Overview
Preparing and administering an injection safely and effectively requires following hygiene protocols and a reproducible technique.
Here we will demonstrate the steps for administering the two types of injections used for HRT: intramuscular and subcutaneous.
There is no discernible difference between intramuscular and subcutaneous injections in terms of safety or efficacy, which is exactly why we ALWAYS recommend subcutaneous, since they are easier to administer and cause significantly less pain.
Supplies
Common supplies: alcohol pad, 1ml syringe
21-23G needle, 1" - 1 1/2". It is recommended to have another 21-25G needle to insert into the vial.
25-30G needle, 5/8" for injection. Another 21-25G needle is recommended to insert into the vial.
Insertion
Clean the vial's stopper with an alcohol pad and let it air dry.
Attach your thickest needle (lowest G) to the 1mL syringe. Uncap it carefully.
Draw some air into the syringe. Turn the vial so that the rubber cap is facing down.
Insert the needle through the rubber cap and push the air into the vial. This helps create pressure so the liquid flows more easily.
Draw the liquid from the vial, drawing a little more than necessary.
Slowly push the plunger to remove air bubbles and adjust the dose to the correct amount.
Remove the needle from the vial and cap it carefully. Switch to your thinnest needle (highest G) for the injection.
Injection Sites
Injection sites for IM:
Divide the upper part of the thigh (above the knee) into three imaginary vertical and horizontal sectors, creating a 3x3 grid. The ideal injection site is the vastus lateralis muscle, which will be the middle or middle-outer sector of the grid.
Injection sites for SubQ:
The abdomen, avoiding the area around the navel, is a common site for subcutaneous injections. The upper part of the thigh is also an option for subcutaneous injections, similar to the IM site.
Injection
The needle must always be inserted at a 90-degree angle to the skin. Clean the injection site with an alcohol pad. Stretch the skin gently with one hand. Slowly, insert the needle. It is normal to feel pressure or pain. Insert it deeply. Then, slowly press the plunger to administer the medication. It is recommended to wait about ~10 seconds before withdrawing the needle. Withdraw it at the same angle at which it was injected. Massage the area after the injection to distribute it through the tissues.
The needle should be inserted at a 45-degree angle to the skin to ensure that the medication is deposited in the subcutaneous fat layer. Clean the injection site with an alcohol pad. Stretch the skin gently with one hand. Slowly, insert the needle. It is normal to feel pressure or pain. Insert it deeply. Then, slowly press the plunger to administer the medication. It is recommended to wait about ~10 seconds before withdrawing the needle. Withdraw it at the same angle at which it was injected. Massage the area after the injection to distribute it through the tissues.
Always rotate injection sites to avoid irritation and lumps. A general rule is: inject into the other leg or the other side of the abdomen, and try to always inject at a different site, even if only 1-2cm away.