Photo by Raghavendra V. Konkathi on Unsplash

I started injecting testosterone in 2023. At times, I had limited access to doctors and health insurance, but I have been taking testosterone consistently for about two and a half years in total.

I currently take 100mg every ten days, injected subcutaneously into the thigh. My doctor orders labs every six to twelve months at the end of my injection cycle; I normally measure about 500ng/dl of total testosterone in the blood.

I am planning to share about my experiences in another post, perhaps when I hit the three-year mark. For now, here are my tips on taking testosterone. I believe we can all learn from one another, so please share your tips in the comments.

1. Get a competent doctor

This is my most important piece of advice. If you are lucky enough to have health insurance or another way to “shop around” for doctors, use that to your advantage. I originally went through Planned Parenthood when I didn’t have health insurance, and that was fine. However, once I signed up for a health insurance plan, I did research on local doctors and chose a primary care provider who had excellent reviews. If he hadn’t treated me with respect and care, I would have switched to another doctor until I found one who understood me and treated me well.

Doctors can be intimidating, anxiety-inducing, condescending, and can even negatively affect your health. For these reasons, I needed to find a provider who made me feel comfortable and listened to my concerns.

I’m grateful that I get my prescription through my primary care provider because testosterone affects many of my health conditions. If you’ve read my other posts, you’ll know that I have bipolar disorder, and I recently had an ovarian tumor removed. Without my PCP, it would have been much harder to access my bipolar medication and find a surgeon to do my hysterectomy.

Some qualities of a good doctor (in my opinion):

• In network with your health insurance
  • If you don’t have health insurance, look for a doctor or practice that uses sliding-scale payments.
• Not too far away; if you have to use sick time for doctor’s appointments, you don’t want to waste hours on driving.
• Listens to your concerns without being dismissive
• Smart and uses their resources
• Respectful of your identity and acknowledges the ways identity can affect your health
  • This isn’t just your gender; doctors often discriminate based on race, disability, sexual orientation, or other factors.
• Explains medical concepts in a way you understand without being condescending
• Understands your financial barriers

Some tips on choosing a doctor:

• Know the difference between a D.O., M.D., P.A., and N.P., and choose someone who aligns with your needs.
• Look for a background in public health, human services, or similar. These degrees focus on treating the person as a whole rather than fixing a singular issue.
• Look at reviews, considering the factors that you care about the most.

2. Manage anxiety

It’s normal to get anxiety when dealing with needles, especially if you’re injecting yourself. If your anxiety is a significant barrier for you, it’s worth mentioning to your doctor. Sometimes they can prescribe hydroxyzine, a short-term anxiety medication. If medication isn’t the right route, another option is to change your needle size. I have used insulin needles, and while they take longer to draw up the medicine, they are more comfortable.

I am diagnosed with anxiety, but I no longer use prescription medication to manage it. Instead, I use CBD gummies. Availability can differ by location; if you live in a place that has legalized CBD, it’s worth looking into. I know someone who owns his own CBD company, and I’ve learned that it’s important to look for full-spectrum gummies and a high dose. I use gummies that contain 50mg of CBD, taken twice a day. CBD does not induce a high, as consumers commonly misunderstand.

CBD isn’t for everyone and isn’t meant to cure any medical condition. I have nothing to gain from my testimonial and am just sharing my experience.

3. Consider gel

Testosterone gel is as effective as testosterone injections. If you struggle with needle anxiety or a potentially irregular shot schedule, gel can be a viable option for you. Some points to consider before starting gel are the potential to transfer to other people or pets, skin sensitivity, and the monetary cost.

When I was considering gel, I found that my insurance would have made me pay about $200 per month (I normally pay $10 per month for injections). GoodRx coupons would bring that down to about $70, but that’s still too expensive for my budget. It’s important to research your insurance coverage before deciding if gel is right for you.

4. Deal with urticaria (if applicable)

A Reddit search shows that many trans men struggle with something similar to cholinergic urticaria, also known as heat rash. This is a very painful, itchy sensation when body temperature rises. Somehow, after searching through scholarly databases, I can’t find any research that acknowledges this. Here is what I’ve found can help with urticaria, which started for me six months into my testosterone journey.

