How to Give Yourself a Hormone Injection: Intramuscular (IM), ppgoh.org/genderaffirmingcare

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THESE MEDICATIONS ARE GIVEN IM 2) PREPARE MEDICATION • Depot medroxyprogesterone acetate • Check to confirm the correct medication1, strength2, 3 • Estradiol valerate and expiration date . • Estradiol cypionate • Check for floaters or visible particles. • Testosterone cypionate* • Roll the medication vial in your hands to warm it up.

• Testosterone enanthate* 3 *can also be given via subcutaneous injection 1 ______

WHAT IS AN IM INJECTION? 2

An injection that places the medicine deep into the muscle. • Be sure to wash your hands before starting, and have a clean and stable workspace. ______

______3) PREPARE SYRINGE

1) SUPPLIES • Don’t let the needles touch any surfaces. • Medication in a vial • The first time you use the vial, remove the cap (the cap gets thrown away) on the vial to reveal the rubber stopper. • One disposable syringe • Wipe off the rubber stopper of medication vial with • Two needles that are alcohol and allow it to air dry. 21-23 gauge, 1-1.5” • One for drawing • Open the syringe and screw the needle onto it. up medication • Pull back the safety (or cap). This is needle dependent • One for injecting and your needle may or may not have a safety. medication • Pull air back into the syringe (the same amount that is • Two alcohol wipes or the medication amount). a couple cotton balls • Put the needle into the vial and turn the vial upside down. and alcohol • Inject air into the vial, pull back the plunger to the • Bandaid medication amount, check for bubbles, and tap the • Any hard sided plastic syringe to remove them. container with a lid. • Turn the vial right side up, and remove the needle from You may use laundry the vial. Put the safety back on the needle if applicable. detergent or other hard-sided plastic • Remove the needle from the syringe and place it in household containers the sharps container. as a sharps container. • Put a new needle on the syringe. Don’t touch the end of the syringe or needle where they connect.

591-01-21 | Implemented January 2021 ______

4) PREPARE INJECTION SITE 6) DISPOSAL • Vastus lateralis: divide the top of your thigh into • Dispose of the needle and syringe in the sharps thirds, and inject the needle into the middle third, as container, and apply your a band-aid. demonstrated in the graphic. • When the vial is empty, place it in the sharps • Change the site with each injection. container. • Wipe off your skin with an alcohol pad or cotton ball, • When the sharps container is full, tape the lid and and allow it to air dry. throw it in the trash.

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TIPS FOR REDUCING INJECTION PAIN

• Never reuse needles.

• Use separate drawing up and injecting needles.

Injection site • Let your skin dry fully from the alcohol wipes before injecting. • Ice the area before applying alcohol wipes to numb the area.

• Keep the muscle in the injection area warm and relaxed. • Inject the medication when it’s at room temperature. ______• Break through the skin quickly with the needle. 5) INJECT MEDICATION • Insert the needle straight into the skin and pull it out • Pinch your skin and insert the needle at a again without wiggling or changing its direction. 90 degree angle. • Insert the needle three quarters of an inch to one inch deep. • Slowly push the plunger all the way in (the medication is thick).

0.75” — 1” deep skin

muscle adipose tissue (fat)

591-01-21 | Implemented January 2021