There are a few different ways to take your hormones.
For testosterone:
- Topical gel (and other topical preparations)
- Sticky patches
- Implantable pellets
- Injections
- Oral or nasal preparations
For estrogen:
- Sublingual tablet (swallowing is so old school)
- Sticky patches
- Injections
These aren’t all the ways, of course, but they are the most common ways to take hormones. When it comes down to it, a lot of gender diverse and transgender people take their hormones through injections.
Testosterone and estrogen solutions were initially made to be injected into muscles. This requires a longer needle (1.5 inches) and hurts! Repeated muscle injections over years can cause scarring in the muscles, known as fibrosis. Unfortunately, fibrosis can cause chronic pain in those old injection sites. NO GOOD!
Thankfully, some research was done to look at safer, less painful, more sustainable, and STILL effective ways to administer hormones: subcutaneous injections! Which is why we now recommend subcutaneous (sub-Q) injections. These involve a much shorter needle (5/8″ of an inch) and are MUCH LESS PAINFUL! Because the needle does not enter large muscles and potentially damage the muscle fibers, sub-Q injections are less likely to cause long term chronic pain issues, too. Yay!
So, if you are still injecting into your muscles, consider talking to your doctor about subcutaneous injections.
Sub-Q is “off-label” use of hormones, but there are several research articles to back it up (links to those articles are at the bottom of this blog.)
Unfortunately, electronic medical records (the software your doctors use to send your prescriptions) make it notoriously hard to order the correct supplies for sub-Q injections. Providers sometimes don’t know what to order, and pharmacies sometimes don’t stock what your provider orders. Sometimes pharmacies give patient supplies that can’t be used together or substitute what was ordered without talking to the provider. It can be a NIGHTMARE!
Here’s a list you can show your pharmacist and/or doctor. Remind them kindly that all components must fit together….
Supplies for subcutaneous injections:
- Needles to draw the solution from the vial (18 – 21 gauge or blunt tip needle 1-2 inches long)
- 1 mL threaded syringes
- 23 – 25 gauge 5/8″ needles
- Alcohol swipes
- Your hormones
- Bandaids
Our how-to blog at https://queerdoc.com/before-your-visit/self-injections/ has more detailed information on how to give yourself a sub-Q injection, and resources for purchasing injection supplies.
Here are some of our favorite how-to videos for subcutaneous injections:
Just under the skin…okay, but where?
There are several places on the body where subcutaneous injections are easier. Sub-Q injections work best where you have a natural under-the-skin fat reservoir:
If you have any questions feel free to reach out to QueerDoc at queerdoc@queerdoc.com!
Get your science on!
Check out these articles supporting subcutaneous injections for testosterone:
- https://www.ncbi.nlm.nih.gov/pubmed/29367424
- https://www.ncbi.nlm.nih.gov/pubmed/28379417
- https://www.ncbi.nlm.nih.gov/pubmed/29264562
Check out this article for estrogen:
Reviewed June, 2021
