Iniezione sottocutanea di testosterone: come farla da soli

Ultimo aggiornamento: Giugno 9, 2026

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In un articolo precedente, vi ho mostrato come eseguire un'iniezione di testosterone nel muscolo (intramuscolare, IM). Oggi voglio presentarvi un'alternativa più delicata e semplice che sta guadagnando popolarità in tutto il mondo: l'iniezione sottocutanea (SC) di testosterone — ovvero l'iniezione nello strato di grasso appena sotto la pelle anziché in profondità nel muscolo.

Molti dei miei pazienti in terapia sostitutiva con testosterone trovano la tradizionale iniezione intramuscolare (IM) scomoda, e alcuni hanno bisogno dell'aiuto di un familiare per raggiungere il muscolo del gluteo o della coscia. La buona notizia è che la ricerca moderna dimostra che la via sottocutanea è altrettanto efficace — e di solito molto più confortevole e facile da auto-somministrare.

Perché considerare la via sottocutanea?

Per quasi 8 decenni, le iniezioni intramuscolari (IM) di testosterone sono state lo standard. Sono economiche e producono livelli di testosterone prevedibili — ma sono difficili da auto-somministrare e spesso associate a fastidio. Di recente, la via sottocutanea (SC) ha guadagnato popolarità perché l'auto-somministrazione è molto più facile, e le evidenze disponibili ne supportano la fattibilità.

I principali vantaggi della via SC includono:

• Auto-iniezione più facile: Non è necessario raggiungere il muscolo profondo né chiedere aiuto.
• Meno dolore: Aghi più sottili e un'iniezione meno profonda la rendono praticamente indolore per la maggior parte degli uomini.
• Nessun rischio di lesione del nervo sciatico: Un rischio noto (sebbene raro) delle iniezioni IM nel gluteo.
• Livelli ormonali stabili: L'iniezione SC produce livelli di testosterone più uniformi e stabili, con picchi e cali meno marcati.
• Migliore aderenza: Poiché è comoda e confortevole, i pazienti hanno maggiori probabilità di proseguire la terapia a lungo termine.

Uno studio clinico di riferimento della durata di 52 settimane pubblicato su The Journal of Urology ha rilevato che un auto-iniettore settimanale di testosterone enantato per via sottocutanea produceva livelli di testosterone stabili con piccole fluttuazioni, e che oltre il 95% dei pazienti non ha riferito alcun dolore legato all'iniezione. Gli autori hanno concluso che la via SC è un'opzione sicura, ben tollerata e praticamente indolore (Kaminetsky et al., J Urol 2019).

IM vs SC: qual è la differenza?

Feature	Intramuscular (IM)	Subcutaneous (SC)
Injection depth	Deep into the muscle	Into the fat layer under the skin
Common site	Buttock or outer thigh	Abdomen (belly) or thigh
Needle size	Longer, larger gauge	Shorter, smaller gauge (23-25G)
Pain level	Moderate discomfort	Minimal — virtually painless
Self-administration	Difficult; may need help	Easy to do alone
Testosterone levels	Larger peaks and troughs	Smoother, more stable

Things You Need to Prepare

• Alcohol swabs
• Your prescribed testosterone vial (e.g., testosterone enanthate or cypionate) — always check the expiry date
• A 1 mL Luer-Lok syringe (preferred to prevent the needle from disengaging due to the oil’s viscosity)
• A drawing-up needle (18-21G) to draw the testosterone from the vial
• A fine short injection needle (23-25 gauge, 5/8-inch) for the subcutaneous injection
• A sharps disposal container

Where to Inject: The Landmark

The two recommended sites for subcutaneous testosterone injection are:

• The abdomen (belly): Inject into the fatty tissue 3 to 5 cm to the side of the belly button (umbilicus). Avoid the area too close to the navel.
• The thigh: The fatty tissue of the front or outer thigh is also a suitable site.

Gently pinch a fold of skin and fat to lift it away from the muscle. This helps ensure the injection goes into the subcutaneous layer and not the muscle.

