1. Make sure your area is clean. Gather the supplies you need and place them on a clean, dry surface.
2. Wash your hands well with soap and warm water.
3. Get in a relaxed position (i.e. standing up, sitting down with back straight in a chair representing good posture).
4. Take an alcohol wipe and tear down the sides to remove the wipe.
5. Clean an area 2 inches in diameter where the injection is going to be made with the alcohol wipe for 3 to 5 seconds. Use firm circular motions while moving outward from the injection site. Let the area dry for 20 seconds.

6. Remove the cap of the needle from the prefilled Testosterone syringe, being careful not to touch the needle.
7. With your thumb and index finger of your non-dominant hand, spread the skin out from the site of the injection.
8. Try to relax the muscle you will be injecting; as injecting into tense muscles will be more painful.
9. Hold the syringe with your thumb and index finger of your dominant hand for maximum support, as you would a pencil.

10. Quickly pierce the skin with the needle at a 90 degree angle and insert the needle all the way into the muscle. Proceed to push down on the plunger so the liquid comes out of the syringe and into the muscle. Make sure all the liquid has left the syringe.

11. Remove the syringe and needle and check the injection site to see that there is no blood or left over medication. Place the needle cover back on the needle and then place it in an appropriate storage container (sharps, orange juice carton, etc.). Dispose of used needles as directed by your doctor.

12. Rub this site in a circling motion for 10-15 seconds with slight pressure so the site will return to normal size. Otherwise, a bump or rising of the skin may occur at the site of the injection.
13. Wash your hands with soap and warm water, record the date, time and site of injection on a record sheet. It is recommended that you alternate body sites each time you give an injection. Keeping a written record will help you remember where you injected last.
14. Afterwards, monitor signs of redness, swelling, irritation or bleeding at the injection site. Observe yourself for 15 minutes to make sure no reaction has occurred or ask someone to monitor you as well.
15. Contact your physician if: (i) a fever, sneezing, or coughing develops after the injection; or (ii) there is a lump, swelling, or bruising where the injection was given that does not go away.
16. Seek care immediately or call 911 if: (i) a rash or itching develops after the injection is given; (ii) shortness of breath develops after the injection is given; or (iii) the mouth, lips, or face swells after the injection is given.

1. Make sure your area is clean. Gather the supplies you need and place them on a clean, dry surface.

2. Wash your hands well with soap and warm water.
3. Take an alcohol wipe and tear down the sides to remove the wipe.
4. Wipe off the top of the vial with the alcohol wipe for 3-5 seconds to make sure the vial is clean.

5. Draw the amount of air equal to the amount of liquid you will draw.

6. Inject the needle into the vial through the rubber stopper on top, push down the plunger, and draw back the prescribed amount of medication.

7. Make sure to get all of the air bubbles out; the maximum amount is about the size of a pinhead.
8. Take out the syringe. Turn the syringe needle side up and tap the syringe with your finger to get all of the air bubbles to the top. Clear the air bubbles out of the syringe by pushing up on the plunger slightly until they are all gone.

9. Get in a relaxed position (i.e. standing up, sitting down with back straight in a chair representing good posture).
10. Take an alcohol wipe and tear down the sides to remove the wipe.
11. Clean an area 2 inches in diameter where the injection is going to be made with the alcohol wipe for 3 to 5 seconds. Use firm circular motions while moving outward from the injection site. Let the area dry for 20 seconds.

12. Remove the cap of the needle from the syringe, being careful not to touch the needle.
13. With your thumb and index finger of your non-dominant hand, spread the skin out from the site of the injection.
14. Try to relax the muscle you will be injecting; as injecting into tense muscles will be more painful.
15. Hold the syringe with your thumb and index finger of your dominant hand for maximum support, as you would a pencil.

16. Quickly pierce the skin with the needle at a 90 degree angle and insert the needle all the way into the muscle. Proceed to push down on the plunger so the liquid comes out of the syringe and into the muscle. Make sure all the liquid has left the syringe.

17. Remove the syringe and needle and make sure there is no blood or left over medication. Place the needle cover back on the needle and then place it in an appropriate storage container (sharps, orange juice carton, etc.). Dispose of used needles as directed by your doctor.

