ការចាក់ Testosterone ក្រោមស្បែក៖ វិធីចាក់ដោយខ្លួនឯង

បានធ្វើបច្ចុប្បន្នភាពចុងក្រោយ៖ ខែ​សីហា 30, 2026

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នៅក្នុងអត្ថបទមុន ខ្ញុំបានបង្ហាញអ្នក ពីវិធីចាក់ Testosterone ចូលសាច់ដុំ (intramuscular, IM)។ ថ្ងៃនេះ ខ្ញុំចង់ណែនាំអ្នកអំពីជម្រើសដ៏ស្រួល និងថ្នមជាង ដែលកំពុងពេញនិយមនៅទូទាំងពិភពលោក៖ ការចាក់ Testosterone ក្រោមស្បែក (SC) — គឺការចាក់ចូលស្រទាប់ខ្លាញ់ដែលនៅពីក្រោមស្បែកដោយផ្ទាល់ ជំនួសឱ្យការចាក់ជ្រៅចូលសាច់ដុំ។

អ្នកជំងឺរបស់ខ្ញុំជាច្រើននាក់ដែលកំពុងទទួល ការព្យាបាលដោយការជំនួស Testosterone យល់ឃើញថាការចាក់ IM បែបប្រពៃណីមិនស្រួលខ្លួន ហើយខ្លះត្រូវការជំនួយពីសមាជិកគ្រួសារដើម្បីចាក់ចូលសាច់ដុំគូទ ឬភ្លៅ។ ដំណឹងល្អគឺ ការស្រាវជ្រាវទំនើបបង្ហាញថា វិធីចាក់ក្រោមស្បែកក៏មានប្រសិទ្ធភាពដូចគ្នាដែរ — ហើយជាធម្មតា ស្រួលជាងច្រើន និងងាយស្រួលចាក់ដោយខ្លួនឯង។

One thing to be clear about before the technique. This guide is written for men who are already under the care of a doctor for testosterone deficiency and who hold a prescription. Testosterone is a prescription-only medicine, and the decision to start it rests on symptoms together with blood tests taken on more than one morning — never on a description of how the injection is performed. If you are using testosterone, or a testosterone-like compound, obtained online, from a gym or from any source other than a pharmacy, technique is the smallest of the problems: those products are frequently mislabelled, and the reasons are set out in a separate article on unregulated men’s health products.

ហេតុអ្វីគួរពិចារណាវិធីចាក់ក្រោមស្បែក?

ជិត ៨ ទសវត្សរ៍មកហើយ ការចាក់ Testosterone ចូលសាច់ដុំ (IM) គឺជាស្តង់ដារ។ វាមានតម្លៃថោក និងបង្កើតកម្រិត Testosterone ដែលអាចព្យាករណ៍បាន — ប៉ុន្តែវាពិបាកចាក់ដោយខ្លួនឯង និងជារឿយៗ ភ្ជាប់នឹងភាពមិនស្រួលខ្លួន។ ថ្មីៗនេះ វិធីចាក់ក្រោមស្បែក (SC) បានពេញនិយម ដោយសារតែ ការចាក់ដោយខ្លួនឯងងាយស្រួលជាងច្រើន ហើយភស្តុតាងដែលមានគាំទ្រលទ្ធភាពអនុវត្តរបស់វា។

អត្ថប្រយោជន៍សំខាន់ៗនៃវិធី SC រួមមាន៖

• ការចាក់ដោយខ្លួនឯងងាយស្រួលជាង៖ មិនចាំបាច់ចាក់ចូលសាច់ដុំជ្រៅ ឬសុំជំនួយឡើយ។
• Less pain: Smaller needles and a shallower injection make it considerably more comfortable for most men.
• គ្មានហានិភ័យនៃការរបួសសរសៃប្រសាទ sciatic៖ ដែលជាហានិភ័យដែលគេស្គាល់ (ទោះបីកម្រ) ជាមួយការចាក់ IM នៅគូទ។
• កម្រិតអ័រម៉ូនមានស្ថិរភាព៖ ការចាក់ SC បង្កើតកម្រិត Testosterone រលូន និងមានស្ថិរភាពជាង ដោយមានកម្រិតខ្ពស់បំផុត និងទាបបំផុតតិចជាង។
• ការប្រកាន់ខ្ជាប់ការព្យាបាលប្រសើរជាង៖ ដោយសារតែវាមានភាពងាយស្រួល និងស្រួលខ្លួន អ្នកជំងឺទំនងជានឹងបន្តការព្យាបាលរយៈពេលវែង។

