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B, Total testosterone concentrations after intramuscular (IM) and SC administration of testosterone enanthate in 14 transgender men (24). A, Mean trough concentrations of testosterone in hypogonadal men on weekly 75 mg subcutaneous (SC) testosterone enanthate (29). Commonly used testosterone esters include testosterone enanthate (7 carbons side chain), cypionate (8 carbons), and undecanoate (11 carbons). In this review, we summarize the published data on the pharmacokinetics and safety of SC administration of both long-acting (enanthate and cypionate) and ultralong-acting (undecanoate) testosterone esters in hypogonadal and transgender men. With appropriate training, patients should be able to safely self-administer testosterone esters SC with relative ease and less discomfort compared with the IM route. Massey Drugs supports men’s health clinics with dependable compounded testosterone therapy designed for consistent dosing and patient adherence.
During week 7 of the study, the dose of testosterone was either reduced to 50 mg/week or increased to 100 mg/week with the aim of maintaining on-treatment serum testosterone levels within the normal range (27). In another study, 150 hypogonadal men were started on SC testosterone enanthate 75 mg/week for 52 weeks, which was administered via a novel SC autoinjector (27). In 2006, a pilot study demonstrated the feasibility of the SC route as an effective option for testosterone therapy with testosterone esters (23). Recently, after assessing its safety and efficacy, the Food and Drug Administration approved an autoinjector device for weekly SC self-administration of testosterone enanthate (27, 29). In addition, testosterone therapy is used for gender-affirming (hormone) therapy for transgender men to induce masculinization (and suppress endogenous estradiol concentrations in patients with intact ovaries) (2).
Therefore, the pharmacokinetics of testosterone esters administered via IM vs SC route will vary according to the lymphatic circulation of the tissue. Unmodified testosterone has a half-life of 10 minutes; to overcome this limitation, testosterone is esterified and then dissolved in oil to allow for sustained release into the circulation after injection. Indeed, this might explain the observation that IM injections are less painful in overweight and obese men (34). More recently, newer formulations of testosterone replacement have become available, which include ultralong-acting testosterone undecanoate for IM injection, transdermal patches and gels, buccal tablets, intranasal sprays, and oral testosterone undecanoate (Table 1), thus providing a range of options to choose from. Currently, testosterone therapy is indicated for men with unequivocal, organic, or pathologic androgen deficiency to alleviate symptoms and maintain secondary sexual characteristics by raising testosterone into the normal male range (1). In addition, we provide guidance for clinicians on how to counsel and manage their patients who opt for the SC route. Injections with intramuscular (IM) testosterone esters have been available for almost 8 decades and not only result in predictable serum testosterone levels but are also the most inexpensive modality.
Continue to rotate the injection area from one glute to the other. Most testosterone users eventually self-inject when they realize that the process is (usually) painless. A problem with injection into the glute is that many people lack flexibility and coordination and cannot turn to their side far enough to reach the glute. The ideal spot to inject testosterone is 2 to 3 inches beneath the iliac crest.
If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal. Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. Injections deliver testosterone directly into the bloodstream, resulting in faster, stronger effects compared to other methods. Certain medical issues can cause an increased risk of serious reactions and could influence the safety and effectiveness of your treatment. If you feel any shortness of breath, chest tightness, or dizziness after injecting, you must contact a nurse immediately. Many of these symptoms are conditions that would be treated easily with medical care, but it’s still important that you are aware of the possible side effects of this sort of treatment. Before injecting, clean the site thoroughly with an alcohol swab to minimise the risk of infection.
Hair loss is a common concern among male patients and often requires individualized topical therapy. Whether managing testosterone replacement therapy (TRT), erectile dysfunction, hair loss, or acne, our team provides practical compounding solutions designed to support adherence, clinic workflow, and patient outcomes. As always, if you’re unsure, consult a healthcare professional before starting self-injection routines.

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