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How to Inject Testosterone Intramuscularly, Shallow IM or Subcutaneously ?
How to Inject Testosterone Safely
The following information was taken from the book: Testosterone: A Man's Guide
How to Inject Testosterone Safely
Some men prefer testosterone injections because of the convenient dosing and/or they report feeling much better when using injections versus gels. Sometimes their insurance companies only pay for injections. Men without health insurance also tend to use injections since they are a lot cheaper than gels. If your doctor empowers you to self-inject at home, it will be more convenient and possibly cheaper (some physicians charge for the office visit). I tell men that they can always switch from gels to injections and vice versa depending on what they learn as they optimize their testosterone replacement.
So you've decided to go with injectable testosterone. Your decision may arise out of your realization that you won't remember to make daily use of the gels. It may have made the choice because your insurance company refuses to pay for anything but the injectable. If your doctor is letting you self-inject there are some things for you to know:
• Keep it safe. Sharing used needles with another person is a definite no. And this goes for the syringes too. You can contract all kinds of diseases including hepatitis B and C, and HIV. Doctors give you a prescription for syringes and needles for a reason. There is no need to risk ruining your health. Don't even think about re-using your own syringes and needles. Unclean needles and syringes can cause infections. Buy a “sharps” container and put your used needles and syringes in it. These containers are available at most pharmacies. Those using underground testosterone usually have the most difficult time trying to find syringes since pharmacies won't provide supplies without a prescription. .
Keep it moving. Try not to inject into the exact same area more than twice a month. Vigorously massage the area after you've injected. This helps reduce pain.
Keep it clean. Wash your hands before starting. Clean the area to be injected using an alcohol swab. Clean the top of the testosterone vial with an alcohol swab before you insert the needle to draw the product. The alcohol swabs are available at most pharmacies and do not require a prescription.
Keep it sharp. Use a new needle every time. I personally like using smaller gauge needles (18 gauge, 1 inch) which are bigger in size, to draw the testosterone from the bottle. I then use a new larger gauge needle, which is smaller in size (23 gauge, 1 inch) when injecting. The reason for this is that after a needle is used once, it loses its sharpness. Injections with dull needles hurt a lot more. I ask the pharmacist to sell me several 18 gauge needles without syringes for drawing the testosterone, plus the same number of 23 gauge, 1 inch, 3 ml syringes. Some doctors think that it is difficult to inject through a thin needle of this size, but I have done it for years without any such problems. I would rather take a little longer injecting than having to endure the pain caused by using a thicker needle.
• What to look for before injecting.
o Expiration dates
- Check the expiry dates of every product.
o Waste
- Make sure that contaminated waste is disposed of
safely. Ask your pharmacist to sell you a plastic sharps container.
Materials needed
Vial with required testosterone, 20-23 gauge syringe with a capacity of 3 ml and a needle length of 1-1.5 inches, an extra 18 gauge needle for drawing testosterone into the syringe, two alcohol swabs.
Guide to Injecting Testosterone:
1. Wash your hands (with a disinfectant/anti-bacterial soap).
2. Layout your vial of testosterone, needle and/or syringe, alcohol wipes and tissue on a clean surface (e.g. a clean towel, paper towel, etc).
3. Sit down and get comfy.
4 Change the 23 gauge needle that comes with the syringe for an 18 gauge one for drawing testosterone from the vial. Set aside the 23 gauge needle for injecting later.
5 Unseat/loosen the cap from the needle. Leave the cap on loose until ready to draw the testosterone. Remember not to touch the needle! Wipe off the “nipple” on the top of the vial with an alcohol wipe.
6 Remove the cap of the needle without touching the needle or the needle touching anything. Draw around l cc of air into the syringe by pulling back on the plunger.
7 Up-end the testosterone vial.
8 Insert the needle through the center of the neoprene nipple.
9 With the needle tip immersed in the fluid, slowly depress the plunger, pushing all of the air into the oil (you'll see the bubbles). After all the air is out of the syringe, slowly pull back on the plunger until the proper amount of testosterone is drawn into the syringe.
