Transgender Health

Administration Matters: Subcutaneous vs. Intramuscular Injection

Since March of 2013 I have been taking hormone replacement therapy; at first my wife was administering my shots once a week intramuscularly (IM), which is to say that I got a shot in the ass each week. Earlier in this year my dosage was changed from weekly to every three days and now it’s every four days. About a month ago I switched to the subcutaneous shots in the hopes that I would be able to self-administer my shots in case my wife and I were apart when I was due for my testosterone shots.

The needles for subcutaneous are a lot smaller than those for IM, the difference is a 29 gauge vs 25 gauge; the larger the gauge, the smaller the needle. The former is the same needle used for insulin injections by diabetics. Not only is the needle smaller, but the syringe itself is also smaller. While a smaller needle and syringe make the puncture from the needle less painful (if you use the same needle to draw and inject) they also make injecting the testosterone more difficult and a longer process. Testosterone is a lot more viscous than insulin, and therefore takes longer to draw and inject with such a small needle.

When I began to have my testosterone administered via subcutaneous rather than intramuscular I noticed a marked difference in the way I felt. Prior testosterone shots gave me a bit of a sore throat on occasion and I was ravenously hungry the next day. I also didn’t feel as heavy and had less problems with depression or mood swings when taking my testosterone via IM.

After my first sub q shot the entire injection site burned like it was on fire, for two days after the injection my side was extremely tender and it was uncomfortable to even have clothing touch it. I thought perhaps the reaction to the first subcue shot was a fluke and ended up taking a total of four sub q shots. All of which yielded similar after effects. Before anyone says that I was injecting wrong, my wife gives me all my shots; before she came down with fibromyalgia she was a veterinary assistant and knows how to give both subcue and IM shots. The difference in giving human shots and animals shots is pretty much nil. Also, we discussed the injection sites with my endocrinologist for a lengthy period of time before we actually administered the shots.

The biggest shock for me, was when I started having mood swings again. For no reason I would become depressed and be on the verge of tears, and the next moment I would be angry. This was on par with my issues before I started testosterone in March of 2013. Taking hormone replacement therapy has actually helped a lot with my mood swings, which was a pleasant surprise for not only myself but also my wife. It occurred to me that the cause of this sudden change in mood swings could be caused by the way that my body was or wasn’t absorbing the testosterone.

The day after I switched back to IM shots rather than sub q, the mood swings stopped, my appetite was back and I was beginning to feel a lot more normal that I had been. As the injection site pains in my sides began to fade so did my opinion that it was a good idea to take my shots sub q. The needle stick may hurt a little less, but in the end the cons are far more than the pros of taking my shots in the ass.

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9 thoughts on “Administration Matters: Subcutaneous vs. Intramuscular Injection

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