Step-by-Step: How to Do a Subcutaneous Testosterone Injection

⚠️ Important: Do NOT attempt your first injection by yourself. You must be trained and supervised by a medical professional until you are fully competent.

1. Wash your hands thoroughly and sit in a comfortable chair with your supplies ready.
2. Decide on your injection site (abdomen 3-5 cm beside the navel, or thigh). Alternate sites with each injection.
3. Draw the prescribed testosterone dose from the vial using the larger drawing-up needle (18-21G) on your Luer-Lok syringe.
4. Remove all air bubbles from the syringe (air must not be injected).
5. Replace the drawing-up needle with the fine injection needle (23-25G).
6. Clean the injection site with an alcohol swab and let it air-dry.
7. Gently pinch a fold of skin and insert the needle at a 45 to 90-degree angle into the fatty tissue.
8. Slowly inject the testosterone over several seconds.
9. Remove the needle and gently press the site with a clean cotton ball or gauze. Do not rub.
10. Dispose of the needle and syringe safely in your sharps container.

Note: For the ultralong-acting ester testosterone undecanoate (a larger volume), the injection should be given more slowly over 2-3 minutes. Discuss the correct technique with your urologist, as this formulation has specific considerations.

Recommended Dose

Based on clinical studies, a common starting dose for subcutaneous testosterone enanthate or cypionate is 75 mg once weekly. This slightly lower weekly dose is usually sufficient to achieve healthy testosterone levels. Your doctor may adjust the dose down to 50 mg or up to 100 mg per week based on your blood test results. On-treatment testosterone should be measured midway between injections, and monitoring should continue periodically.

Possible Side Effects

Local reactions are usually mild and temporary, and may include:

• Minor redness, itching, or a small painless lump at the injection site
• Light bruising or bleeding

Because testosterone levels achieved via SC are similar to IM, the general systemic effects of testosterone therapy still apply and require monitoring — including a possible rise in red blood cell count (hematocrit), blood pressure, and PSA. This is why regular follow-up with your urologist is essential.

If you would like to discuss whether subcutaneous testosterone therapy is right for you, or to be trained in proper self-injection technique, Dr. Soarawee Weerasopone offers consultations at Bangkok Hospital Headquarters. Prenota una consulenza qui.

Domande frequenti

Is subcutaneous testosterone injection as effective as intramuscular?

Yes. Multiple studies show that subcutaneous (SC) injection of testosterone enanthate or cypionate produces serum testosterone levels comparable to the intramuscular (IM) route. In fact, SC injection often produces smoother, more stable hormone levels with smaller peaks and troughs, while being easier to self-administer and less painful.

Where do I inject subcutaneous testosterone?

The two recommended sites are the abdomen — 3 to 5 cm to the side of the belly button — and the fatty tissue of the thigh. Gently pinch a fold of skin and fat, then insert the fine needle at a 45 to 90-degree angle. Always rotate injection sites to avoid irritation.

What size needle should I use for subcutaneous testosterone?

Clinical studies typically use a 1 mL Luer-Lok syringe with a fine 23 to 25-gauge, 5/8-inch needle for the injection itself, and a larger 18 to 21-gauge needle to draw the oil-based testosterone from the vial. A Luer-Lok syringe is preferred because the oil’s viscosity can otherwise cause the needle to detach.

Is subcutaneous testosterone injection painful?

For most men, no. In a 52-week clinical trial, more than 95% of patients reported no injection-related pain with weekly subcutaneous testosterone. The smaller needle and shallower injection make it virtually painless compared with the traditional intramuscular route.

Can I switch from intramuscular to subcutaneous injections?

Often, yes. Many patients successfully switch from IM to SC injection while maintaining stable testosterone levels. Studies in patients who switched routes found no significant change in hormone levels, and most preferred not to return to IM injection. Always make this change under the guidance of your urologist.

Disclaimer: Questo contenuto è redatto e revisionato dal Dr. Soarawee Weerasopone, urologo certificato presso il Bangkok Hospital Headquarters. È inteso solo a scopo educativo e non costituisce consulenza medica. Consultare sempre un professionista sanitario qualificato prima di iniziare qualsiasi trattamento medico.