By Mike Kocsis | 7 minutes read | Last updated: April 16, 2020 Categories: Medication Testosterone TRT
Medically Reviewed by Dr. George Touliatos
As the popularity of testosterone injection treatments continues to rise, it becomes increasingly evident that they are among the most highly effective solutions for individuals dealing with low testosterone levels. Nevertheless, there is growing interest in exploring subtle adjustments that might significantly enhance the effectiveness of these treatments. Notably, there are several injection site options available for testosterone therapy. Before selecting the ideal injection site for your treatment, it’s essential to familiarise yourself with each injection type and understand how the chosen location can impact the treatment’s effectiveness.
In this article, we are going to examine two types of intramuscular (im) injection sites: ventrogluteal im injections and dorsogluteal im injections. One of the questions that many men ask who are undergoing testosterone injections is which injection site is best? This debated topic is somewhat difficult to prove beyond a reasonable doubt, but we are going to give you all of the information that is available on these two injection sites.
Glute Injection Site Effectiveness and Safety
If you’re seeking the most effective and safe injection site for your testosterone treatment, it’s essential to consult a medical professional specialising in testosterone therapies. However, medical opinions are far from unanimous. Just like within the TRT (Testosterone Replacement Therapy) community, scientists and doctors hold differing opinions on the best injection sites, or if the injection site significantly impacts the treatment’s outcomes.
Personalisation is Key
We are all unique, with individual medical circumstances, making it challenging to prescribe a one-size-fits-all injection site. Your ideal injection site could vary depending on your specific situation, your medical professional’s recommendation, or even your personal preference. The absence of a universal standard means you can have a say in this important decision.
Prioritizing Safety: The Ventrogluteal Site
Research into injection site safety has favoured the ventrogluteal site as the safest option. This preference arises from the absence of major blood vessels in this region, making it an inherently secure choice for injections. In contrast, the dorsogluteal site, located close to the sciatic nerve, presents more safety concerns.
Source: springer.com
The Preferred Choice, But Not the Only Choice
While many medical professionals favour the ventrogluteal site for its safety, it’s crucial to understand that it may not always be the best option for every situation. Circumstances may call for alternative sites. Nonetheless, the ventrogluteal injection site remains the preferred choice for many, thanks to its established safety record.
About Dorsogluteal Injections
Dorsogluteal injections are one of the most common ways that doctors and patients choose to administer testosterone treatment injections. Here is some information about this type of injection and why so many people choose to use it.
Where is the dorsogluteal im site?
The first thing to understand about the dorsogluteal im site is where it is located. For a visual, you should divide the buttocks into four quadrants. To locate the site of injection you will simply find the upper and outer section of that grid. It is located high on the buttocks, near the thigh. This is one of the most common sites for injections of all kinds, not just testosterone therapy. Even though other injection sites are preferred for testosterone treatments, this site is still perfectly safe, when done correctly.
The pros and cons
Like with other injection sites, there are both pros and cons to using the dorsogluteal injection site for your testosterone replacement therapy. Understanding these pros and cons will help to guide you to make the right decision and stay informed throughout the process.
Pros
Easy to locate: One of the main benefits of dorsogluteal injection site is that it is very easy to locate. This means that even for a beginner to TRT and injections, it will be easy to find the location where you are supposed to put the injection.
Cons
Challenging for self-injectors: if you are going to be doing your injections yourself and you don’t have the greatest amount of flexibility, then this injection site might not be the best for you. To reach the location to perform the injection, you will have to twist and turn, which is not ideal for some people.
Incorrect placement can lead to pain during injection: If you do get the injection site wrong due to its difficulty to reach, then it can be quite painful as well. Nobody wants to experience pain with injecting, so those who are unable to get the injection point right on a consistent basis might find this injection site difficult to use regularly. There is research to back this up that suggests dorsogluteal injections are, by nature, more painful than injections that occur in the ventrogluteal location.
Near the sciatic nerve: In addition to the pain that is often involved and the hard-to-reach location of the dorsogluteal site, it is also near the sciatic nerve, which means that you will need to aspirate. This adds time and difficulty to the process, making it less than ideal if you are able to get the same effectiveness out of another injection location.
Overall, the dorsogluteal site for injections should work fine for anyone who is able to use the injection site correctly. If you think that you will have trouble using the injection site as directed by our doctors, then we would advise you to inject into the ventrogluteal site.
