Hey guys,
If you're on TRT, there's a good chance you started with intramuscular (IM) injections. That's how a lot of us were taught to do it.
But here's something I wish I'd known sooner: you don't necessarily have to inject testosterone into muscle.
One of the best changes I've made to my TRT routine was switching to subcutaneous (SubQ) injections.
No more repeatedly sticking what feels like a whale harpoon deep into my glutes. Less pain, fewer issues with scar tissue, and an injection routine I'm not trying to avoid.
And the best part? Research suggests SubQ testosterone can be just as effective as IM for many patients.
What's the difference?
IM injections deliver testosterone into muscle, typically using longer, larger needles.
SubQ injections deliver testosterone into fatty tissue just beneath the skin, often allowing for smaller, shorter needles and a more comfortable experience.
Let's talk needle sizes
Traditional IM injections commonly use 22G to 25G needles, while SubQ injections can use smaller insulin-style syringes, sometimes in the 27G to 31G range.
Here's the trick: the higher the gauge number, the thinner the needle.
| 27G | Generally faster to draw and inject, but potentially more uncomfortable than smaller insulin needles. |
| 29G | A nice middle ground between comfort and speed. |
| 31G | Potentially more comfortable, but considerably slower with thicker, oil-based testosterone. |
The gauges in between let you find what works best for you. And since TRT is often a lifelong routine, you've got plenty of time to dial it in.
Not every needle or testosterone formulation is suitable for SubQ, so work with your provider on the right setup.
But does SubQ actually work?
Here's where it gets interesting.
A 2006 study followed 22 men with low testosterone who used regular insulin syringes for weekly SubQ injections. All 22 achieved testosterone levels within the normal range at the measured peak and trough, and none reported local injection reactions.1
And in a 2023 study of 41 men using testosterone cypionate with 27G, half-inch needles, 94% of those who answered the comparison question said SubQ was easier and less painful, while 74% preferred it over their previous TRT method.2
|
22 of 22
men in normal range at peak and trough on weekly SubQ, with no local reactions (2006).
|
94%
said SubQ was easier and less painful than their previous method (2023).
|
These are relatively small studies, but they show why SubQ is worth considering.
A little bonus for TRT Vault owners
Smaller syringes also mean you can fit more of them inside your TRT Vault. More organized supplies and longer between restocks.
Not exactly a groundbreaking medical discovery, but a nice perk! (If you don't have a Vault yet, the whole lineup is on one page.)
The bottom line
I'm not saying everyone should switch to SubQ. If IM works great for you, keep doing your thing.
But if you're tired of painful injections or dealing with scar tissue, it's worth discussing SubQ with your prescribing provider before changing your routine.
I wish I'd learned about it sooner.
Hope this helps!
Mitch
Founder, TRT Vault
This article shares my personal experience and published research for educational purposes, not medical advice. Consult your healthcare provider before changing your injection method, supplies, or medication.
Scientific references
- Al-Futaisi, A. M., Al-Zakwani, I. S., Almahrezi, A. M., & Morris, D. (2006). Subcutaneous administration of testosterone: A pilot study report. Saudi Medical Journal, 27(12), 1843–1846. pubmed.ncbi.nlm.nih.gov/17143361
- Our experience with subcutaneous injection of non-proprietary testosterone cypionate as a novel approach for hypogonadism (2023). The Journal of Sexual Medicine, 20(Supplement 1). Conference abstract. academic.oup.com