How to safely and effectively do an intramuscular testosterone injection

Wash your hands thoroughly with soap. Hand washing is one of the most important things you can do to prevent infection.

Where to inject testosterone medication?

Option 1 (Recommended) – Gluteus Maximus muscle in the buttocks: 

We recommend injecting into the glute injection site as it is normally the most comfortable area to inject into, with very little discomfort during and after injecting. It is also one of the safest areas to inject, with a very low likelihood of crossing a vein or nerve. 

Where to inject testosterone into buttocks?

You should aim to inject on either buttock at the top corner furthest away from the spine.

Glute intramuscular testosterone injection site

Option 2 – Vastus lateralis muscle in the thigh: 

• This injection site is sometimes slightly more uncomfortable than the Gluteus Maximus to inject into, but some people find it easier to see and administer the injection because it is in front of them rather than to the side/back.
• Look at your thigh and divide it horizontally into 3 equal parts. The injection will go in outer middle third.
• Form a V with your fingers by separating your first finger from the other 3 fingers. Place the heel of your hand on the bone (femur) that ends before the knee bends and aim the injection right above the V in the centre of the thigh.
• An easier way to find it - its where the pocket of your jeans would be. Don't do it on the TOP of your thigh, on the sides a bit.

Step 3: Preparing the Injection Dose

• Open the syringe package carefully, taking care not to touch the open end of the syringe against anything, including your hands.
• Open the 18G needle package carefully, taking care not to touch the open end of the needle against anything, including your hands. Screw the 18G needle onto the end of the syringe.
• Pull the 18G needle cover straight off the needle. Do not let the needle touch any surfaces.
• Insert the injection needle (not the 18G needle) into the rubber vial, flip the vial and pull back on the plunger.
• Slowly pull back on the plunger to fill the syringe with the medication to the number (ml or cc) that matches the dose your doctor has prescribed.
• Withdraw the needle from the ampoule and turn the syringe upside down so you can check for air bubbles in the syringe. If there are air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe. Pull back on the plunger slightly, then push the plunger up to remove air. Take care not to touch the needle with you fingers or against any surfaces.
• Switch the fill needle to an injection needle if you are drawing from an ampoule.
• You should leave the needle cover on until you are ready to give the injection.
• Repeat the process to fill more syringes if you need to.

Step 4: Give the Testosterone Injection

• Clean the injection site skin with an alcohol swab; let it air dry.
• Gently hold the skin around the injection site so that the skin is slightly taut.
• Insert the IM needle into the muscle at a 90 degree angle with one quick and firm motion.
• After inserting the needle into the muscle take your hand off the skin.
• Complete the injection by pushing the medication slowly into the muscle. You may feel some mild pressure as the medicine enters your muscle.
• When you finish injecting the full dose of the medication into the muscle, remove the needle slowly and at the same right angle that you inserted the needle. Sometimes you might see a small drop of blood at the injection site, this is normal and nothing to be alarmed about.
• Gently press an alcohol swab on the testosterone injection site. Hold pressure on site until there is no bleeding. You can place a band aid/plaster on the injection site if needed.

Tips for Reducing Testosterone Injection Pain

• Inject medicine that is at room temperature.
• Let the skin dry after using alcohol wipes before injecting.
• Keep the muscles in the Testosterone injection area relaxed.
• Break through the skin quickly with the needle.
• Don’t change the direction of the needle as it goes in or comes out.
• Do not reuse disposable needles.
• Keep needles in freezer. Cold metal is sharper

For videos on injections google "testosterone injections"