What is the optimal time to check serum testosterone levels after intramuscular (IM) testosterone injection?

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Last updated: April 8, 2025 • View editorial policy

From the Guidelines

The best time to check testosterone levels after an injection is midway between injections, targeting a mid-normal value (500-600 ng/dL) 1.

Key Considerations

  • For patients receiving testosterone injections, levels should be measured midway between injections 1.
  • The timing of testosterone measurements will vary depending on the preparation, but for injections, mid-cycle testing is recommended 1.
  • Morning testing (between 8-10 AM) is generally preferred as testosterone naturally fluctuates throughout the day 1.

Rationale

Testosterone ester medications like cypionate and enanthate have a predictable release pattern in the body, with levels rising after injection, peaking within 1-2 days, and then gradually declining 1.

Important Points to Note

  • Consistency is important—try to have your blood drawn at approximately the same time of day and same point in your injection cycle for each test 1.
  • Your healthcare provider may adjust this timing based on your specific treatment goals, symptoms, and testosterone formulation 1.
  • The goal of testing at mid-cycle is to provide the most representative picture of your average hormone levels 1.

From the Research

Time to Check Testosterone After Injection

  • The timing of checking testosterone levels after injection is not explicitly stated in the provided studies, but it can be inferred based on the pharmacokinetics of different testosterone formulations.
  • For intramuscular injections of testosterone esters, such as testosterone enanthate, plasma testosterone levels typically peak shortly after injection and then decline rapidly, becoming subnormal in the days before the next injection 2.
  • In contrast, intramuscular injections of testosterone undecanoate have a more favorable pharmacokinetic profile, with plasma testosterone levels remaining stable and within the normal range for 12 weeks after injection 2.
  • For subcutaneous testosterone injections, serum testosterone levels have been shown to remain stable between injections, with mean levels remaining well within the normal range 3.
  • The American Family Physician recommends measuring testosterone levels after initiation of therapy to ensure that levels rise appropriately and to monitor for potential complications 4.
  • The frequency of monitoring testosterone levels may vary depending on the individual patient and the specific formulation used, but it is generally recommended to check levels periodically to ensure that they remain within the normal range 5, 6.

References

Guideline

practical use of pharmacotherapy for obesity.

Gastroenterology, 2017

Research

Testosterone Therapy: Review of Clinical Applications.

American family physician, 2017

Research

Testosterone therapy--what, when and to whom?

The aging male : the official journal of the International Society for the Study of the Aging Male, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.