They determine this by
- the prescribed injection frequency
- the type of medication (ex. oil base or water base)
- volume of medication being injected (ex. is the patient injecting 10 units a day, or is the patint prescribed to inject 100 units once weekly)
Daily injections require the smallest amout of medication, therefore a 5/16″ insulin needle is useable.
Twice weekly injections typically require a shallow intramuscular injection, and a 5/8″ to 1″ needle is suffice.
A single weekly injection is rarely prescribed, but it would typically require a longer needle such as 1 -1/4″ to 1 – 1/2″.
The needle length it is proportionate to the volume of oil you’re prescribed to inject.
A ⅝” or 1″ length needle is universally ideal for any size man, in all intramuscular locations.
Please disregard any online content suggesting you need a 1 – 1/2″ needle for intramuscular injections.
Those needle lengths are commonly used by individuals using very high doses of unprescribed androgenic anabolic steroids.
Subcutaneous vs. Intramuscular Injections
TRT patients are routine and consistent with their dosing and therefore needle length does not affect testosterone absorption in any significant way.
Will The Needle Length Affect The Absorption of My Medication
Using the wrong size needle can certainly affect how your medication becomes absorbed.
Any injection site swelling or scar tissue can reduce or slow the absorption of your medication.
Swelling usually occurs when the patient injects too much medication at once.
If a patient is prescribed 0.4mL twice weekly and he attempts to use a 5/16″ insulin needle for his injections – this will cause swelling and irritation. This is too much medication / too shallow of an injection.
We had patients come to us from other clinics who reported they were provided 18 or 20 gauge needles. That is excessive thick and typically only used for drawing medication. This led to scar tissue, which did affect medication absoprtion.
Whether a patient is injecting intramuscular or subcutaneous, we recommend 25-31 gauge needles. These are thin and not known to cause scar tissue.
Other Things to Know
Whether you perform a deep intramuscular, subcutaneous, or sub dermal, it makes no difference in total dose / medication uptake, but it can affect the absorption speed.
The absorption speed (how fast it gets to the bloodstream) bears little significance in TRT since it does not affect half life.
The 5/16” Insulin Needle
There is no exact number for everyone, but we find most men cannot subcutaneously inject more than 15-20 units (30-40mg) at a time without experiencing minor swelling.
The ⅝” or 1″ Intramuscular needle
A ⅝” or 1″ needle is ideal for all size men, and oil based and water based medication volumes under 1mL.
Best Videos On Intramuscular & SQ Stomach Injections
The Sweet Spot For Glute Injections
The Ventrogluteal Injection Site Anatomy
Glute Injection ,Buttock injection – Everything You Need To Know – Dr. Nabil Ebraheim
How To Inject Your TRT
How To Perform A 100% Painless Thigh Injection – by Nurse Scott
How To Do A Pain Free Deltoid Injection – Full Guide and Demonstration
A Basic Glute Injection