How to do an Intramuscular Testosterone Injection

How to safely and effectively do an intramuscular testosterone injection

Click here to watch a video tutorial

Step 1: Find a comfortable, well-lit working place and clean your work area

  1. Organise your medications and the equipment you will need for injecting so that you have everything ready in front of you.

For example you would typically need:

  • 1 or 2 syringes (1ml)
  • 1 ampoule of testosterone
  • 1 filter needle (18G)
  • 1 injecting needle (23G or 25G, 1 inch length)
  • 1 or 2 alcohol wipes
  • Sharps bin

2. Check the expiration date on the ampoule of Testosterone. Do not use medication with particles, medication that is discoloured or has expired.

3. Wash your hands thoroughly with soap, and dry off with paper towel or kitchen roll if possible.

Hand washing is one of the most important things you can do to prevent infection.

Step 2: Selecting and Preparing the Injection Site

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

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

Glute intramuscular testosterone injection site

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.

Thigh testosterone injection site

Step 3: Preparing the Injection Dose

1. Check the packaging of the syringes and needles you are going to use.

2. If the packaging has been opened or damaged, do not use those syringes or needles.

3. Snap open the ampoule using the ampoule snapper provided. You do this by placing the ampoule into the ampoule snapper, with the dot marking on the top section of the ampoule facing towards you as you close the ampoule snapper.

4. If you do not have an ampoule snapper, you can snap the top off the ampoule with your fingers whilst firmly holding the bottom section of the ampoule, but be careful to mind out for tiny broken shards of glass. Set down the open ampoule on a level surface.

5. Open the syringe package carefully, taking care not to touch the open end of the syringe against anything, including your hands.

6. 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.

7. Pull the 18G needle cover straight off the needle. Do not let the needle touch any surfaces.

8. Keep the ampoule on your flat working surface and insert the needle straight down through the centre of the ampoule.

9. 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.

10. 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. Take care not to touch the needle with you fingers or against any surfaces. Then slowly push the plunger up to force the air bubbles out of the syringe without removing the needle from the bottle. You can leave a little bit of air where the needle meets the syringe which can be pushed out later before you inject.

11. After the air bubbles are gone, remove the 18G needle and replace it with the 25G, 1 inch needle. You should leave the needle cover on until you are ready to give the injection.

12. Check to make sure that you have the correct dose in the syringe. It is very important that you use the exact dose prescribed by your doctor.

Step 4: Give the Testosterone Injection

1. Clean the injection site skin with an alcohol swab; let it air dry.

2. Gently hold the skin around the injection site so that the skin is slightly taut.

3. Insert the IM needle into the muscle at a 90 degree angle with one quick and firm motion.

4. After inserting the needle into the muscle take your hand off the skin.

5. Gently pull back on the plunger of the syringe to check that blood doesn’t come back into the syringe (this is called ‘aspirating’). If you see blood in the needle/syringe, do not inject the medicine and remove the needle immediately. You must discard the medicine and try again with fresh equipment and medicine if blood does come up the needle into the syringe when you aspirate.

6. If you do not see any blood in the needle, you can complete the injection by pushing the medication slowly into the muscle. You may feel some mild pressure as the medicine enters your muscle.

7. 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.

8. 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.
  • Remove all air bubbles from the syringe before injection.
  • 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.

Instructions for Disposing of 'Sharps':

Improper disposal of syringes and other sharp objects can pose a health risk and damage the environment.

Please always dispose of your used syringes and needles using a sharps bin.

The sharps box should then be disposed of in line with the following NHS guidelines –

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