Contact your care team about the use of this medication in children. This medication is injected into a muscle. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. Cleveland Clinic is a non-profit academic medical center. Once a patient qualifies for testosterone therapy (1, 2), risks and benefits of therapy as well as pros and cons of each formulation should be discussed (see Table 1). Studies involving SC administration of testosterone cypionate or enanthate have used 1-mL Luer-Lok syringes with a 20- or 25-gauge 5/8-inch needle to inject testosterone into the SC tissue of the abdomen or thigh (28, 47). All patients should receive training from medical personnel on how to self-inject testosterone. Because studies of SC testosterone therapy are limited, this needs to be verified in future studies. Local and systemic adverse events during subcutaneous administration of testosterone esters (number of events in parenthesis) Table 3 summarizes the local and systemic adverse effects reported by studies that administered testosterone esters via SC. SubQ uses much smaller needles (27-30 gauge vs gauge) and doesn’t penetrate as deeply, resulting in less discomfort during and after injection. Regular lab work and check-ins allow us to optimize your protocol over time, adjusting injection method, frequency, or dosing based on your results and feedback. At NRG Clinic, we believe the injection method should fit your life—not the other way around. Your provider can assess whether your body composition is suitable for subcutaneous delivery. These insulin-style syringes are significantly less intimidating and cause minimal discomfort during injection. This method has become increasingly popular among TRT clinics due to improved patient comfort and ease of self-administration. But it’s important to remember that TRT comes with potential risks and side effects. Your healthcare provider will work with you to figure out which option is best for you. TRT doesn’t fix or cure the underlying cause of low testosterone. However, when given to men with hypogonadism in the short- and medium-term, testosterone replacement therapy does not increase the risk of cardiovascular events (including strokes and heart attacks and other heart diseases). Adverse effects of testosterone supplementation may include increased cardiovascular events (including strokes and heart attacks) and deaths based on three peer-reviewed studies involving men taking testosterone replacement. A postmarketing analysis by the manufacturer of Aveed (testosterone undeconate injection) found that POME occurred at a rate of less than 1% per injection per year for Aveed. These include the testosterone/epitestosterone ratio (normally less than 6), the testosterone/luteinizing hormone ratio and the carbon-13/carbon-12 ratio (pharmaceutical testosterone contains less carbon-13 than endogenous testosterone). However, it has been reported that AndroGel, a transdermal gel formulation of testosterone, has become the most popular form of testosterone in androgen replacement therapy for hypogonadism in the United States. Testosterone has been marketed for use by oral, sublingual, buccal, intranasal, transdermal (patches), topical (gels), intramuscular (injection), and subcutaneous (implant) administration.