About Ventrogluteal Injections
The other injection site that you can use for testosterone replacement therapy injections is the ventrogluteal site. There are two main sites that doctors and individuals use for these types of injections, and this site and the dorsogluteal site are the two. Ventrogluteal sites are much more commonly used because of the various benefits that they present. With this information about ventrogluteal sites, you’ll be able to have a thoughtful discussion with your medical professional to determine if this is the right injection site for you.
Where is the ventrogluteal im site?
The first thing that you’ll need to know about the ventrogluteal im site is its location. The location of the site is crucial because it determines how effective the injection is, how painful it is, and how easy it is to administer the injection. While the dorsogluteal site is very easy to locate, this site is a bit more challenging. This is one potential downside to it, however with some practice, you should be able to locate it fairly easily after a while.
The ventrogluteal intramuscular injection site is located on the hip at the high part of the hip. To locate this site, it takes a bit of medical training, which we will provide you with. To locate it, place the palm of your hand on the femur on the part that protrudes. Place your index finger on the anterior iliac crest of the femur and spread your middle and index finger away from each other. The injection site is in the middle of the “V” that is created when this is done. To find this site, you’ll need to know your anatomy quite well and ensure you are placing your hands in the correct location.
Ventrogluteal im injection procedure
- Prepare everything, ensure you have your syringe, filter needle, other needles and testosterone ready, along with a disposal bin.
- Open your syringe bag and filter the needle bag, keeping the packaging on where possible in order to not contaminate the needle.
- We recommend using an 18 Gauge filter needles which we supply our clients with.
- Screw the filter needle onto the syringe, leaving the protection cap on the needle.
- Open your testosterone box and get out the glass single-use ampule. Break the top off the ampule from the dot and dispose of the top.
- Take the top protection cap off the filter needle and draw up from the ampule your correct dose as prescribed by your doctor.
- Draw any air and testosterone downwards and into the syringe and pop the filter needle protection cap back on.
- Dispose of the single-use ampule, do not use any further testosterone from it.
- Open the packing for your injection needle, we recommend the 25 Gauge needle.
- Take your syringe and untwist the filter needle with cap off and put it in your sharps bin
- Put your injection needle with packaging left on onto the syringe, once secured remove the packaging and push up all the air out of the syringe until you hit your dosage marker on the syringe.
- Clean the injection area using an alcohol wipe once you have located it using our instructions as above (this is the upper outer quadrant of the glute or ventrogluteal injection site).
- Dart the needle into the muscle and push in relatively quickly.
- Press and wipe the area with an alcohol wipe and dispose of your injection needle into the sharps bin.
Follow our Ventrogluteal im injection procedure video
Pros and Cons
Even with some of the added complexity that comes with using an ventrogluteal intramusular injection site for testosterone replacement therapy, it is still the site that most doctors and medical professionals prefer to use when administering testosterone replacement therapy. That is because it comes with tons of benefits to love.
Away from major arteries and vessels: The main benefit of the ventrogluteal injection site is that it is far away from any of the major blood vessels in the leg. This includes nerves, vessels, and the sciatic nerve. In addition to the lack of nerves and vessels around this site, the tissue that surrounds the ventrogluteal site is thick and strong. With these factors in mind, the ventrogluteal site is so popular because doctors and patients feel confident that they will not cause harm to the patient when using this site for the injection for testosterone replacement therapy.
Slightly easier to to reach: Due to the location of the injection site, the ventrogluteal injection site is only slightly easier to reach than the dorsogluteal site, but those who are injecting themselves mostly find it easier than trying to twist and turn to find the other location. Finding the exact injection location, however, is still quite challenging in this site. The more that you practice with this injection site, the better.
If you are going to use this injection site for your testosterone replacement therapy injections, you should enlist the help of a medical professional to help you with the first few injections so that you can ensure you have a good grasp of what is going to be required to effectively administer treatments in this manner.
Conclusion
Testosterone replacement therapy is quickly becoming one of the most commonly used treatments out there, and as a result, there are millions of men worldwide who are looking to learn more about the treatment, how it is administered, and where is the best location to use for treatment. Knowing the best location for your treatment can drastically improve the effectiveness of the treatment and the comfort that you are able to experience while undergoing the treatment. For men who are dealing with the symptoms of low testosterone on a daily basis, it is more important than ever to get the injection site right and learn as much as possible about the possibilities when it comes to injection sites.
Both injection sites offer pros and cons however, we would recommend the ventrogluteal site over dorsogluteal injection site as it is a lower risk area to inject into and once you get used to the procedure, finding the location it becomes easier over time. We have outlined the ventrogluteal im injection technique above that we use throughout our clinics.
Evidence Based Research
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References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: April 16th, 2020
