睾酮皮下注射：如何自行注射

最后更新： 2026年8月30日

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在之前的一篇文章中，我向您展示了如何将睾酮注射到肌肉中（肌肉注射，IM）。今天，我想向您介绍一种在全球日益流行、更温和、更简便的替代方法：睾酮皮下注射（SC）——即注射到皮肤正下方的脂肪层，而非深入肌肉。

我有许多接受睾酮替代疗法的患者觉得传统的肌肉注射（IM）不舒服，有些人还需要家人帮忙才能注射到臀部或大腿肌肉。好消息是，现代研究表明皮下注射途径同样有效——而且通常舒适得多，也更易于自行注射。

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.

为何考虑皮下注射途径？

近 80 年来，肌肉注射（IM）睾酮一直是标准方法。它价格低廉，能产生可预测的睾酮水平——但难以自行注射，且常伴有不适感。近来，皮下注射（SC）途径日益受到欢迎，因为自行注射要容易得多，现有证据也支持其可行性。

皮下注射（SC）途径的主要优势包括：

• 自行注射更简便：无需注射到深层肌肉，也无需他人帮忙。
• Less pain: Smaller needles and a shallower injection make it considerably more comfortable for most men.
• 无坐骨神经损伤风险：这是臀部肌肉注射（IM）已知的（虽然罕见）风险。
• 激素水平稳定：皮下注射（SC）能产生更平稳、更稳定的睾酮水平，峰值与谷值波动更小。
• 更好的依从性：由于方便且舒适，患者更有可能长期坚持治疗。

A landmark 52-week clinical trial published in 泌尿外科杂志 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?

特性	肌肉注射	皮下
注射深度	深入肌肉	进入皮肤下的脂肪层
常见网站	臀部或大腿外侧	腹部（肚子）或大腿
针号	更长，更大的规格	更短，更细的规格 (23-25G)
疼痛等级	温和不适	Usually mild
自行给药	困难；可能需要帮助	Easy to do alone once taught
睾酮水平	更大的峰和谷	更顺畅，更稳定

你需要准备的东西

• 酒精棉片
• 您处方中的睾酮安瓿（例如，睾酮庚酸酯或睾酮环戊丙酸酯）——请务必检查有效期
• A 1 mL Luer-Lok syringe (preferred to prevent the needle from disengaging due to the oil’s viscosity)
• 用于从药瓶中抽取睾酮的抽吸针（18-21G）
• 用于皮下注射的细短注射针（23-25号，5/8英寸）
• A sharps disposal container — a rigid, puncture-proof container kept for needles only, never the household bin

注射地点：地标

皮下注射睾酮推荐的两个部位是：

• 腹部：将药物注射到肚脐（脐部）一侧3至5厘米处的脂肪组织中。避免注射在离肚脐太近的区域。.
• 大腿：大腿前侧或外侧的脂肪组织也是合适的取脂部位。.

轻轻捏起一块皮肤和脂肪，使其远离肌肉。这有助于确保注射进入皮下层而不是肌肉。. 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.

循序渐进：如何进行皮下睾酮注射

⚠️ 重要： 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. 彻底洗手，然后坐在舒适的椅子上，准备好你的用品。.
2. 选择注射部位（腹部肚脐旁3-5厘米处，或大腿）。每次注射时轮换注射部位。.
3. 使用较大的抽取针（18-21G）从药瓶中抽取处方剂量的睾酮到您的鲁尔锁注射器中。.
4. 从注射器中清除所有气泡（切勿注射空气）。.
5. 将抽吸针头更换为细注射针头（23-25G）。.
6. 用酒精棉签清洁注射部位，然后让其自然风干。.
7. 轻轻捏起一小片皮肤，以 45 至 90 度角将针头插入脂肪组织。.
8. 慢慢地在几秒钟内注射睾酮。.
9. 拔出针头，用干净的棉球或纱布轻轻按压注射部位。不要揉搓。.
10. 请将针头和注射器安全地丢弃在您的利器盒中。.
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.

可能出现的副作用

局部反应通常是轻微和短暂的，可能包括：

• 注射部位轻微发红、瘙痒或出现小无痛结节
• 轻微瘀伤或出血
• 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.

给药途径很大程度上是个人偏好问题；监测计划是强制性的。看看结构化的长期随访是如何在 我们的睾酮治疗服务.

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 曼谷医院总部 and at Samitivej Sriracha Hospital, Chonburi — 088-022-1445.

曼谷医院远程医疗服务适用于无法亲自就诊的患者，包括国际患者——请通过电子邮件提前向泌尿科预约： 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.

常见问题解答

皮下注射睾酮是否和肌肉注射一样有效？

是的。多项研究表明，睾酮烯醇酯或环戊丙酸睾酮的皮下（SC）注射可产生与肌肉内（IM）途径相当的血清睾酮水平。事实上，皮下注射通常能产生更平稳、更稳定的激素水平，峰谷值较小，同时更易于自行注射且疼痛感较低。.

皮下注射睾酮的注射部位有腹部（肚脐周围2英寸以外）、大腿前外侧和臀部外上侧。

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.

您应该使用多大的针头注射皮下睾酮？

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.

皮下注射睾酮会痛吗？

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.

我能从肌肉注射换成皮下注射吗？

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.

免责声明 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.