테스토스테론 피하주사: 스스로 하는 방법

마지막 업데이트: 6월 9, 2026

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이전 글에서는 근육에 테스토스테론을 주사하는 방법(근육 주사, IM)을 보여드렸습니다. 오늘은 전 세계적으로 인기를 얻고 있는 더 부드럽고 간편한 대안을 소개하고자 합니다: 테스토스테론 피하주사(SC) — 근육 깊숙이가 아니라 피부 바로 아래 지방층에 주사하는 방법입니다.

테스토스테론 대체 요법을 받는 제 환자분들 중 많은 분이 기존의 근육 주사(IM)를 불편해하시며, 일부는 둔부나 허벅지 근육에 주사하기 위해 가족의 도움이 필요합니다. 좋은 소식은, 최신 연구에 따르면 피하 주사 방법도 똑같이 효과적이며 — 보통 훨씬 더 편안하고 자가 주사하기 쉽다는 것입니다.

왜 피하주사를 고려해야 할까요?

거의 80년 동안 근육 주사(IM) 테스토스테론이 표준이었습니다. 저렴하고 예측 가능한 테스토스테론 수치를 만들어내지만 — 자가 주사가 어렵고 종종 불편함을 동반합니다. 최근 피하주사(SC) 방법이 인기를 얻고 있는데, 자가 주사가 훨씬 더 쉽기 때문이며, 현재의 근거도 그 실행 가능성을 뒷받침합니다.

피하주사(SC) 방법의 주요 이점은 다음과 같습니다:

• 더 쉬운 자가 주사: 깊은 근육에 도달하거나 도움을 요청할 필요가 없습니다.
• 통증 감소: 더 가는 바늘과 더 얕은 주사로 대부분의 남성에게 거의 통증이 없습니다.
• 좌골 신경 손상 위험 없음: 둔부 근육 주사(IM)의 알려진 (드물지만) 위험입니다.
• 안정적인 호르몬 수치: 피하주사(SC)는 최고점과 최저점의 변동이 작아 더 매끄럽고 안정적인 테스토스테론 수치를 만들어냅니다.
• 더 나은 치료 순응도: 편리하고 편안하기 때문에 환자가 장기적으로 치료를 지속할 가능성이 더 높습니다.

The Journal of Urology에 발표된 획기적인 52주 임상 시험에서, 주 1회 피하 테스토스테론 에난테이트 자가 주사기가 변동이 작은 안정적인 테스토스테론 수치를 만들어냈으며, 95% 이상의 환자가 주사와 관련된 통증이 없다고 보고했다는 사실이 밝혀졌습니다. 저자들은 피하주사(SC) 방법이 안전하고 내약성이 우수하며 거의 통증이 없는 선택지라고 결론지었습니다 (Kaminetsky et al., J Urol 2019).

근육 주사(IM) vs 피하주사(SC): 무엇이 다를까요?

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. 여기서 상담을 예약하세요.

자주 묻는 질문 (FAQ)

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.

면책 조항: 본 내용은 방콕 병원 본사의 전문의인 Soarawee Weerasopone 박사가 작성하고 검토한 것입니다. 교육 목적으로만 제공되며 의학적 조언을 구성하지 않습니다. 모든 의학적 치료를 시작하기 전에 항상 자격을 갖춘 의료 전문가와 상담하십시오.