A landmark 52-week clinical trial published in ទិនានុប្បវត្តិ​វិទ្យាសាស្ត្រ​ប្រព័ន្ធ​ទឹកនោម found that a weekly subcutaneous testosterone enanthate auto-injector produced steady testosterone levels with small fluctuations, and that more than 95% of patients reported no injection-related pain (Kaminetsky et al., J Urol 2019). Worth knowing what that figure describes: the trial used a licensed auto-injector device delivering a fixed dose, not a vial and a hand-held syringe. The comfort of the shallow route carries over; the exact percentage belongs to the device.

IM vs SC: What Is the Difference?

លក្ខណៈពិសេស	ចាក់តាមសាច់ដុំ (IM)	ក្រោមស្បែក (SC)
ជម្រៅនៃការចាក់	ជ្រៅទៅក្នុងសាច់ដុំ	ចូលទៅក្នុងស្រទាប់ខ្លាញ់ក្រោមស្បែក
ទីតាំងទូទៅ	គូទ ឬភ្លៅខាងក្រៅ	ពោះ (ពោះ) ឬភ្លៅ
ទំហំម្ជុល	រង្វាស់វែងជាង និងធំជាង	ខ្លីជាង និងតូចជាង (២៣-២៥ក្រាម)
កម្រិតនៃការឈឺចាប់	ភាពមិនស្រួលកម្រិតមធ្យម	Usually mild
ការគ្រប់គ្រងដោយខ្លួនឯង	ពិបាក; អាចត្រូវការជំនួយ	Easy to do alone once taught
កម្រិតតេស្តូស្តេរ៉ូន	កំពូល និង ចំណុចប្រសព្វធំៗ	រលោងជាងមុន មានស្ថេរភាពជាងមុន

រឿងដែលអ្នកត្រូវរៀបចំ

• សំឡីជូតជាតិអាល់កុល
• ដបថ្នាំតេស្តូស្តេរ៉ូនដែលអ្នកបានចេញវេជ្ជបញ្ជា (ឧទាហរណ៍ តេស្តូស្តេរ៉ូន អេណាន់ថេត ឬ ស៊ីភីយ៉ូណេត) — តែងតែពិនិត្យមើលកាលបរិច្ឆេទផុតកំណត់
• A 1 mL Luer-Lok syringe (preferred to prevent the needle from disengaging due to the oil’s viscosity)
• ម្ជុល​សម្រាប់​ទាញ​យក​តេស្តូស្តេរ៉ូន (18-21G) ដើម្បី​ទាញ​យក​តេស្តូស្តេរ៉ូន​ចេញពី​ដប​ថ្នាំ
• ម្ជុលចាក់ខ្លីល្អិត ( ទំហំ 23-25 រង្វាស់, 5/8 អ៊ីញ ) សម្រាប់ចាក់ក្រោមស្បែក
• A sharps disposal container — a rigid, puncture-proof container kept for needles only, never the household bin

កន្លែងដែលត្រូវចាក់ថ្នាំ៖ ចំណុចសម្គាល់

កន្លែងពីរដែលត្រូវបានណែនាំសម្រាប់ចាក់តេស្តូស្តេរ៉ូនក្រោមស្បែកគឺ៖

• ពោះ៖ ចាក់ចូលទៅក្នុងជាលិកាខ្លាញ់ ចម្ងាយ 3 ទៅ 5 សង់ទីម៉ែត្រ ទៅចំហៀងផ្ចិត (ផ្ចិត) ។ ជៀសវាងតំបន់ដែលនៅជិតផ្ចិតពេក។.
• ភ្លៅ៖ ជាលិកាខ្លាញ់នៃភ្លៅខាងមុខ ឬខាងក្រៅក៏ជាកន្លែងសមស្របមួយដែរ។.

