13 Easy Steps To Self-Injecting HRT

The FOLX guide to safely and comfortably injecting hormones

Icons of gauze, a bandaid, an alcohol pad, a syringe, and a vial of hormones.

Get comfortable, put on some good music, and follow along with these instructions. 

You’re about to ace it. If you are new to HRT, you and your doctor can decide which method and frequency is best for you. Once you make that decision, the instructions are pretty much the same, except the size of the needle and the injection site will differ.

Want a video tutorial instead? Check out our step-by-step videos for intramuscular (IM) or subcutaneous (SubQ) injections.

Let’s get started.

1. First things first: wash your hands

Be sure to WASH. YOUR. HANDS. Cleanliness is important—no one wants an infection.

2. Next, gather supplies and make a clean, comfortable work area

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  • Alcohol pads x 2 (one to wipe down your vial top, one to clean your skin)
  • Medication vial (either T or E)
  • Band-aid
  • Sterile syringe (1mL)
  • Needle (18-22G) for drawing up the medication from the vial
  • Needle for administering medication 22-23G, 1-1.5inch for intramuscular (IM)
  • Needle for administering medication 25G, 5/8 inch for subcutaneous (SubQ)
  • Sharps container for disposal

3. Check the medication

  • Correct medication name
  • Check the expiration date
  • Make sure the medication isn't discolored
  • Make sure there are no visible particles

4. Time to prep the injection dose

  • With an alcohol swab, rub the rubber stopper at the top of the T or E vial
  • Connect the sterile needle (22G) to the sterile syringe (1mL)
  • Draw air into the syringe equal to that of your dose with the cap still on
  • Push the needle into the upright vial and inject the air into the vial 

5. Flip the vial upside down and pull on the plunger 

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  • This draws medication into the syringe equal to that of your dose
  • Make sure the tip of the needle is below the medication line so that you’re drawing up medication and not air!

6. Turn the vial upright 

  • Remove the needle tip from the vial
  • Pull down on the plunger 
  • Make sure any medication that may be left in the draw up needle is drawn into the syringe

7. Engage the safety device on the draw-up needle (or recap the needle if it’s not a safety needle)

  • Twist off the draw-up needle from the syringe
  • Place the draw-up needle in sharps container

8. Connect a new needle to inject

  • New 22G to the syringe for IM injection
  • New 25G for SubQ
    This ensures that your injection needle is new and has not been dulled by inserting into vial top!

9. Check for air bubbles

  • Make sure to remove as many air bubbles as possible by flicking the side of the syringe
  • Push the plunger until air bubbles are cleared from syringe

10. Choose your injection site

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  • Common IM sites: outer thigh, buttocks
  • Common SubQ sites: belly, thigh 
  • Clean injection site with alcohol swab

11. Go time: give yourself the injection

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  • ”Prime” the needle by pushing gently on the plunger of the syringe so that the medication fills up the length of the needle
  • Move your thumb &index finger into place by holding taught the skin at your chosen injection site
  • Quickly enter the skin at a 90-degree angle for IM injections or at a 45-degree angle for SubQ
  • Slowly push the plunger down to empty the syringe and inject the hormones

12. Remove the needle from the site of injection

  • Pull needle directly out of injection site at same angle you entered
  • Use gauze or bandaid to cover and put a little pressure at injection site

13. Discard needle

  • Engage safety device
  • Push the plunger till air bubbles are cleared from syringe

That’s it!

Congrats. Take a breath. You did it—and that was all you.

With the different routes and dosages of testosterone and estrogen, there are a lot of ways to find the one that fits best for each individual body. For existing FOLX members with questions about self-injecting, don't hesitate to schedule time with a clinician. And for those who’ve just got some more questions, read up on HRT here, and feel free to reach out to us at support@folxhealth.com.