You and your physician have chosen to use an injectable form of Testosterone to treat your testosterone deficiency. Many people are apprehensive about the injection. The first thing to remember is that the injection is to be done slowly, easily to minimize the discomfort of the injection process. The second is that the area you are going to inject is a large mass of muscle or fat, and that you should have little to no concern about “hitting something important.”
Testosterone Injection Instructions
Back to full listPreparation
Preparing the syringe
If you were given syringes with the needle attached, the syringe should also have markings that divide it into areas marked 0.1 intervals. The syringe should come with or be attached to a needle that is 22-gauge up to a 25-gauge needle.
For those that received the needles and the syringes in separately sealed packages, you will need to put the two pieces together yourself. You need to remove the syringe from the package being careful not to touch the exposed tip of the syringe to your fingers or other objects. Next remove the needle from its package being careful not to touch the exposed open (not the sharp end) of the needle. Take the open end of the needle (not the sharp end) and screw it tightly onto the end (the tip) of the syringe.
Withdraw the testosterone
The testosterone is in an oil, which makes it thick and hard to draw into the syringe. Keeping the testosterone in the medicine cabinet (and not in a refrigerator), or by rolling the vial between your palms for a few minutes, makes it the easiest to withdraw. Remove the cap from the top of the testosterone vial. Cleanse the rubber 6 with a sterile alcohol swab. We recommend that you simply buy cotton balls and a bottle of rubbing alcohol, as it is the least expensive way, and will take you a long time. Remove the hard plastic covering from the needle and draw as much air into the syringe as you are prescribed to withdraw of the testosterone. Insert the needle into the rubber top of the testosterone vial. Injecting the air into the vial will keep the vial from building up a vacuum and making it more difficult in the future to withdraw the testosterone. Invert the vial and syringe while keeping the needle below the fluid line. Pull back on the plunger to the dose recommended. The testosterone is very thick and will draw into the syringe slowly, a drop or small stream at a time. Remove more than the amount that you were prescribed by a few 1/10s of a milliliter and then inject back into the bottle until you have the top of the plunger at the mark prescribed. In this way, any air that was in the syringe has now gone back into the vial. Remove the needle from the vial and confirm that the dose that you have been prescribed is the same as that in the syringe. Recap the needle.
Injecting
Inject the needle: “The needle only goes where the alcohol goes first” In other words, before the needle touches the top of the testosterone vial or the skin in the area you are going to inject, both areas must be wiped with alcohol and the alcohol allowed drying. It is the drying action of the alcohol that causes the bacteria to die. Use a cotton ball and alcohol to cleanse this AREA, where you will be injecting.
Intramuscular Injections
Locate the spot: “If you cannot see the needle, do not inject.” This is a simple rule you are taught to prevent you from injecting the sciatic nerve, the major nerve of your leg and controls movement and sensation. By putting your hand as though it were in your back pocket so that your hand is as far towards the middle of your butt as possible, this area is the area that you DO NOT WANT to inject into, as this is where the sciatic nerve travels. However, by simply noting on your hand where your thumb and forefinger meet, this outlines the area into which it is safe and easy to inject. You notice that this area is what we call the upper outer quadrant of the butt. If you have questions about whether you are in the correct location, then have a health professional show you. You may also view the injection area online at www.spotinjections.com and view under the “GLUTE” tab.
Remove the cap from the needle and using the same hand as the side of you are injecting into, place the tip of the needle against the skin at a 90-degree angle to the skin (that is, point it straight in) and slowly increase the pressure inwards until the needle goes through the skin and into the muscle below. Inject the testosterone slowly into the muscle. While holding the plunger down, you pull the needle from the area and recap the needle with its hard plastic covering. Cleanse the injection site with the alcohol swab and apply a Band-Aid if necessary. There may be a bit of bleeding after the injection, but this is usually just a few drops or a small stream down the butt, which stops quickly. If you continue to bleed, notify your physician, or go to the nearest emergency room.
Subcutaneous Injections
If you are instructed to inject subcutaneously, this means that you will be injecting fat just below the skin. This method is not used for testosterone over 0.2mLs. The fat around your midsection is the easiest to inject. Simply put the tip of the needle anywhere a few inches away from the belly button. Keeping the needle at a 45-degree angle to the skin, push the needle slowly through the skin and keep inserting until about ½ inch is under the skin and into the subcutaneous fat.
Inject the needle: “The needle only goes where the alcohol goes first” In other words, before the needle touches the top of the testosterone vial or the skin in the area you are going to inject, both areas must be wiped with alcohol and the alcohol allowed drying. It is the drying action of the alcohol that causes the bacteria to die. Use a cotton ball and alcohol to cleanse this AREA, where you will be injecting. Remove the cap from the needle and using the same hand as the side of you are injecting into, place the tip of the needle against the skin at a 90-degree angle to the skin (that is, point it straight in) and slowly increase the pressure inwards until the needle goes through the skin and into the muscle below. Inject the testosterone slowly into the muscle. While holding the plunger down, you pull the needle from the area and recap the needle with its hard plastic covering. Cleanse the injection site with the alcohol swab and apply a Band-Aid if necessary. There may be a bit of bleeding after the injection, but this is usually just a few drops or a small stream down the butt, which stops quickly. If you continue to bleed, notify your physician, or go to the nearest emergency room.
Disposal
Never use a needle and syringe more than once. They get dull after one injection and if used twice increases not only your pain, but also it increases the chance of getting an infection.
Dispose of the needle and syringe appropriately. Most pharmacies that dispense the needles will also have a needle container you may use, and once full, that pharmacy should have a place to dispose of your used needles and syringes. You may also get needle disposal kits online at www.wastemd.com or on Amazon, as they both have an online service.
Warning
If you develop redness, pain and swelling over the injection area, an infection may have developed from improper handling of the needle or improper injection technique. Although uncommon, it does occur and may need to be treated with a procedure that cuts open the area and drains the infection out along with receiving IV antibiotics and being admitted to a hospital. Consult your physician at once or go to your local Emergency Room.
If you do not follow the instructions as laid out above or you inject into the area over which your hand covered (inner upper quadrant), then you may injure the sciatic nerve and this could lead to numbness, weakness and even paralysis of the leg (although extremely rare). Consult your physician at once or go to your local Emergency Room. If you develop acne, irritability, aggressive behavior, breast development, or difficulty with urination, please consult your physician.