Subcutaneous Testosterone for Hormone and Muscle Health

Abstract

Subcutaneous testosterone injections, often called SubQ or SC testosterone injections, place testosterone into the fatty tissue just beneath the skin instead of deep inside a muscle. For properly selected patients, this route may offer a simpler way to receive injectable testosterone. Research in men shows that subcutaneous testosterone can produce testosterone levels comparable to intramuscular injections while often being easier and more comfortable to self-administer (Figueiredo et al., 2022).

At Wellness Doctor RX, we view hormone health as part of whole-body wellness. Testosterone can influence muscle, bone, body composition, sexual health, and other body functions, but hormone treatment works best when it is connected with nutrition, exercise, metabolic health, sleep, rehabilitation, and proper medical monitoring. Our integrative model combines medical oversight with functional medicine, chiropractic care, and rehabilitation.

For patients who do not want testosterone pellets or deep intramuscular injections, SubQ testosterone may provide another option. However, women require special consideration because the strongest evidence for testosterone therapy in women involves transdermal treatment, and no testosterone product is currently FDA-approved specifically for women in the United States.

What Is a Subcutaneous Testosterone Injection?

Testosterone injections have traditionally been given into a large muscle. This is called an intramuscular, or IM, injection.

A subcutaneous injection works differently. Instead of passing through the skin and entering muscle tissue, the needle enters the fatty layer directly under the skin.

This difference may sound small, but it can change how a patient experiences long-term treatment.

A major review in the Journal of Clinical Endocrinology & Metabolism examined available research on subcutaneous testosterone. The authors found that subcutaneous testosterone enanthate and testosterone cypionate can produce predictable testosterone concentrations. They also reported that SubQ injections are easier to self-administer and cause less discomfort than traditional IM injections (Figueiredo et al., 2022).

Dr. Thomas A. Hatzilabrou’s white paper, The Quiet Case for the Subcutaneous Needle, reviews this developing evidence and argues that intramuscular administration should not automatically be considered the only practical injectable option. The paper describes research showing comparable exposure, easier administration, and potentially smoother concentration patterns with SubQ delivery.

SubQ Testosterone vs. Intramuscular Testosterone

Intramuscular testosterone works. It has been used for decades and remains an appropriate choice for many patients.

The question is whether every patient needs a deep-muscle injection.

SubQ testosterone may offer several practical advantages:

• A shorter, finer needle
• Easier access to the injection area
• Less injection discomfort for many patients
• Easier self-administration
• Less anxiety surrounding a deep injection
• An alternative to implanted testosterone pellets
• Greater flexibility for some long-term treatment plans

In a crossover study comparing subcutaneous and intramuscular testosterone, overall testosterone exposure was comparable between the two routes. Participants also reported less pre-injection anxiety, less pain during the injection, and less pain afterward with SubQ treatment (Wilson et al., 2018).

Another study found that subcutaneous testosterone was an effective alternative to IM treatment and was preferred by many of the participants who experienced both methods (Spratt et al., 2017).

This does not mean SubQ is automatically “better” for everyone. It means patients and clinicians have another route to discuss.

Can SubQ Testosterone Produce Steadier Levels?

One interesting difference between muscle and fatty tissue is blood supply.

Muscle tissue is well supplied with blood. Subcutaneous fat is generally less vascular. This difference may affect how quickly an oil-based testosterone ester leaves the injection site.

The Hatzilabrou white paper explains that placing the medication in subcutaneous tissue may create a slower-release depot. The paper reviews evidence suggesting that this can reduce some of the large peak-to-trough changes seen with certain IM dosing schedules.

Clinical research also supports the possibility of relatively stable testosterone concentrations with weekly SubQ administration. One study measuring testosterone at several points during the week found that mean free and total testosterone remained relatively stable between injections (McFarland et al., 2017).

That doesn’t mean everyone will respond the same way. Absorption can vary, and dose requirements are individual.

This is why laboratory monitoring matters.

Why a Smaller Needle Can Matter

For someone receiving hormone treatment over months or years, the experience of taking the medication can affect whether the treatment plan is followed.

A patient may understand why testosterone was prescribed but still dislike repeatedly placing a long needle deep into a muscle.