(Not everyone's dosage is the same. Check your prescription or consult with your physician or pharmacist for the correct amount. Some will inject more than l cc, some less.)
10 You may need to “pump” the plunger to get a complete fill. As long as you don't remove the needle, you can let the fluid go in and out as much as needed.
11 When you have the correct amount in the syringe, gently pull the needle out of the vial.
12 Draw a small amount of air into the syringe—one very small bubble.
13 Slip the needle back into the cap if you want to take a break before injecting. (It's really important not to touch the needle itself at any point.)
14 Change the needle to a 23 gauge one
15 Pick an injection site on your thigh or buttocks (see Figure). You'll want to alternate sites, so remember which site you last injected. For your thigh, target the spot by placing one hand just about at your knee and the other at your hip—the area in between is pretty much fair game. The best area is the outer part of the quad, so stay to the outside of the midline of your thigh, but not too far to the outside/underside. The buttocks are slightly more tricky—both to reach and to isolate the exact spot. Talk to your physician or nurse about the exact location.
16 Clean the injection site with an alcohol wipe.
17 Wipe in a circular motion, to a circumference of about two inches surrounding the injection site. Allow the skin to dry to prevent the alcohol from being introduced into the muscle as the needle is inserted, causing pain or burning. Remember not to touch the area just cleansed with the alcohol wipe.
Uncap the needle—remember not to touch the needle or the swabbed area on your thigh. The air bubble should be near the plunger end of the syringe.
18. Go to it and stick it in! Fast or slow, either is fine. Pierce the skin at a 90-degree angle. It must go through the subcutaneous tissue/fatty tissue and deep into the muscle.
19 If using a 1” needle, stop about 1/8” from the base; if using a 1.5” needle, stop about 1/4” from the base. (This is true for average-sized bodies. Talk with your physician about the appropriate needle length for your body.)
20. After the needle has been inserted, aspirate by holding the barrel of the syringe steady with your non-dominant hand and by pulling back on the plunger with your dominant hand. You'll see some air bubbles in the testosterone. If there's just air/clear fluid—no
blood—then it's ok to proceed. If there is blood, either push the needle in or pull the needle back a little and pull back on the plunger again, or pull the needle out and start over.
21 Holding the syringe steady, inject the testosterone steadily and slowly by depressing the plunger until all of the testosterone is injected. The air bubble in the syringe should follow the testosterone and will “pack” the testosterone down into your muscle. There will be a slight “pop” as the bubble leaves the syringe.
22 Pull the needle out—again, slow or fast depending upon your preference. (I think it's usually best to pull out slow. Sometimes the injection site may bleed a little when you withdraw the needle, just be prepared to apply some gentle pressure with some clean tissue(s).
23 Slide the needle back into the cap. (Remember DO NOT reseat the cap by pressing the tip of the cap towards the needle's point.) Dispose of your needles properly in what is known as a sharps container (i.e., a needle disposal container).
Once you inject a few times, you should lose begin to lose your fear of injecting. You can also have your partner or good friend inject you if you do not feel comfortable doing so. Your doctor's medical staff can help you develop your technique.
Personal Comment: I think I have great injection technique using my upper glutes but I have experienced the post-injection cough. It is a strange feeling compared to inhaling very cold air that makes you cough and feel out of breath for a few minutes. This probably has happened to me only five times in 16 years of testosterone use When it has happened I find that breathing quickly into a paper bag helps it go away faster. Honestly, I cannot tell you if I used a different injection site since I always use the upper buttock area close to my hip. By the way, I hate injecting in my legs since I think it hurts a lot more and the potential for problems is greater. But some men do not feel comfortable or capable of turning around a bit in front of a mirror to inject in the upper glutes close to the hip. Some have their partners or roommates inject them. Some others go through the trouble of visiting their doctor's nurse to inject. I think independence is important, so learn whatever works for you so that you do not need anyone else to do it for you.
