I get an intra muscular injection of testosterone every two weeks and it's true that it's not as easy as a sub q injection would be, but it also definitely doesn't require a nurse.
there's a few good injection sites (upper arm, buttock, thigh or even pecs) and after I was shown once how it's done, I can do it myself. it's also essentially painless.
Off topic, feel free not to answer if it's too personal but I'm curious how is every two week injections working for you for Testosterone? Are you on TRT for Hypogonadism or is it something else? I haven't heard too many people be on that kind of protocol..
I'm Hypogonad and I'm on self administration of sub q injections twice a week and it's quite annoying. My urologist told me it's best to split it this way since more frequent injections avoids a "crash".
I would like to have less frequent injections if I could!
It depends on the exact type of Testosterone being used. Each type has a different half-life and absorption profile.
The most common - Testosterone Cypionate should be best used twice a week to avoid the "crashes" - if you care about keeping your levels relatively stable. Other forms of Testosterone have different half-lives and should be taken at differing schedules.
I never saw the point in subq shots for TRT. They are less effective, and are recommended solely for patient comfort and compliance. If you can manage a twice-weekly deep IM injection, I personally have had great results with that once I learned the locations. Nearly as painless as subq and better more consistent results.
Overall it doesn't matter a whole ton unless you are doing it for specific performance enhancing reasons. Being off "optimal schedule" a few days isn't going to make a meaningful difference for most.
Both graphs are 200mg per week. Green is dosed at once every 7 days, while the blue is broken into 7 smaller doses per week. (I haven't included axis and such, because it's really just the shape I'm trying to highlight)
As you can see, more frequent dosing results in steadier levels.
When administering your testosterone once per week, you will have to make one of a couple trade offs:
1) Dose high enough that you are above the level you want to be by the end of the week. This avoids the "crash" you mention, which will consist of both low-testosterone (low-libido, fatigue, etc) and low-estrogen[1] (joint pain, etc) side effects. Dosing higher means you shift the whole graph up, and you will be at supra-physiological levels of testosterone and estrogen, and the high estrogen side effects are no fun: nipple sensitivity, emotional fluctuations (think crying at the sight of puppy pictures), gynecomastia (development of breast tissue), horrible back acne, etc.
2) Dose on the lower side to avoid avoid high testosterone/estrogen side effects. This shifts the whole graph down, and now you're below where you want to be by the end of the week, and you now feel more like you did before you started TRT.
3) Somewhere between the above two options, and add an aromatase inhibitor (like anastrozole) to minimize high estrogen levels. You'll still have excessively high testosterone though... and you'd really be better off avoiding the high testosterone peaks instead of adding another drug to the mix.
I used to go into a clinic once a week for an intramuscular injection of testosterone cypionate. In order to not feel like shit the last two or three days of the week, I had to up my dose such that my back broke out in a constellation of acne, and probably negatively impacted my health in other more meaningful (but less obvious) ways.
Now I inject testosterone propionate every night. I managed to lower my dose so that I'm always hovering right around where I want to be, instead of bouncing all over the place.
That's another benefit of increased injection frequency: you can lower the total amount of testosterone injected per week while staying within therapeutic range.
1: Your body produces estrogen by aromatising testosterone. More testosterone and/or more aromatase -> higher estrogen. Less testosterone and/or aromatase -> lower estrogen.
This is true generally in pharmacology, but the plasma concentration of the androgen esters (prodrugs) isn't a good measure of "active" testosterone in your system. Thus the graph is a bit of an exaggeration. Basically, as long as the slopes are the same (rate of breakdown ≈ rate of prodrug conversion), you'd get ~same plasma levels.
Ideally they'd break down at a constant rate (they don't, but close enough) leading to steady levels despite levels of the prodrug steadily diminishing. This makes once a week dosing of testosterone cypionate (for example) viable for many, but not all, as you've discovered.
Dosing less but more often helps minimize the uncertainty/variability in breakdown/conversion, thus being more reliable at the cost of convenience.
there's a few good injection sites (upper arm, buttock, thigh or even pecs) and after I was shown once how it's done, I can do it myself. it's also essentially painless.