From the Guidelines
Injection site swelling after testosterone shots is common and usually resolves within a few days, and to minimize swelling, proper injection technique and site rotation are crucial. To minimize swelling, rotate injection sites between the gluteal muscles, thighs, or deltoids, and use proper injection technique including cleaning the area with alcohol before injecting 1. Use the Z-track method by pulling the skin to one side before inserting the needle, then releasing after withdrawal to prevent leakage into subcutaneous tissue. Apply gentle pressure after injection but avoid massaging the area. If using testosterone cypionate or enanthate, injecting slowly with a 23-25 gauge needle can reduce trauma. Mild swelling can be managed with cold compresses for 15-20 minutes several times daily and over-the-counter anti-inflammatory medications like ibuprofen (400-600mg every 6-8 hours with food).
Some key points to consider when administering testosterone shots include:
- Using the correct dosage and formulation, as outlined in Table 3 of the study by Bhasin et al. 1
- Being aware of the potential advantages and disadvantages of different testosterone formulations, such as the risk of injection-associated pulmonary oil microembolism with extra-long-acting injections 1
- Monitoring for signs of infection, such as severe swelling, pain, redness, warmth, fever, or abscess, and seeking medical attention if necessary
It's also important to note that the body's inflammatory response to the injection, as well as the fact that testosterone is suspended in oil, can contribute to swelling 1. However, with proper technique and management, swelling can be minimized and resolved quickly. Seek medical attention if swelling is severe, persists beyond a week, is accompanied by significant pain, redness, warmth, fever, or if you develop an abscess, as these may indicate infection requiring antibiotics.
From the FDA Drug Label
Miscellaneous: Inflammation and pain at the site of intramuscular injection.
- Injection site reactions are possible with testosterone shots, including inflammation and pain.
- Swelling is not explicitly mentioned, but inflammation can be associated with swelling.
- Based on the available information, it can be inferred that injection site swelling may occur, but this is not directly stated in the drug label 2 or 3.
- A conservative clinical decision would be to monitor for any signs of injection site reactions, including swelling, and take appropriate action if necessary.
From the Research
Injection Site Swelling with Testosterone Shots
- Injection site swelling is a potential side effect of testosterone shots, but the provided studies do not directly address this specific issue.
- However, the studies do discuss the safety and efficacy of different administration routes, including intramuscular (IM) and subcutaneous (SC) injections 4, 5, 6.
- A study comparing IM and SC testosterone injections found that SC injections were associated with lower levels of post-therapy estradiol and hematocrit, but did not mention injection site swelling 5.
- Another study found that SC testosterone injections were well-tolerated and appeared to be as effective as IM injections in delivering equivalent testosterone levels, with lower self-reported scores for preinjection anxiety, pain during injection, and postinjection pain 6.
- The studies suggest that SC injections may be a safer and more tolerable option for testosterone therapy, but more research is needed to fully understand the potential side effects, including injection site swelling 4, 5, 6.
- Older studies, such as one from 1986, focused on the effects of chronic testosterone cypionate therapy on circulating hormone levels and sexual function, but did not address injection site swelling 7.