Research reviewed by Figueiredo and colleagues found that SubQ testosterone can be administered with smaller needles, is generally easier to learn, and may cause less discomfort.

Mayo Clinic also describes an FDA-approved testosterone enanthate product that is administered under the skin of the abdominal area and can be self-administered after proper training.

A 2026 review of subcutaneous drug delivery also examined broader concerns about pain, bioavailability, and other perceived limitations of the SubQ route. Although that article focuses on biologic medications rather than testosterone specifically, it shows how subcutaneous delivery is becoming an important area of modern drug-delivery research (Bittner et al., 2026).

Testosterone, Muscle Strength, and Whole-Body Health

Testosterone should not be viewed as only a sexual hormone.

It is also closely linked to muscle tissue, bone, body composition, red blood cell production, and reproductive function.

When a person has a medically confirmed testosterone deficiency and an appropriate indication for treatment, restoring testosterone to an appropriate physiologic range may help address some of the effects associated with deficiency.

At Wellness Doctor RX, we connect hormone health with functional health.

Testosterone alone does not automatically build strong muscles. Muscles still need appropriate resistance, movement, nutrition, protein, sleep, and recovery.

A more complete wellness program may therefore look at:

• Testosterone and other appropriate hormone levels
• Muscle mass and strength
• Body composition
• Blood sugar and metabolic health
• Nutrition and protein intake
• Sleep quality
• Exercise tolerance
• Joint and spinal mobility
• Strength and conditioning
• Injury history
• Cardiovascular risk
• Long-term health goals

Wellness Doctor RX focuses on testosterone as part of a broader discussion of muscle mass, metabolism, sexual health, energy, and healthy hormone balance.

How Integrative Chiropractic Care Fits In

Chiropractic care and testosterone therapy have different purposes.

Testosterone does not correct restricted joint movement, poor lifting mechanics, muscle imbalance, or an incomplete rehabilitation program. Likewise, chiropractic care does not replace medically indicated hormone treatment.

They can, however, fit into the same whole-body health strategy.

In my clinical observations, I, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, often see that the best results come from examining both the biological and mechanical sides of health.

For example, hormone evaluation may assess the internal environment that supports muscle and bone. Chiropractic and rehabilitative care can then address the way those muscles, joints, and nerves function during real movement.

An integrative plan may include:

• Chiropractic evaluation and treatment
• Corrective and resistance exercise
• Neuromuscular rehabilitation
• Mobility training
• Functional medicine testing
• Nutritional support
• Body-composition management
• Hormone evaluation when medically appropriate
• Progressive return to exercise or sport

This matches the Wellness Doctor RX model, which combines chiropractic medicine, functional medicine, metabolic considerations, rehabilitation, and whole-person care rather than treating a single symptom in isolation.

Can Women Receive SubQ Testosterone?

Women naturally produce testosterone, and it plays important roles in female physiology.

However, this area requires careful medical judgment.

The attached Worldborne Medical review points out that there is no testosterone product currently FDA-approved specifically for women in the United States. It also explains that the strongest randomized evidence for testosterone treatment in women involves transdermal therapy rather than subcutaneous injections.

Therefore, SubQ testosterone should not be presented as the proven preferred route for women.

In selected women, a qualified clinician may consider testosterone after reviewing the diagnosis, symptoms, medical history, medications, laboratory findings, treatment goals, and available alternatives. If an injectable route is chosen, dosing should be highly individualized and monitored to avoid excessive androgen exposure.

The white paper specifically recommends confirming physiologic-range exposure and documenting the clinical reasoning when testosterone is used in women.

For women especially, more testosterone is not better.

The goal is appropriate treatment for an appropriate indication.

Pellets, IM Injections, SubQ, or Another Option?

There is no single testosterone delivery method that fits every patient.

Possible formulations may include intramuscular injections, subcutaneous injections, gels, patches, oral products, nasal preparations, and implanted pellets, depending on the patient and indication.

Pellets can provide months of hormone delivery but require implantation. Topical products avoid needles but require regular application and may transfer medication to another person’s skin. IM injections are familiar and inexpensive but may be uncomfortable or difficult for some people to self-administer. SubQ injections remain injections, but they may offer a simpler middle ground for some patients (Figueiredo et al., 2022).

