Intramuscular testosterone replacement therapy
Testosterone injection must be given by deep intramuscular injection; it is not recommended in individuals with bleeding disorders or those receiving anticoagulation. Give the injection very slowly to minimise discomfort, and take care to avoid inadvertent intravenous administration.
For intramuscular testosterone replacement therapy, use:
1 testosterone undecanoate 1000 mg by deep intramuscular injection; repeat after 6 weeks and then every 10 to 14 weeks, according to clinical response and serum testosterone concentration. For more gradual replacement, give the second dose after 10 to 14 weeks male androgen deficiency, intramuscular therapy testosterone
OR
2 testosterone enantate 250 mg by deep intramuscular injection, every 2 to 3 weeks testosterone
OR
2 testosterone esters 250 mg by deep intramuscular injection, every 2 to 3 weeks. testosterone
See Monitoring testosterone replacement therapy for guidance on adjusting testosterone therapy.
Although uncommon, coughing, dyspnoea, sweating, chest pain, dizziness, paraesthesia, or syncope can occur during or immediately after injection of testosterone. This has been attributed to pulmonary oil microembolism. Treatment is supportive, and further therapy with intramuscular testosterone is not contraindicated.
Testosterone enantate or testosterone ester injections may be associated with marked fluctuation in testosterone concentration, leading to variation in energy, wellbeing and libido.