Most young, healthy bodybuilders don’t see heart risks early, but it’s smart to know the warning signs. These side effects can stick around as long as you stay on testosterone. When you start testosterone self-injection, it's smart to know the risks. Self-injection brings you closer to your body goals. Your testosterone doctor can also help you watch for side effects. Testosterone can be administered through intramuscular or subcutaneous injections. Many clinicians and patients report meaningful improvements when therapy is carefully monitored. Several factors can cause a dip in women’s testosterone production. This is especially true when both partners manage their hormone health together. Despite its significance, low testosterone in women remains under-discussed. And, this hormone is vital for their overall health and well-being. Few studies have evaluated serum concentrations of 5-dihydrotestosterone (DHT) and estradiol after SC injection compared to the standard IM route. Serum testosterone concentrations (Fig. 6A) did not differ according to route of administration after adjustment for age, body mass index, and clinical diagnosis (26). Therefore, the Food and Drug Administration has recommended that IM administration of testosterone undecanoate be performed slowly by trained personnel in the clinic, and the patient should be observed for at least 30 minutes after injections. Testosterone therapy is sometimes combined with an aromatase inhibitor for men with secondary hypogonadism who wish to conceive children with their partners. Aromatase inhibitors like anastrozole prevent the conversion of testosterone into estradiol by aromatase. In addition to the prevention of testosterone conversion into DHT, 5α-reductase inhibitors also prevent the formation of neurosteroids like 3α-androstanediol from testosterone, and this may have neuropsychiatric consequences in some men. Androgens like testosterone are teratogens and are known to cause fetal harm, such as producing virilization and ambiguous genitalia. However, the association between testosterone supplementation and the development of prostate cancer is unproven. Similar to lymphatics, the hemorheological differences of the vascular compartments of the SC and IM tissues play a role in the pharmacokinetics of testosterone esters. However, the hydrolysis of testosterone esters by tissue esterases is a slow process because of their high lipophilicity, with negligible spontaneous hydrolysis in water (40). After IM or SC administration of a testosterone ester, absorption occurs first by diffusion from the depot into the interstitium (Fig. 2B). The IM and SC routes present a defined phase of absorption, in which the serum concentration of the drug administered progressively increases to a maximum (Cmax) and then decreases according to its elimination half-life. With administration using either route, the ester exits the depot via diffusion into the interstitium, from where it enters the lymphatics and subsequently reaches the circulation where it undergoes hydrolysis by intracellular esterases. A, Illustration of the progressive increase in lipophilicity of testosterone esters with increase in number of carbons in the side chain. Various testosterone esters have different absorption kinetics, with absorption time increasing with longer esterified side chains (fatty acids) because of the increased hydrophobicity of the molecule (Fig. 2A) (37). 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. Taking charge of your testosterone self-injection routine can feel empowering and even life-changing. Switch up your injection spots to keep your skin healthy. Following these steps makes injections quick, clean, and less stressful. With testosterone self-injection, you get it. Serious side effects can include liver problems if your testosterone is too high for too long.
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