ច្របាច់​ស្បែក និង​ខ្លាញ់​ថ្នមៗ​មួយ​ផ្នត់ ដើម្បី​លើក​វា​ចេញ​ពី​សាច់ដុំ។ វិធី​នេះ​ជួយ​ធានា​ថា​ការ​ចាក់​ចូល​ទៅ​ក្នុង​ស្រទាប់​ក្រោម​ស្បែក មិនមែន​ចូល​ទៅ​ក្នុង​សាច់ដុំ​ទេ។. Move the spot every week — injecting repeatedly into the same patch of fat leaves firm lumps that absorb the oil unpredictably, so the dose stops behaving the way your blood tests suggest it should.

មួយជំហានម្តងៗ៖ របៀបចាក់ថ្នាំតេស្តូស្តេរ៉ូនក្រោមស្បែក

⚠️ សំខាន់៖ Do not attempt your first injection by yourself. You must be taught and supervised by a health professional until you are fully competent. Reading a sequence of steps is not the same as having done it once with someone watching, and the steps below are a reminder for men who have already been trained — not a substitute for that training.

1. លាងដៃរបស់អ្នកឱ្យបានស្អាត ហើយអង្គុយលើកៅអីដែលមានផាសុកភាព ជាមួយនឹងសម្ភារៈរបស់អ្នកដែលត្រៀមរួចជាស្រេច។.
2. សម្រេចចិត្តលើកន្លែងចាក់ថ្នាំរបស់អ្នក (ពោះ 3-5 សង់ទីម៉ែត្រ នៅក្បែរផ្ចិត ឬភ្លៅ)។ ប្តូរកន្លែងចាក់ថ្នាំម្តងៗ។.
3. ច្របាច់​កម្រិត​តេស្តូស្តេរ៉ូន​តាម​វេជ្ជបញ្ជា​ចេញពី​ដប​ថ្នាំ​ដោយ​ប្រើ​ម្ជុល​ច្របាច់​ធំ​ជាង (18-21G) នៅលើ​សឺរាំង Luer-Lok របស់អ្នក។.
4. យកពពុះខ្យល់ទាំងអស់ចេញពីសឺរាុំង (ខ្យល់មិនត្រូវចាក់ចូលទេ)។.
5. ជំនួស​ម្ជុល​ចាក់​ដែល​មាន​រន្ធ​តូច (23-25G)។.
6. សម្អាតកន្លែងចាក់ថ្នាំដោយប្រើសំឡីអាល់កុល ហើយទុកវាឱ្យស្ងួតដោយខ្យល់។.
7. ច្របាច់​ស្បែក​ថ្នមៗ រួច​បញ្ចូល​ម្ជុល​ក្នុង​មុំ ៤៥ ទៅ ៩០ ដឺក្រេ​ទៅក្នុង​ជាលិកា​ខ្លាញ់។.
8. ចាក់តេស្តូស្តេរ៉ូនយឺតៗក្នុងរយៈពេលជាច្រើនវិនាទី។.
9. ដកម្ជុលចេញ រួចចុចថ្នមៗលើកន្លែងនោះដោយប្រើសំឡីស្អាត ឬមារៈបង់រុំ។ កុំត្រដុស។.
10. បោះចោលម្ជុល និងសឺរាំងដោយសុវត្ថិភាពនៅក្នុងធុងដាក់ថ្នាំមុតស្រួចរបស់អ្នក។.
11. Never reuse a needle or syringe, and never share them with another person — including a relative or friend on the same treatment. A reused needle is blunt and hurts; a shared one transmits blood-borne infection.

One important exception. The ultralong-acting ester testosterone undecanoate is not a formulation for self-injection at home. It is a large-volume oily preparation, given slowly in a medical setting, after which the patient is observed for a period — because it carries a small but recognised risk of pulmonary oil microembolism and of an anaphylactic reaction, which announce themselves as a sudden cough, tightness in the chest, breathlessness or dizziness during or just after the injection. If you are on testosterone undecanoate, your injections belong in a clinic rather than at your kitchen table.