That is an important distinction for patients who say, “I do not want pellets, and I do not want a big shot.”

SubQ may be an option worth discussing.

Medical Oversight at Wellness Doctor RX

At Injury Medical Clinic PA in El Paso, our Wellness Doctor RX educational and clinical model combines chiropractic and functional medicine with medical collaboration.

Dr. Maria Guadalupe Cardenas, MD, is board-certified in Internal Medicine and has more than 40 years of experience as an internist. She serves as Medical Director and Collaborative Physician. Her listed professional credentials include NPI #1164426749 and Texas MD License #J2933.

Dr. Cardenas provides medical oversight, while I focus heavily on chiropractic care, functional medicine, biomechanics, rehabilitation, and musculoskeletal health.

This multidisciplinary structure allows the team to look at several pieces of the patient’s health at once:

• Medical safety and risk factors
• Laboratory findings
• Hormone and metabolic health
• Musculoskeletal function
• Nutrition
• Rehabilitation
• Lifestyle and exercise
• Long-term wellness goals

This integrated medical-chiropractic model is central to the approach presented throughout Wellness Doctor RX.

Testosterone Therapy Still Requires Monitoring

A smaller needle does not mean a smaller responsibility.

SubQ testosterone produces systemic testosterone exposure. Patients still require appropriate diagnosis, follow-up, and laboratory monitoring.

The Hatzilabrou white paper stresses that testosterone-related safety concerns belong to the hormone and the resulting exposure—not simply to the injection route.

Monitoring may include testosterone levels and other laboratory testing based on age, sex, diagnosis, medical history, formulation, dose, and clinical guidelines.

Treatment should also be adjusted according to both objective findings and clinical response.

Bringing Hormone Health and Movement Together

Subcutaneous testosterone is not a miracle treatment, and it is not right for everyone.

It is another delivery option.

For appropriately selected patients—especially those who dislike deep IM injections or do not want implanted pellets—SubQ testosterone may provide a more manageable way to receive prescribed hormone therapy.

At Wellness Doctor RX, our broader goal is to connect hormone health with the rest of the body. Healthy muscles need appropriate hormonal support, but they also need movement. Bones need proper biological support, but they also respond to mechanical loading. Rehabilitation requires exercise, but exercise works best when nutrition, metabolic health, sleep, and recovery are addressed.

That is where medical care, functional medicine, integrative chiropractic care, nutrition, and rehabilitation can come together.

The goal is not simply a better testosterone number.

The goal is a healthier, stronger, better-functioning person.

---

References

Bittner, B., Buist, N., Bruin, G., et al. (2026). Challenging the myths of subcutaneous delivery: An industry expert perspective. Journal of Controlled Release, 393, 114800. Challenging the myths of subcutaneous delivery

Figueiredo, M. G., Gagliano-Jucá, T., & Basaria, S. (2022). Testosterone therapy with subcutaneous injections: A safe, practical, and reasonable option. Journal of Clinical Endocrinology & Metabolism, 107(3), 614–626. Testosterone Therapy With Subcutaneous Injections

Hatzilabrou, T. A. (2026). The Quiet Case for the Subcutaneous Needle. Worldborne Medical, Clinical Frontiers: Androgen Series.

McFarland, J., Craig, W., Clarke, N. J., & Spratt, D. I. (2017). Serum testosterone concentrations remain stable between injections in patients receiving subcutaneous testosterone. Serum Testosterone Concentrations Remain Stable Between Injections

Spratt, D. I., Stewart, I. I., Savage, C., et al. (2017). Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection. Journal of Clinical Endocrinology & Metabolism, 102(7), 2349–2355. Subcutaneous Injection of Testosterone Is an Effective and Preferred Alternative to Intramuscular Injection

Wilson, D. M., Kiang, T. K. L., & Ensom, M. H. H. (2018). Pharmacokinetics, safety, and patient acceptability of subcutaneous versus intramuscular testosterone injection for gender-affirming therapy: A pilot study. American Journal of Health-System Pharmacy, 75(6), 351–358. Pharmacokinetics, Safety, and Patient Acceptability of Subcutaneous Versus Intramuscular Testosterone

Wellness Doctor RX. (2026). Testosterone health and performance support. Wellness Doctor RX Testosterone Health and Performance Support