What you should know getting started
What should I expect?
A “typical” dose is 100-200 milligrams injected every two weeks, and the cost will vary depending on insurance. In 2-10 weeks, you should start to see the effects of the testosterone: development of facial hair, deepening of the voice, changes in body mass, decreased glandular tissue in the breasts and clitoral enlargement.
Each person is different, so it may take more or less time to see changes, and it may take several months to a few years to achieve the full effect of the testosterone.
What about side effects?
While using testosterone, the most common side effect is acne, which up to half of patients experience. Your doctor will also monitor your liver function, especially if you have risk factors for liver disease. In some high risk patients, testosterone can worsen liver function or existing liver damage. Many patients also experience some soreness at or around the injection site for a few days after their injection. You may also experience a change in sense of smell.
Before you inject
Make sure your testosterone vial is free of any crystals, discoloration, or other contamination.
Prepare the area: make sure you are in a safe, clean environment. Wash your hands and make sure you swab the vial and the area you are injecting with alcohol to get rid of any unwelcome bacteria. Breathe! The first few injections can be nerve-wracking while you get used to the process. Try to keep yourself calm – sometimes the support of a close friend or family member helps.
NOTE: Crystals can form in cold environments – dissolve them in warm bath water. Also, make sure you have an appropriate container close by, such as a sharps container, to dispose of the used needle. Safety is a top priority!
Injecting – a step-by-step guide
After you have prepared the area, you can follow these basic steps for the injection:
1. Draw up your dose – it may help to use a larger needle for this step. Inject air equal to the amount of liquid you will draw up and tip the vial upside down while you draw up your dose. Try to get rid of any air bubbles in the syringe by flicking them to the top and pushing the air out.
2. Change to a smaller needle if you used a larger one to draw up the medication.
3. Insert the needle into your muscle at a 90 degree angle. Most people use their upper, outer thigh. When inserting the needle, there will be more resistance through the skin, then less as you move through the subcutaneous fatty layer, then more again when you hit the muscle. Most people use a needle length which allows the entire needle to be inserted.
4. Inject the testosterone. A slower injection can help reduce soreness.
5. Remove the needle and toss the syringe in a sharps container. Use a cotton swab or bandage if some bleeding is present.
We are here to help!
If you don’t find the answers to your questions, please feel free to give us a call or stop in. We want to help you feel comfortable and safe with your medications and are happy to talk with you in more detail.
This brochure was created as part of my student internship. If you have any further questions or would like to know more, please contact the Community Pharmacy staff.
Victor Warne DPH-4, 2015
UW Student of Pharmacy School
1. Vance SR, Halpern-felsher BL, Rosenthal SM. Health care providers’ comfort with and barriers to care of transgender youth. J Adolesc Health. 2015;56(2):251-253.
2. Giltay EJ, Gooren LJ. Effects of sex steroid deprivation/administration on hair growth and skin sebum production in transsexual males and females. J Clin Endocrinol Metab. 2000;85(8):2913-2921.
3. Gooren LJ, Giltay EJ. Review of studies of androgen treatment of female-to-male transsexuals: effects and risks of administration of androgens to females. J Sex Med. 2008;5(4):765-776.
4. Gooren LJ, Giltay EJ, Bunck MC. Long-term treatment of transsexuals with cross-sex hormones: extensive personal experience. J Clin Endocrinol Metab. 2008;93(1):19-25.
5. Slagter MH, Gooren LJ, Scorilas A, Petraki CD, Diamandis EP. Effects of long-term androgen administration on breast tissue of female-to-male transsexuals. J Histochem Cytochem. 2006;54(8):905-910.
6. Lapauw B, Taes Y, Simoens S, et al. Body composition, volumetric and areal bone parameters in male-to-female transsexual persons. Bone. 2008;43(6):1016-1021.
7. Mueller A, Kiesewetter F, Binder H, Beckmann MW, Dittrich R. Long-term administration of testosterone undecanoate every 3 months for testosterone supplementation in female-to-male transsexuals. J Clin Endocrinol Metab. 2007;92(9):3470-3475.
8. Wierckx K, Elaut E, Van caenegem E, et al. Sexual desire in female-to-male transsexual persons: exploration of the role of testosterone administration. Eur J Endocrinol. 2011;165(2):331-337.
9. Costantino A, Cerpolini S, Alvisi S, Morselli PG, Venturoli S, Meriggiola MC. A prospective study on sexual function and mood in female-to-male transsexuals during testosterone administration and after sex reassignment surgery. J Sex Marital Ther. 2013;39(4):321-335.