Testosterone injection is a prescription treatment that must match the product, dose, route, injection site and schedule prescribed by your clinician. Testosterone products are not interchangeable. Some are injected into a muscle, while others go under the skin.
Your first self-injection should be supervised or demonstrated by a healthcare professional. The FDA label cited in this guide is dated 2022, and some product instructions require an abdominal injection site at least 2 inches from the navel. If you have not been shown how to inject your specific product, do not guess. Contact your prescriber or pharmacist.
Testosterone Injection at a Glance
| Question | Safe answer |
|---|---|
| Where does it go? | Into a muscle or under the skin, depending on the prescribed product |
| How much should you use? | Only the prescribed dose |
| How often should you inject it? | Follow your prescription exactly |
| Can you use any testosterone vial? | No. Confirm the product name, strength, formulation and expiry date |
| Can testosterone undecanoate be self-injected? | Some products, including Aveed, must be given by trained healthcare staff in a monitored setting |
| Can needles or syringes be reused? | No. Use a new sterile needle and syringe every time |
Before Injecting Testosterone
Gather:
- Your prescribed testosterone
- A new sterile syringe and needle, or the prescribed injection device
- Alcohol swabs
- Clean gauze or cotton
- An approved sharps container
- Your medication instructions
Then:
- Wash and dry your hands.
- Check the medication name, concentration, prescribed dose and expiration date.
- Inspect the solution. Do not use it if it is cloudy, contains particles, has an unusual color according to the product instructions or has expired.
- Prepare the injection on a clean surface.
- Choose the injection site specified by your clinician.
- Do not inject into skin that is red, swollen, bruised, hard, tender, scarred or infected.
Testosterone formulations differ in their route, injection volume and handling requirements. Follow the instructions for your specific product.
How to Give a Subcutaneous Testosterone Injection
A subcutaneous injection goes into the fatty tissue beneath the skin. Some testosterone products are prescribed this way, often in the abdomen. Use the site and device instructions provided for your product.
- Clean the selected area with an alcohol swab and let it air-dry.
- Avoid the navel and the surrounding area. For products that specify abdominal injections, MedlinePlus advises staying at least 2 inches from the navel.
- Pinch a fold of skin and fatty tissue.
- Insert the needle at the angle taught by your clinician or shown in the product instructions.
- Inject the prescribed amount steadily.
- Remove the needle. Apply gentle pressure with clean gauze if there is minor bleeding.
- Put the needle and syringe directly into a sharps container.
- Rotate injection sites instead of using the same spot each time.
Do not inject into muscle when giving a subcutaneous injection. Do not change the needle length, injection angle or dose without professional advice.
How to Give an Intramuscular Testosterone Injection
An intramuscular injection places testosterone into a muscle. Testosterone cypionate, for example, is labeled for intramuscular use. The correct muscle and needle length depend on the product, your body size and your clinician's instructions.
If your clinician has trained you to give the injection:
- Clean the selected site and let it dry.
- Position the muscle as instructed.
- Insert the needle straight into the muscle at the angle demonstrated by your clinician. An intramuscular injection is commonly given at 90 degrees.
- Inject the prescribed dose.
- Withdraw the needle steadily.
- Apply light pressure with gauze if needed.
- Put the needle and syringe directly into a sharps container.
- Record the date, dose and injection site if your clinic recommends keeping a treatment log.
Do not choose a buttock, thigh or shoulder site from an online diagram. A healthcare professional must show you the correct landmark. An incorrectly placed intramuscular injection can injure a nerve, blood vessel or other tissue.
Important Exception: Testosterone Undecanoate
Do not self-inject testosterone undecanoate products such as Aveed unless your healthcare provider confirms that your specific product is approved for home use. Aveed must be administered by trained healthcare staff because serious breathing problems and allergic reactions can occur during or shortly after the injection. Patients must be observed in the healthcare setting for at least 30 minutes afterward.
Safe Needle and Vial Practices
Follow these rules for every injection:
- Use a new sterile needle and syringe each time.
- Never reuse a needle or syringe.
- Never share testosterone, needles or syringes.
- Do not put a used needle back into a medication vial.
- Follow the label instructions for single-dose and multidose vials.
- Discard the medication if its sterility is questionable.
- Put used equipment directly into an approved sharps container.
The CDC summarizes this as one needle, one syringe, only one time. Reusing equipment can contaminate medication and transmit infections, including hepatitis B, hepatitis C and HIV.
When to Seek Medical Help
Contact your prescriber promptly if you develop increasing pain, redness, warmth, swelling, hardness, drainage or fever at the injection site.
Seek emergency care for:
- Trouble breathing, throat tightness, fainting or widespread hives
- Chest pain or sudden shortness of breath
- New leg pain, swelling, warmth or redness
- Severe weakness, confusion or neurological symptoms
- An erection that lasts unusually long
- A needle injury, broken needle or injection into the wrong area
Testosterone treatment also requires medical monitoring. Possible concerns include an increased red blood cell count, blood pressure changes, reduced sperm production, urinary or prostate symptoms, sleep apnea and mood changes. Do not increase the dose or injection frequency for bodybuilding, athletic performance or appearance without medical supervision.