Dose — and Why It Is Not Yours to Adjust

In the 52-week auto-injector trial, the starting dose was 75 mg once weekly, moved down to 50 mg or up to 100 mg according to blood levels. Those figures appear here because patients reasonably ask what is typical — not as a schedule to follow. Your own dose is set by your doctor from your symptoms and your blood results, and on-treatment testosterone is measured midway between injections.

The number that most often forces a change is not testosterone at all. It is the haematocrit — the proportion of your blood made up of red cells. Testosterone raises it, and if it climbs too far the blood becomes thicker, which matters for clotting risk. That is managed by lowering the dose, spacing the injections differently or, in some cases, donating blood — none of which anyone can judge without the test. Blood pressure and PSA are followed for the same reason. Taking more than you were prescribed does not produce a better result; it produces a higher haematocrit.

ផលប៉ះពាល់ដែលអាចកើតមាន

ប្រតិកម្មក្នុងតំបន់ជាធម្មតាស្រាល និងបណ្ដោះអាសន្ន ហើយអាចរួមមាន៖

• ឡើងក្រហមតិចតួច រមាស់ ឬមានដុំពកតូចមួយដែលមិនឈឺចាប់នៅកន្លែងចាក់ថ្នាំ
• ស្នាមជាំស្រាលៗ ឬហូរឈាម
• Firm thickened patches of fat if the same spot is used repeatedly — the reason for rotating sites

Because testosterone levels achieved via SC are similar to IM, the general systemic effects of testosterone therapy still apply and require monitoring — a rise in red blood cell count (haematocrit), blood pressure and PSA, suppression of the body’s own production, worsening of untreated sleep apnoea, and breast tenderness or enlargement. This is why regular follow-up with your urologist is essential. Changing the route does not change any of it.

What Is Not Normal — and What Cannot Wait

Most injection-site reactions settle within a day or two. These do not, and should be looked at rather than waited out:

• Spreading redness, increasing swelling, warmth or any discharge at the injection site — particularly with fever or chills. That is an infection, and it needs to be seen the same day rather than at the next appointment.
• Pain that is worse on day three than it was on day one, or a lump that keeps growing.

Separately, testosterone therapy itself has a short list of symptoms that are not for the next appointment either. Chest pain, sudden breathlessness, pain or swelling in one calf, or a sudden severe headache with weakness or difficulty speaking are emergencies — go to hospital and tell the team you are on testosterone. The same applies to a cough, chest tightness or dizziness during or just after an injection of testosterone undecanoate.

What Injections Do to Fertility

This is the part most often missing from an article about technique. Testosterone given from outside switches off the signal from the brain that drives the testicles, and sperm production falls with it. In many men on weekly injections the sperm count drops to zero. Testosterone is not a fertility treatment — for as long as you are on it, it does the opposite.

It is usually reversible after stopping, but recovery is measured in months rather than weeks and is not guaranteed in every man. If children are a possibility — now or in a few years — say so before you start, because there are ways of raising testosterone that do not suppress sperm production, and because azoospermia discovered later is very often the treatment itself rather than a separate problem. This is set out in more detail on the male fertility and microsurgery service page.

The route of administration is largely a matter of preference; the monitoring schedule is not optional. See what structured long-term follow-up looks like under our testosterone therapy service.

If you would like to discuss whether subcutaneous testosterone therapy is appropriate for you, or to be taught the injection technique properly, Dr. Soarawee Weerasopone consults at ទីស្នាក់ការកណ្តាលមន្ទីរពេទ្យបាងកក and at Samitivej Sriracha Hospital, Chonburi — 088-022-1445.