How to Inject Testosterone Intramuscularly, Shallow IM or Subcutaneously ?
How to Inject Testosterone Safely
The following information was taken from the book: Testosterone: A Man's Guide
How to Inject Testosterone Safely
Some men prefer testosterone injections because of the convenient dosing and/or they report feeling much better when using injections versus gels. Sometimes their insurance companies only pay for injections. Men without health insurance also tend to use injections since they are a lot cheaper than gels. If your doctor empowers you to self-inject at home, it will be more convenient and possibly cheaper (some physicians charge for the office visit). I tell men that they can always switch from gels to injections and vice versa depending on what they learn as they optimize their testosterone replacement.
So you've decided to go with injectable testosterone. Your decision may arise out of your realization that you won't remember to make daily use of the gels. It may have made the choice because your insurance company refuses to pay for anything but the injectable. If your doctor is letting you self-inject there are some things for you to know:
• Keep it safe. Sharing used needles with another person is a definite no. And this goes for the syringes too. You can contract all kinds of diseases including hepatitis B and C, and HIV. Doctors give you a prescription for syringes and needles for a reason. There is no need to risk ruining your health. Don't even think about re-using your own syringes and needles. Unclean needles and syringes can cause infections. Buy a “sharps” container and put your used needles and syringes in it. These containers are available at most pharmacies. Those using underground testosterone usually have the most difficult time trying to find syringes since pharmacies won't provide supplies without a prescription. .
Keep it moving. Try not to inject into the exact same area more than twice a month. Vigorously massage the area after you've injected. This helps reduce pain.
Keep it clean. Wash your hands before starting. Clean the area to be injected using an alcohol swab. Clean the top of the testosterone vial with an alcohol swab before you insert the needle to draw the product. The alcohol swabs are available at most pharmacies and do not require a prescription.
Keep it sharp. Use a new needle every time. I personally like using smaller gauge needles (18 gauge, 1 inch) which are bigger in size, to draw the testosterone from the bottle. I then use a new larger gauge needle, which is smaller in size (23 gauge, 1 inch) when injecting. The reason for this is that after a needle is used once, it loses its sharpness. Injections with dull needles hurt a lot more. I ask the pharmacist to sell me several 18 gauge needles without syringes for drawing the testosterone, plus the same number of 23 gauge, 1 inch, 3 ml syringes. Some doctors think that it is difficult to inject through a thin needle of this size, but I have done it for years without any such problems. I would rather take a little longer injecting than having to endure the pain caused by using a thicker needle.
• What to look for before injecting.
o Expiration dates
- Check the expiry dates of every product.
o Waste
- Make sure that contaminated waste is disposed of
safely. Ask your pharmacist to sell you a plastic sharps container.
Materials needed
Vial with required testosterone, 20-23 gauge syringe with a capacity of 3 ml and a needle length of 1-1.5 inches, an extra 18 gauge needle for drawing testosterone into the syringe, two alcohol swabs.
Guide to Injecting Testosterone:
1. Wash your hands (with a disinfectant/anti-bacterial soap).
2. Layout your vial of testosterone, needle and/or syringe, alcohol wipes and tissue on a clean surface (e.g. a clean towel, paper towel, etc).
3. Sit down and get comfy.
4 Change the 23 gauge needle that comes with the syringe for an 18 gauge one for drawing testosterone from the vial. Set aside the 23 gauge needle for injecting later.
5 Unseat/loosen the cap from the needle. Leave the cap on loose until ready to draw the testosterone. Remember not to touch the needle! Wipe off the “nipple” on the top of the vial with an alcohol wipe.
6 Remove the cap of the needle without touching the needle or the needle touching anything. Draw around l cc of air into the syringe by pulling back on the plunger.
7 Up-end the testosterone vial.
8 Insert the needle through the center of the neoprene nipple.
9 With the needle tip immersed in the fluid, slowly depress the plunger, pushing all of the air into the oil (you'll see the bubbles). After all the air is out of the syringe, slowly pull back on the plunger until the proper amount of testosterone is drawn into the syringe.
