Getting testosterone shots requires a blood test confirming low levels, a doctor’s evaluation of your symptoms, and a prescription. The process typically involves two separate blood draws, a physical exam, and an ongoing monitoring plan once you start treatment. Most people begin by visiting their primary care doctor or a urologist, though endocrinologists and some telehealth clinics also prescribe testosterone.
What Qualifies You for a Prescription
Doctors won’t prescribe testosterone based on symptoms alone. You need both documented low levels on blood work and symptoms that match. The American Urological Association uses a total testosterone level below 300 ng/dL as the diagnostic cutoff, while the Endocrine Society places the lower limit of normal at 264 ng/dL in healthy, nonobese young men. In practice, most clinicians treat the 300 ng/dL threshold as the line.
The key requirement is that you need two separate blood draws on two different mornings, both showing low levels. Testosterone peaks in the early morning and drops throughout the day, so both draws need to happen before about 10 a.m. A single low reading isn’t enough for a diagnosis because levels fluctuate day to day based on sleep, stress, illness, and other factors.
Common symptoms that support a diagnosis include low energy, reduced sex drive, erectile difficulty, loss of muscle mass, increased body fat, depressed mood, and trouble concentrating. If your levels come back low but you have no symptoms, most doctors will hold off on treatment and retest later.
The Step-by-Step Medical Process
Your first visit will typically involve discussing your symptoms and getting a blood order for total testosterone. If that comes back low, your doctor will schedule a second blood draw to confirm. During this evaluation, expect a targeted physical exam that checks body composition, body hair patterns, breast tissue for any enlargement, and testicular size and consistency.
Once two low readings are confirmed, your doctor will order additional blood work before starting treatment. This includes checking your red blood cell concentration (hematocrit) because testosterone can thicken your blood, which carries cardiovascular risks. Men over 40 will also get a PSA test to screen for prostate issues. Your doctor may check a hormone called luteinizing hormone to determine whether the problem originates in the brain’s signaling or in the testes themselves, since this distinction affects the treatment approach.
If you’re interested in having children, bring this up before starting. Testosterone shots suppress sperm production, sometimes significantly. Your doctor should discuss fertility preservation options or alternative treatments that maintain sperm count.
Types of Injectable Testosterone
The two most commonly prescribed injectable forms are testosterone cypionate and testosterone enanthate. They’re nearly identical in how they work, with half-lives of about seven to nine days. Both are typically injected every one to two weeks, though some doctors prescribe smaller, more frequent doses to keep levels steadier and reduce the “roller coaster” effect of peaks and valleys.
Standard dosing ranges from 50 to 400 milligrams every two to four weeks, but your doctor will adjust based on your follow-up blood work. The goal is to bring your total testosterone into the middle of the normal range, not to push it as high as possible.
How Injections Are Given
Testosterone shots are given either intramuscularly (into the muscle) or subcutaneously (under the skin). Intramuscular injections go into the buttock, thigh, or deltoid muscle. Subcutaneous injections are typically given into the abdominal fat. Many doctors now offer subcutaneous as an option because patients find it more comfortable, using a shorter, thinner needle.
Most people learn to self-inject at home after their doctor or nurse demonstrates the technique during an office visit. You’ll rotate injection sites to avoid irritation or scar tissue buildup. If self-injecting isn’t something you’re comfortable with, you can schedule regular office visits for a nurse to administer the shot, though this is less convenient for injections needed every week or two.
What Happens After You Start
Your doctor will check your testosterone level after you’ve been on treatment long enough for levels to stabilize, typically a few weeks in. This first follow-up confirms whether your dose needs adjusting. After that, expect blood work every 6 to 12 months for as long as you’re on therapy.
The most important marker your doctor will track is hematocrit, the percentage of your blood made up of red blood cells. Testosterone stimulates red blood cell production, and levels above 54% increase the risk of blood clots. If your hematocrit climbs too high, your doctor may lower your dose or have you donate blood to bring it down. Estradiol (a form of estrogen) is checked if you develop breast tenderness or swelling, but it’s not routinely required for everyone.
If your testosterone levels normalize but your symptoms don’t improve within three to six months, your doctor should discuss whether continuing treatment makes sense. Low testosterone isn’t always the cause of the symptoms people attribute to it, and staying on unnecessary therapy exposes you to risks without benefit.
Where to Go and What It Costs
You have several options for getting started. A primary care doctor can diagnose and prescribe testosterone. Urologists and endocrinologists specialize in hormonal conditions and may be more experienced with dosing and monitoring. Telehealth clinics that focus on hormone therapy have become widely available, though quality varies. Planned Parenthood also offers hormone therapy at many locations, often on a sliding scale based on income.
Cost depends heavily on insurance. Many health plans cover testosterone injections when prescribed for a documented medical diagnosis, though you may still owe a copay. Generic testosterone cypionate is one of the least expensive options. Without insurance, the medication itself can range from roughly $30 to $100 per month depending on your pharmacy and dose, but you’ll also need to factor in the cost of blood work and office visits. Some clinics bundle everything into a monthly fee. If cost is a barrier, ask your doctor about generic options and check prices at different pharmacies, since they can vary widely.