Последнее обновление: Август 15, 2026

В предыдущей статье я показал вам, как выполнять инъекцию тестостерона в мышцу (внутримышечно, IM). Сегодня я хочу познакомить вас с более мягкой и простой альтернативой, набирающей популярность во всём мире: подкожная (SC) инъекция тестостерона — введение в слой жира прямо под кожей, а не глубоко в мышцу.
Многие из моих пациентов, получающих заместительную терапию тестостероном, находят традиционную внутримышечную инъекцию (IM) неудобной, а некоторым требуется помощь члена семьи, чтобы добраться до мышцы ягодицы или бедра. Хорошая новость в том, что современные исследования показывают: подкожный способ столь же эффективен — и обычно гораздо удобнее и проще для самостоятельного введения.
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.
Почему стоит рассмотреть подкожный способ?
На протяжении почти 8 десятилетий внутримышечные (IM) инъекции тестостерона были стандартом. Они недороги и обеспечивают предсказуемый уровень тестостерона — но их трудно вводить самостоятельно, и они часто связаны с дискомфортом. В последнее время подкожный (SC) способ набирает популярность, поскольку самостоятельное введение намного проще, а имеющиеся данные подтверждают его осуществимость.

Основные преимущества подкожного (SC) способа включают:
- Более простое самостоятельное введение: не нужно добираться до глубоких мышц или просить о помощи.
- Less pain: Smaller needles and a shallower injection make it considerably more comfortable for most men.
- Нет риска повреждения седалищного нерва: известный (хотя и редкий) риск при внутримышечных инъекциях в ягодицу.
- Стабильный уровень гормонов: подкожная (SC) инъекция обеспечивает более ровный и стабильный уровень тестостерона с меньшими пиками и спадами.
- Лучшая приверженность лечению: поскольку это удобно и комфортно, пациенты с большей вероятностью продолжают терапию в долгосрочной перспективе.
A landmark 52-week clinical trial published in The Journal of Urology 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?
| Функция | Внутримышечно (ВМ) | Подкожный (П/К) |
|---|---|---|
| Глубина инъекции | Глубоко в мышцу | В жировой слой под кожей |
| Общий сайт | Ягодица или внешняя часть бедра | Живот (брюхо) или бедро |
| Размер иглы | Длиннее, большего калибра | Короче, меньший калибр (23-25G) |
| Уровень боли | Умеренный дискомфорт | Usually mild |
| Самоуправление | Трудно; может понадобиться помощь | Easy to do alone once taught |
| Уровень тестостерона | Большие пики и впадины | Плавнее, стабильнее |
Что нужно подготовить
- Спиртовые салфетки
- Вам выписан флакон с тестостероном (например, тестостерон энантат или ципионат) — всегда проверяйте срок годности
- A 1 mL Luer-Lok syringe (preferred to prevent the needle from disengaging due to the oil’s viscosity)
- Игла для забора (18-21G) для набора тестостерона из флакона
- Тонкая короткая инъекционная игла (23–25 калибр, 5/8 дюйма) для подкожных инъекций
- A sharps disposal container — a rigid, puncture-proof container kept for needles only, never the household bin

Куда колоть: Ориентир
Два рекомендуемых места для подкожной инъекции тестостерона:
- Живот: Введите препарат в жировую ткань на расстоянии 3–5 см в сторону от пупка (умбилика). Избегайте области, расположенной слишком близко к пупку.
- Бедро: жировая ткань передней или наружной поверхности бедра также является подходящим местом.
Аккуратно возьмите складку кожи и жира, чтобы приподнять ее от мышцы. Это поможет гарантировать, что инъекция будет сделана в подкожный слой, а не в мышцу. 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.
Пошаговое руководство: Как сделать подкожную инъекцию тестостерона
⚠️ Важно: 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.
- Тщательно вымойте руки и сядьте в удобное кресло, приготовив все необходимое.
- Выберите место инъекции (живот в 3-5 см от пупка или бедро). Чередуйте места инъекций.
- Наберите предписанную дозу тестостерона из флакона с помощью более крупной иглы для набора (18-21G) на шприце с наконечником Luer-Lok.
- Удалите все пузырьки воздуха из шприца (воздух вводиться не должен).
- Замените иглу для приготовления с растворителем на тонкую инъекционную иглу (23-25G).
- Протрите место инъекции спиртовой салфеткой и дайте высохнуть на воздухе.
- Аккуратно сожмите кожную складку и введите иглу под углом от 45 до 90 градусов в жировую ткань.
- Медленно вводите тестостерон в течение нескольких секунд.
- Удалите иглу и аккуратно прижмите место укола чистым ватным шариком или марлей. Не трите.
- Безопасно утилизируйте иглу и шприц в контейнер для острых предметов.
- 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.
Возможные побочные эффекты
Местные реакции обычно слабые и временные, и могут включать:
- Незначительное покраснение, зуд или небольшой безболезненный узелок в месте инъекции
- Легкие ушибы или кровотечение
- 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.
Путь введения — это в значительной степени вопрос предпочтений, график наблюдения не является необязательным. Посмотрите, как выглядит структурированное долгосрочное наблюдение в рамках наши услуги по тестостероновой терапии.
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 Головной офис Бангкокской больницы and at Samitivej Sriracha Hospital, Chonburi — 088-022-1445.
Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at 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.
Часто задаваемые вопросы
Является ли подкожная инъекция тестостерона такой же эффективной, как внутримышечная?
Да. Многочисленные исследования показывают, что подкожное (П/К) введение тестостерона энантата или ципионата приводит к уровню тестостерона в сыворотке, сравнимому с внутримышечным (В/М) введением. На самом деле, П/К введение часто приводит к более ровному, стабильному уровню гормона с меньшими пиками и спадами, при этом его легче вводить самостоятельно и оно менее болезненно.
Куда вводить подкожный тестостерон?
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.
Какой размер иглы использовать для подкожного введения тестостерона?
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.
Болезненна ли подкожная инъекция тестостерона?
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.
Могу ли я перейти с внутримышечных на подкожные инъекции?
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.
Отказ от ответственности: 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.
Медицински написано и проверено: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters, in urological practice since 2016. Fellowship: Robotic Surgery, Chang Gung Memorial Hospital, Taiwan (2019) · Observership: Endourology, Juntendo University Hospital, Tokyo (2022) · Research Scholar & Clinical Observer, Scott Department of Urology, Baylor College of Medicine, USA (2025–2026).

Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (da Vinci Xi) and Kidney Stone treatment. He is currently a Research Scholar and Clinical Observer at the Scott Department of Urology, Baylor College of Medicine (2025–2026), under Prof. Mohit Khera. He completed a Robotic Surgery Fellowship at Chang Gung Memorial Hospital, Taiwan (2019) and an Endourology Observership at Juntendo University Hospital, Tokyo (2022).


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