សេវាថែទាំសុខភាពពីចម្ងាយរបស់មន្ទីរពេទ្យបាងកកអាចរកបានសម្រាប់អ្នកជំងឺដែលមិនអាចចូលរួមដោយផ្ទាល់បាន រួមទាំងអ្នកជំងឺអន្តរជាតិផងដែរ — សូមរៀបចំវាជាមុនតាមរយៈអ៊ីមែលទៅកាន់ផ្នែកជំងឺប្រព័ន្ធទឹកនោមតាមរយៈ bhquro@bdms.co.th. It suits reviewing blood results or discussing a change of route; the first injection, however, has to be taught face to face. Samitivej Sriracha is in-person only.

សំណួរដែលសួរញឹកញាប់

តើការចាក់តេស្តូស្តេរ៉ូនក្រោមស្បែកមានប្រសិទ្ធភាពដូចការចាក់តាមសាច់ដុំដែរឬទេ?

មែនហើយ។ ការសិក្សាច្រើនបង្ហាញថា ការចាក់ថ្នាំតេស្តូស្តេរ៉ូនអេណាន់ថេត ឬស៊ីភីយ៉ូណេតក្រោមស្បែក (SC) បង្កើតកម្រិតតេស្តូស្តេរ៉ូនក្នុងសេរ៉ូមដែលអាចប្រៀបធៀបទៅនឹងការចាក់ថ្នាំតាមសាច់ដុំ (IM)។ តាមពិតទៅ ការចាក់ថ្នាំតាមស្បែកជារឿយៗបង្កើតកម្រិតអរម៉ូនដែលរលូន និងមានស្ថេរភាពជាងមុន ជាមួយនឹងកំពូល និងបាតតូចជាងមុន ខណៈពេលដែលងាយស្រួលចាក់ដោយខ្លួនឯង និងមិនសូវឈឺចាប់។.

តើខ្ញុំត្រូវចាក់តេស្តូស្តេរ៉ូនក្រោមស្បែកនៅឯណា?

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, both to avoid irritation and to prevent firm patches of fat that make absorption unpredictable.

តើខ្ញុំគួរប្រើម្ជុលទំហំប៉ុនណាសម្រាប់វាស់តេស្តូស្តេរ៉ូនក្រោមស្បែក?

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. Needles are single-use and must never be shared.

តើការចាក់តេស្តូស្តេរ៉ូនក្រោមស្បែកមានការឈឺចាប់ទេ?

For most men it is mild. In a 52-week clinical trial of a licensed weekly auto-injector, more than 95% of patients reported no injection-related pain; that figure describes the device rather than every syringe technique, but the smaller needle and shallower injection do make the SC route considerably more comfortable than the traditional intramuscular one.

តើខ្ញុំអាចប្តូរពីការចាក់ថ្នាំចូលសាច់ដុំទៅជាការចាក់ថ្នាំក្រោមស្បែកបានទេ?

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. One formulation is excluded: testosterone undecanoate is given in a medical setting, not self-injected at home.

Will testosterone injections affect my fertility?

Yes, and it is important to know this before starting rather than afterwards. Testosterone from outside suppresses the brain signal that drives sperm production, and in many men on weekly injections the sperm count falls to zero. It usually recovers after stopping, but over months rather than weeks, and not in every man. If you may want children, raise it at the first consultation — other ways of raising testosterone exist that do not suppress sperm production.

What should I do if the injection site becomes red and swollen?

A small area of redness or a painless lump for a day or two is ordinary. Redness that spreads, swelling that increases, warmth, any discharge, or fever and chills point to infection and should be seen the same day rather than at your next appointment. Pain that is worse on day three than on day one is the other sign worth acting on.

Can I be started on testosterone by teleconsultation?

Bangkok Hospital Telemedicine is available and suits reviewing results, discussing a change of route or planning follow-up — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Starting therapy is different: it needs an in-person assessment and morning blood tests, and the first injection has to be taught face to face. Samitivej Sriracha is in-person only.

ការបដិសេធ៖ This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only, does not constitute medical advice, and is not a substitute for being taught in person before you inject yourself. No advice, diagnosis or prescription is given through personal messaging channels or social media. Always consult a qualified healthcare professional before starting or changing any medical treatment. If you develop chest pain, sudden breathlessness, swelling in one calf, or spreading redness and fever at an injection site, seek emergency or same-day care rather than waiting for an appointment.