Sweat therapy (physical heat)

This is the concept that your urticaria is sweat struggling to leave the body, so getting yourself to sweat will reduce the pain for the rest of the day. Some people take hot baths or buy a portable sauna. I haven’t tried a sauna, but I have tried baths, and it seemed to only work if the water temperature was too hot for comfort. This could be a suitable solution for some people, but it wasn’t for me.

Sweat therapy (exercise)

Similar to the previous solution, this one has the same concept, using exercise instead of the external environment. Doing cardio for about ten minutes or more (depending on the individual) will raise your body temperature, cause you to sweat, and reduce the pain for the rest of the day. This could be a great solution if you are okay with doing cardio each day.

Supplements

This is what I do to manage my pain. Dosages will be different for everyone, but I take a high dose of L-glutamine and vitamin D. This has completely solved my problem for almost a year now. If I stop taking it, the pain and itching return.

5. Manage hunger

When I started testosterone, my hunger skyrocketed. I gained about 40 pounds. Most of that went to my build and muscle mass rather than visible fat. I benefited from leaning into my hunger and allowing myself to gain weight because now I have a body that feels more like myself. I also know that food is expensive, and it’s not reasonable to spend all day eating. There can be a middle ground.

I have a hard time reading my body’s signals. When I’m hungry, I rarely realize until I feel as though I’m starving. Something I have been trying to do in order to make feeding myself easier and cheaper is meal planning. On Sundays, I figure out what my partner and I want to eat that week, and I go grocery shopping. Then, I make all of my meals for the first half of the week. I make the rest when I run out of food on Wednesday or Thursday. I benefit from reducing friction in my day, and planning helps me do just that.

If meal planning isn’t for you, counting calories can be helpful (even if you don’t restrict – just paying attention to what you eat can be beneficial). I have used Cronometer (not sponsored) in the past because this app has no guilt or shame built into the interface. If you struggle with disordered eating, I would not recommend counting calories.

My final recommendation on this point is to make sure your food is fulfilling for you. Don’t eat things you don’t like just because they’re healthy. Instead, find healthy versions of foods you do like. You can also add things like spinach or lentils to many foods to add beneficial nutrients.

6. Stock up on what you need

This is especially important if you have your ovaries removed, like I do. If I stop taking testosterone, I will go into menopause. Therefore, I stock up on needles, alcohol swabs, Band-Aids, and testosterone vials.

Injection equipment

There are medical supply websites where you can order needles, syringes, and alcohol swabs in bulk. This costs more upfront but saves money in the long-term. I order all of my supplies online in packs of 100 to 200. If you inject yourself every week like most people do, 100 needles will last you nearly two years. These sites require you to upload a picture of your prescription to order.

I would not recommend ordering from Amazon. They are not sterile for human use and may have defects.

Testosterone vials

Saving the leftovers from my 1ml testosterone vials is another way I make sure I have long-term access to testosterone. I take 0.5ml, so I can get two doses out of one vial. I fill my prescription on time so that I always have more than what I need. Pharmacists will tell you not to do this, but multiple doctors have told me that it’s fine. Who you listen to is up to your discretion.

Band-Aids

I only use Band-Aids meant for sensitive skin. They are much easier to take off. I have hairy legs, and I used to shave a small area before my shot. However, after I discovered that sensitive skin Band-Aids exist, I never went back. They are a little more expensive, but worth the convenience if you can afford them.

7. Make your shot easier

One thing I do to make my shot a little easier is making sure I’m sitting with correct posture. There are two options that work for shots in the thigh to make them as painless as possible. I usually sit with my feet flat on the floor and my thighs sitting on a hard surface (normal posture for sitting in a chair). Another option that I’ve heard works well, but I have not tried, is sitting on the floor with your legs straight. I would not recommend sitting on a bed to do your shot because beds are a softer surface.

The last tip I have to make your experience easier is to put your shot date on your calendar or in your planner. I am someone who forgets to do my shots or puts them off, but having the date in my calendar makes it easier to force myself to do it.

This has been all of my advice for taking testosterone. If you have any other advice that I haven’t mentioned here, please comment so that others can learn from you. Thanks for reading!