(Not everyone's dosage is the same. Check your prescription or consult with your physician or pharmacist for the correct amount. Some will inject more than l cc, some less.)
10 You may need to “pump” the plunger to get a complete fill. As long as you don't remove the needle, you can let the fluid go in and out as much as needed.
11 When you have the correct amount in the syringe, gently pull the needle out of the vial.
12 Draw a small amount of air into the syringe—one very small bubble.
13 Slip the needle back into the cap if you want to take a break before injecting. (It's really important not to touch the needle itself at any point.)
14 Change the needle to a 23 gauge one
15 Pick an injection site on your thigh or buttocks (see Figure). You'll want to alternate sites, so remember which site you last injected. For your thigh, target the spot by placing one hand just about at your knee and the other at your hip—the area in between is pretty much fair game. The best area is the outer part of the quad, so stay to the outside of the midline of your thigh, but not too far to the outside/underside. The buttocks are slightly more tricky—both to reach and to isolate the exact spot. Talk to your physician or nurse about the exact location.
16 Clean the injection site with an alcohol wipe.
17 Wipe in a circular motion, to a circumference of about two inches surrounding the injection site. Allow the skin to dry to prevent the alcohol from being introduced into the muscle as the needle is inserted, causing pain or burning. Remember not to touch the area just cleansed with the alcohol wipe.
Uncap the needle—remember not to touch the needle or the swabbed area on your thigh. The air bubble should be near the plunger end of the syringe.
18. Go to it and stick it in! Fast or slow, either is fine. Pierce the skin at a 90-degree angle. It must go through the subcutaneous tissue/fatty tissue and deep into the muscle.
19 If using a 1” needle, stop about 1/8” from the base; if using a 1.5” needle, stop about 1/4” from the base. (This is true for average-sized bodies. Talk with your physician about the appropriate needle length for your body.)
20. After the needle has been inserted, aspirate by holding the barrel of the syringe steady with your non-dominant hand and by pulling back on the plunger with your dominant hand. You'll see some air bubbles in the testosterone. If there's just air/clear fluid—no
blood—then it's ok to proceed. If there is blood, either push the needle in or pull the needle back a little and pull back on the plunger again, or pull the needle out and start over.
21 Holding the syringe steady, inject the testosterone steadily and slowly by depressing the plunger until all of the testosterone is injected. The air bubble in the syringe should follow the testosterone and will “pack” the testosterone down into your muscle. There will be a slight “pop” as the bubble leaves the syringe.
22 Pull the needle out—again, slow or fast depending upon your preference. (I think it's usually best to pull out slow. Sometimes the injection site may bleed a little when you withdraw the needle, just be prepared to apply some gentle pressure with some clean tissue(s).
23 Slide the needle back into the cap. (Remember DO NOT reseat the cap by pressing the tip of the cap towards the needle's point.) Dispose of your needles properly in what is known as a sharps container (i.e., a needle disposal container).
Once you inject a few times, you should lose begin to lose your fear of injecting. You can also have your partner or good friend inject you if you do not feel comfortable doing so. Your doctor's medical staff can help you develop your technique.
|
Personal Comment: I think I have great injection technique using my upper glutes but I have experienced the post-injection cough. It is a strange feeling compared to inhaling very cold air that makes you cough and feel out of breath for a few minutes. This probably has happened to me only five times in 16 years of testosterone use When it has happened I find that breathing quickly into a paper bag helps it go away faster. Honestly, I cannot tell you if I used a different injection site since I always use the upper buttock area close to my hip. By the way, I hate injecting in my legs since I think it hurts a lot more and the potential for problems is greater. But some men do not feel comfortable or capable of turning around a bit in front of a mirror to inject in the upper glutes close to the hip. Some have their partners or roommates inject them. Some others go through the trouble of visiting their doctor's nurse to inject. I think independence is important, so learn whatever works for you so that you do not need anyone else to do it for you.
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