This is how I self-inject on a weekly basis. I am not a doctor or any other kind of medical professional, just a transgender person who handles my own HRT. Here’s the method I use for intramuscular injections at home which you are welcome to read as educational material, and I’ve written it as instructions for myself.
1. Collect your syringe, needles, alcohol wipes and vial. You should place these items onto a sterile surface while you get ready to inject, but you can create a clean zone by laying down a tray or mat to put them on top of. You’ll need one syringe big enough to hold your full dose, one needle to draw up from the syringe and one needle to inject with. The wipes are for disinfecting the vial and your skin.
For an intramuscular injection of something even mildly viscous (like if you are injecting HRT suspended in a carrier oil) you’ll want 21g needles to draw up your dose and 23g needles to inject. These should be colour-coded, and in my case the green (21g) is to draw and the blue (23g) is to inject. The higher the number associated with the needle, the smaller it is, and that makes for the most painless injection possible.
Once you have everything laid out, use an alcohol wipe to disinfect the top of your vial if you have a reusable one. If you are using a single-use vial or ampoule, there’s still no harm in wiping it down first.
2. Draw up your dose! First, open up the syringe package and your needle for drawing up. Twist the top onto your syringe, remove the cap, and pull back on the syringe to pull air into it. Pull in slightly more air than you need for your full dose if you are using a multi-use vial where you can afford to lose some of the liquid, but keep it close to exact if you only have the exact amount that you need in the vial.
Push the needle into the vial while holding it upside-down, inject the air, then pull back to fill it with your dosage. You may have slightly more than you need at this point, if you added extra air and pulled back the same amount.
3. Switch to your injection needle. Cap off the drawing needle and put it aside, then twist on your injecting needle. Remove the cap. The top of the needle will be an empty space with air in it now, because of the cavity there, so you’ll want to hold it upright and flick the syringe a couple of times so it’s all at the top. Then push the bottom of the syringe to get rid of this air until you see a bead of liquid at the top. It’s okay if it takes you more than one try to get air bubbles out, that’s why it’s a good idea to pull up a tiny bit extra so you can afford to lose a little. Make sure that at the end of this, the dose you have is correct.
4. Prepare your thigh. Work out where to inject by placing your hand at your knee and seeing where your wrist hits on your leg, then put your wrist at your hip and see where your fingertips reach. Your injection zone is between these two points on the outside of your thigh. Disinfect the area with an alcohol wipe. Do this after a shower and with a couple of wipes over a larger area for peace of mind.
5. Inject. Bring the needle to the right spot, then push it through light you’re throwing a dart without letting go of it. One smooth and quick motion. The needle should be almost all the way in at the end of this. If you do it slowly, you’ll feel it go through skin and then fat and then muscle.
Draw back on the syringe to make sure no blood is pulled back into your dose – this means the needle is in a vein. Your artery is too far from this point for you to hit it, but there are small veins around. Restart if there is blood, with a new needle. If you are into the muscle in the right place, there will be no blood and the vacuum will create what looks like tiny bubbles. There is no actual air here. Now you can inject! Push down on the plunger slowly until the full dose is in, wait a moment, then pull the needle out and recap.
6. Clean up. Wipe the injection site. There may be a little blood if you nicked a vein on the way in. Don’t worry about this, it’s common and won’t impact your injection effectiveness. Put a plaster over your injection site once clean. Remove both needles and put them in a sharps container, then dispose of the rest of the waste wrappings and wipes. Disinfect the top of your vial again if it’s multi-use and put it somewhere dark and relatively cool.
You did it!
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