18. Rub the injection site in a circling motion for 10-15 seconds with slight pressure. Otherwise, a bump or rising of the skin may occur at the site of the injection.
19. Wash your hands with soap and warm water, record the date, time and site of injection on a record sheet. It is recommended that you alternate body sites each time you give an injection. Keeping a written record will help you remember where you injected last.
20. Afterwards, monitor signs of redness, swelling, irritation or bleeding at the injection site. Observe yourself for 15 minutes to make sure no reaction has occurred or ask someone to monitor you as well.
21. Contact your physician if: (i) a fever, sneezing, or coughing develops after the injection; or (ii) there is a lump, swelling, or bruising where the injection was given that does not go away.
22. Seek care immediately or call 911 if: (i) a rash or itching develops after the injection is given; (ii) shortness of breath develops after the injection is given; or (iii) the mouth, lips, or face swells after the injection is given.

Helpful Reminders:
1. The most important aspect to successfully complete this task is to understand the materials that we are using to draw medication from a vial.
2. Understand the dosage prescribed by your doctor.
3. Make sure you are practicing aseptic technique (detailed practices and methods performed under carefully restricted conditions while the goal is to minimize contamination by pathogens). Good hand washing is essential!

1. Gather up all equipment needed, and thoroughly read and understand the directions.

2. If for instance the directions say apply 1 milliliter topically, then we are to apply ONLY 1 milliliter.

3. Make sure your hands are washed, and the body part you are applying the topical is clean by wiping with alcohol wipe.
4. Remove the cap of the syringe.

5. The syringe is broken down into increments of mL (Milliliters); the plunger must start out at the 10mL mark indicating that there is 10mL of gel or cream in the syringe.

6. Hold the syringe with your dominant hand over the desired spot of application (i.e. behind the knee or on the inner thigh).

7. Push the plunger with your thumb or other hand so that ONLY the specified amount leaves the syringe.

8. Rub the indicated amount excreted from the syringe on your application site until the cream or gel is no longer visible.

9. Place the cap back on the syringe and store away for the next application.
10. Wash hands when complete.
11. Keep this area dry for 4-6 hours and avoid getting wet.

Types of Gels and Creams:
1. Types of gels and creams may include the following either as a combination or alone: Estradiol, Testosterone and Progesterone.
2. These come in 5, 10, or 20 milliliters no matter what size the syringe is.
3. The gel or creams are preloaded into a syringe which includes the plunger and cap.

Helpful Reminders:
1. NEVER USE ORALLY!
2. Avoid getting in the eye or open wounds.
3. If swallowed, consult your physician immediately.

Please note the following cautions when using topical testosterone preparations to minimize the potential for secondary exposure:

• Adults who use testosterone gels should wash their hands with soap and warm water after every application.
• Adults should cover the application site with clothing once the gel has dried.
• Adults should wash the application site thoroughly with soap and warm water prior to any situation where skin-to-skin contact with another person is anticipated.
• Children and women should avoid contact with testosterone application sites on the skin of men who use these products.

1. Make sure your work area is clean and that you have washed your hands.

2. To begin drawing from the bacteriostatic water, remove the hard stopper cap or the duster on the top of the vial.

3. Wipe off the top of the vial with the alcohol wipe for 3-5 seconds to make sure the vial is clean.

4. Open the syringe and needle from their packaging and connect the two by twisting into place. If they are already connected, simply remove it from the packaging.

5. Untwist the cap from the needle. DO NOT TOUCH THE NEEDLE. IF YOU DO, GET A NEW ONE. Draw the amount of air equal to the amount of liquid you will draw (for example, pull the plunger to the 6 milliliter mark).

6. Inject the needle into the vial through the rubber stopper on top, push down the plunger, and draw back the 6 milliliters of bacteriostatic water needed to reconstitute the vial of powder. It is okay to draw a little bit extra.

7. Make sure to get all of the air bubbles out; the maximum amount is about the size of a pinhead.
8. Take out the syringe. Turn the syringe needle side up and tap the syringe with your finger to get all of the air bubbles to the top. Clear the air bubbles out of the syringe by pushing up on the plunger slightly until they are all gone. Some water may “squirt” out of the needle. This may be necessary to make sure the plunger is at the correct mark.

1. Remove the hard stopper cap off the top of the vial of powder and proceed to wipe the top of the vial with the alcohol wipe for 3-5 seconds.

2. Take the syringe that has been filled with the bacteriostatic water and inject the needle through the rubber stopper and allow the water to seep into the vial; you may have to push the plunger of the syringe to get all of the bacteriostatic water into the vial.

3. Gently roll the vial back and forth between the palms of your hands to mix the powder into solution.