Categorized | Research

New Study: Subcutaneous Administration of Testosterone Safe, Effective Alternative to IM Injections

Posted on October 24, 2013 by

In North America, the leaflet that comes with injectable testosterone says that T should only be injected intramuscularly, but a growing number of endocrinologists are recommending subcutaneous injections as a convenient, effective alternative.

Subcutaneous injection vs. IM injection - TestosteroneWhat Are Subcutaneous Injections?

aka. SC, SQ, sub-cu, sub-Q or subcut.

The difference between sub-q and IM injections is basically the depth of the injection. A subcutaneous injection is administered into the layer of skin directly below the dermis and epidermis, with a depth of 4-8mm (0.15″-0.2″), while an IM injection is administered into muscle, with a depth of at least 2.5cm (1″.) Subcutaneous injection sites include belly, upper arms, and thighs.

Ryan Sallans has a helpful video demonstrating how to do a sub-q testosterone injection:

YouTube Preview Image

The Case for Sub-Q

In a study initiated by the well-known endocrinologist, Dr. Norman Spack, researchers sought to assess the safety and absorption of subcutaneous testosterone therapy in FTM trans men and hypogonadal cis gender men. They found subcutaneous administration of testosterone to be a safe, effective, and affordable alternative to IM injection.

T levels were well within the therapeutic range varying from 320-824 ng/dL (mean 608± 82SE). No adverse reactions at the site of injection or otherwise were reported or observed. The injections were easily self-administered except for one patient who was blind. Initial data from our study are promising regarding the SC administration of T. SC T was well tolerated and produced therapeutic serum concentrations at doses generally lower than required for IM injections. These data will provide a foundation for additional studies of pharmacokinetics, efficacy and safety to hopefully characterize SC T as a safe, convenient, and affordable alternative to IM injections.
Source: Evaluation of the efficacy of subcutaneous administration of testosterone in female to male transexuals and hypogonadal males.

Also see: Subcutaneous Testosterone: An Effective Delivery Mechanism for Masculinizing Young Transgender Men
Olson, Johanna, Schrager, Sheree M., Clark, Leslie F., Dunlap, Shannon L., and Belzer, Marvin. LGBT Health. Ahead of print. doi:10.1089/lgbt.2014.0018. June 26, 2014

Benefits of Sub-Q

  • Stable T levels often at doses lower than required for IM injections, reducing patient drug costs.
  • Injections are more easily self-administered than IM injections. Not just a convenience, self-administered injections are also a money saver for those who have been paying to have injections administered at a clinic.
  • Shorter needles used with subcutaneous injection are ideal for trans teens, with their smaller musculature.
  • No build up of muscular scar tissue as with IM injections.
  • No risk of sciatic nerve injury from dorsogluteal IM injections.

It’s likely that more and more trans guys will be employing sub-q administration of T, particularly those starting HRT as teens. However, more studies investigating absorption rate, half-life, conversion to Estriadol, and affect on DHT levels are still needed to solidify these latest findings.

What type of testosterone do YOU use? Log your answer in the community survey.

Last updated: 07/12/14

Like this post? Subscribe to the RSS feed to get notified when new content is published. You can also subscribe via email.

Translate: German | Spanish | French | Italian | Portugese | Japanese | Korean | Russian | Chinese Traditional

4 Comment(s)

  1. Mark R. Says:

    Another new learning. I think I agree with the new study that Sub Q is better than IM. Will be sharing this to my friends especially those who are taking testosterone. Thanks!

  2. Devon Says:

    The link to the study is broken. The correct one is below. I also found two earlier, larger studies but these did not include tansmales.

  3. Joshua Riverdale Says:

    Thank you for the updated link!

  4. Devon Says:

    Forgot to mention, the guy in the video uses the same 22ga injection needles. But one advantage of this technique is that you can use a smaller 30ga 1/2″ needle which is tiny and less painful even compared to a 25ga. The small size is also less intimidating to me. This is the same as people use for daily insulin.

    It’s a little slow due to the thickness of the oil, but in a way that’s a good thing as it allows the oil to disperse as you’re injecting rather than blowing a pocket of oil into the tissue. It’s helpful to warm the T to body temp (e.g. put the bottle under your arm for a few minutes).

    It’s so painless that I started injecting half the dose in one site and half in another site rather than all in one site. Since the oil is spread out, there’s less irritation and less of a bump.

    “I’m not a doctor, nor do I play one on TV”

1 Trackback(s)

  1. What are you thinking? - Page 408 - Empty Closets - A safe online community for gay, lesbian, bisexual, transgender people coming out Says::

    […] ask my doc about it if i remember next month mmm yeah tho it seems subQ can be in the upper arms New Study: Subcutaneous Administration of Testosterone Safe, Effective Alternative to IM Injections … and yeah i was initially interested in subQ cuz it wouldn't have the issue of scar tissue like […]

Leave a Comment