Subcutaneous (subq) testosterone injection is a method of self-administering testosterone for hormone replacement therapy (HRT) or other medical conditions. This involves injecting into the fatty tissue just beneath the skin. The subcutaneous route offers convenience for self-administration and reduced discomfort compared to intramuscular injections, allowing slow, steady absorption into the bloodstream.
Optimal Subcutaneous Injection Sites
Optimal subcutaneous testosterone injection sites have sufficient fatty tissue to ensure proper absorption and minimize risk to nerves or blood vessels. The most commonly recommended locations include the abdomen, the outer thighs, and the back of the upper arms.
For abdominal injections, select an area one to two inches from the belly button and avoid the waistline. This region is often preferred due to its accessibility and ample fatty tissue, avoiding major blood vessels or nerves. When using the thighs, the outer middle third of the thigh is chosen, one hand-width above the knee. The back of the upper arm, three inches below the shoulder and above the elbow, is also suitable. The upper buttocks or “love handle” area can also be used.
Factors for Choosing an Injection Site
Within these optimal areas, choose a spot where skin can be pinched to create a fold of one to two inches of fatty tissue. This ensures the medication is delivered into the subcutaneous layer and not into muscle. Avoid injecting into moles, scars, bruised areas, or discolored, swollen, or irritated skin.
Rotating injection sites is important for safe, effective long-term administration. Consistently using the same spot can lead to complications such as lipohypertrophy (fatty lumps or thickened skin) and scarring. Site rotation also helps ensure consistent absorption of the medication and reduces discomfort or tissue damage. Record past injection sites to aid rotation.
Preparing and Administering the Injection
Wash hands with soap and water. Gather supplies: testosterone vial, syringe, separate needles for drawing and injecting, alcohol swabs, and a sharps disposal container. Check the testosterone vial’s expiration date and inspect the liquid for particles or discoloration. Allow the medication to warm to room temperature, which can help reduce injection discomfort.
To draw medication, wipe the vial’s rubber stopper with an alcohol swab and let it air dry. Pull back the syringe plunger to draw air equal to the prescribed dose, then insert the needle into the vial and inject the air. Invert the vial to withdraw the precise dose, tapping the syringe to remove air bubbles before removing the needle. Clean the chosen injection site with an alcohol swab and allow it to dry.
Pinch a fold of skin at the cleaned site between your thumb and index finger. Hold the syringe like a pencil and, with a quick, dart-like motion, insert the needle into the pinched skin at an angle between 45 and 90 degrees, depending on the amount of fatty tissue. Slowly push the plunger until all medication is injected. After injecting, release the pinched skin and smoothly withdraw the needle. Immediately dispose of the used syringe and needle in a sharps container.
Post-Injection Care and What to Watch For
After removing the needle, apply gentle pressure to the injection site with a cotton ball or gauze for a few seconds; avoid rubbing. Minor, temporary side effects at the injection site are common, such as slight bruising, redness, mild pain, itching, soreness, or a small bump or lump. These reactions usually resolve within a few days.
Monitor for signs of more serious complications. Watch for increasing redness, pain, warmth, or swelling at the injection site, the presence of pus or fluid, or a fever, as these can indicate an infection. Be aware of severe allergic reaction symptoms, which may include a spreading rash, hives, swelling of the face, lips, tongue, or throat, difficulty breathing, wheezing, chest pain, or dizziness. If severe symptoms occur, or if minor side effects worsen or persist beyond a few days, seek prompt medical attention.