Subcutaneous vs Intramuscular Testosterone Injections

Since its inception in 1930, Testosterone Replacement Therapy (TRT) has been a preferable choice for most men and even transgender males to treat their hypogonadism (low testosterone level). TRT, or Hormonal Replacement Therapy, as it is sometimes called, is treated with prescription injections, oral tablets, pellets, patches, and gels to increase the testosterone level reduced by hypogonadism. While the use of TRT injections in treating this condition has proven to be the most common and effective over time, many doctors and patients have continued to find better ways of administering the treatment. This is why the two testosterone injection modes used in Testosterone Replacement Therapy (Subcutaneous and Intramuscular) have often been juxtaposed to measure the effectiveness of one over the other and to guarantee better health conditions for those taking the treatment.

This blog post will attempt a compThis blog post will attempt a comparative analysis of the Subcutaneous and Intramuscular injections and how they are both administered to improve the testosterone levels of hypogonadism patients. Patients’ hematocrit response to the Testosterone Replacement Therapy will equally be considered. However, before any of these, an exposition of the two injections used in TRT will be studied.

When men with low testosterone levels are symptomatic from primary or secondary hypogonadism, they are mostly administered testosterone injections. Of the two injections normally administered, the Intramuscular (IM) testosterone is more popular and also the more excruciating of the two. This is because testosterone administered via Intramuscular (IM) injections, as the name goes, have to be injected into the muscle of the patient. For most patients, the Intramuscular injection areas are usually somewhere around the hips, the buttocks, the thigh muscles, and the upper arm. This is to ensure that it goes deep into the muscles of the patient.

On the other hand, the second testosterone injection modal has begun to gain some popularity as more and more patients are seeking a less painful way to get their Testosterone Replacement Therapy. The Subcutaneous (SubQ) testosterone injection is much preferred because it gets the job done without having to go deep into the muscles of the patient. This testosterone injection is inserted into the fat just a little beneath the skin of the patient. The administering areas for this injection include the abdominal areas, the arms, and the front of the thigh. This modal doesn’t leave the patient with an excruciating feeling after the injection.

Apart from the discomforting weekly or biweekly experience of patients administered the Intramuscular (IM) testosterone injection and the seemingly painless experience of those administered the Subcutaneous (SubQ) testosterone, there seem to be other qualities and distinctions between the two injection modals. Their similarities and distinctions are what most patients and providers have used in evaluating which is more effective when it comes to doing the work they were administered to do.

While Intramuscular (IM) testosterone injections are effective, they pose some difficulty when it comes to their self-administration by patients. This is why most patients are often advised not to self-administer to avoid damaging the sciatic nerve. However, with SubQ, patients can easily self-administer testosterone without any fear of damaging a potential nerve in the body.

As regards the efficacy of both the SubQ and the IM testosterone injections, some men and even transgender males have noted slight changes in the use of one over the other. A 2019 study carried out on transgender males after the first six months of the TRT SubQ, and IM testosterone injections by Oregon Health and Science University stated that the efficacy of the Subcutaneous (SubQ) testosterone is about the same as that of the Intramuscular (IM) testosterone. The study carried out by this university also accounted for lesser adverse effects of the SubQ than the IM. This result, together with a similar result from a study carried out on transgender males by Transgender Health, accounted for the equal efficacy of the SubQ and IM testosterone injections.

The study by the Oregon Health and Science University comparing Subcutaneous Testosterone to Intramuscular Testosterone in gender affirming care of transgender Male Adolescents also provided for the Quality of Life (QOL) of adolescent transgender males who were administered either of the two injection modals. According to this study, the males who were administered the SubQ reported a higher and better quality of life and more satisfactory life and testosterone levels than those administered the IM testosterone injection because the SubQ is painless and easier to self-administer than the IM.