IM vs subQ injection
Injectable steroids can be administered in two main ways: intramuscular (IM) and subcutaneous (subQ). Both have their place, and the choice depends on the compound, volume, and personal preference.
Intramuscular (IM)
The needle is inserted deep into muscle tissue. This is the traditional and most common method for steroid injections.
Subcutaneous (subQ)
The needle is inserted into the fat layer just beneath the skin. Increasingly popular for TRT doses and smaller volumes.
For most steroid users: IM injection is the standard for cycle doses (higher volumes). SubQ is increasingly used for TRT doses and smaller volumes (under 0.5ml). If you are injecting 1ml or more per site, IM is the better choice.
Injection sites
Site rotation is essential. Injecting in the same spot repeatedly causes scar tissue buildup, which makes future injections more painful and can affect absorption. Rotate between at least 4-6 sites.
IM injection sites (most common to least)
Ventrogluteal (VG)
SafestThe most recommended site by healthcare professionals. Located on the side of the hip/glute area. Minimal risk of hitting nerves or blood vessels. Can accept larger volumes. Best for beginners despite being slightly harder to locate at first.
Gluteus medius (upper outer glute)
CommonThe traditional 'glute injection'. Target the upper outer quadrant of the buttock. Keep well away from the centre and lower areas to avoid the sciatic nerve. A common site but slightly higher risk than ventrogluteal.
Vastus lateralis (outer thigh)
CommonThe outer middle third of the thigh. Easy to self-inject as you can see the site clearly. Common for people who cannot reach their glutes. Can cause more post-injection pain than glute sites.
Deltoid (shoulder)
Small volumes onlyThe lateral head of the deltoid muscle. Best for small volumes only (under 1.5ml). Easy to access. Used commonly for TRT injections and smaller doses.
SubQ injection sites
For subcutaneous injections, the most common sites are the abdominal fat (avoiding 2 inches around the navel), the outer thigh, and the back of the upper arm. Pinch a fold of skin and inject at a 45-degree angle into the fat layer.
Sites to avoid
Never inject into the inner thigh, calf muscles, or anywhere near visible veins. Do not inject into sites that are red, swollen, or bruised from a previous injection. If you are unsure about a site, choose a well-documented one instead of experimenting.
Sterile technique
Infections from injections are one of the most common and most preventable complications of steroid use. Proper sterile technique is not optional — it is the difference between a routine injection and an abscess that requires surgical drainage.
Non-negotiable rules
Never reuse needles
A needle should be used once and disposed of. Not once per site — once, period. If you draw with one needle, switch to a fresh needle for injecting.
Never share needles, syringes, or vials
This risks transmission of blood-borne viruses including HIV and hepatitis B and C. Sharing multi-use vials can also introduce contamination.
Wash your hands thoroughly before handling any equipment
Soap and water for at least 20 seconds. This is the single most effective way to prevent infection.
Swab the injection site with an alcohol wipe
Use a fresh alcohol swab on the skin where you are going to inject. Let it dry before inserting the needle. Also swab the top of the vial before drawing.
Swab the vial top before drawing
Even if the vial looks clean. Bacteria from your hands or the environment can contaminate the rubber stopper.
Use a clean, flat surface
Prepare your injection on a clean surface. Do not balance equipment on your bed or the edge of a sink. A clean table or desk is fine.
Dispose of sharps safely
Use a sharps bin. Never put loose needles in the regular bin — this is a risk to you, anyone in your household, and waste workers. Needle exchanges provide free sharps bins.
Needle gauge & syringe selection
Needle gauge refers to the thickness of the needle. Higher gauge numbers mean thinner needles. Choosing the right gauge affects comfort, injection speed, and suitability for different sites.
Recommended needles
For drawing from the vial
18-21 gauge (green or blue). Wider bore makes drawing thick oil-based compounds faster. This needle is only for drawing — never inject with a drawing needle, as it will be blunted after piercing the vial stopper and will cause more tissue damage.
For IM injection
23-25 gauge, 1-1.5 inch (blue or orange). 23g is the most common for glute injections. 25g is thinner and more comfortable but takes longer to inject. Length depends on body fat at the injection site — leaner individuals can use 1 inch; those with more body fat at the site may need 1.5 inches to reach the muscle.
For subQ injection
27-30 gauge, 0.5 inch (grey or similar). Insulin-type needles work well for subQ injections of small volumes. These are thin and cause minimal discomfort.
Syringe volume
1ml or 3ml syringes are the most commonly used. 1ml syringes allow more precise measurement for smaller doses. 3ml syringes are useful if injecting larger volumes. Use Luer-lock syringes where the needle screws on (rather than push-fit) to prevent the needle detaching during injection.
Step-by-step injection guide
This is a basic guide for intramuscular injection. If this is your first time, take it slowly. Being nervous is normal.
Wash your hands
Thoroughly with soap and water for at least 20 seconds. Dry with a clean towel.
Prepare your equipment
Lay out on a clean surface: syringe, drawing needle, injection needle, alcohol swabs, and the vial. Check the vial for particles, cloudiness, or discolouration — if anything looks off, do not use it.
Swab the vial top
Wipe the rubber stopper of the vial with an alcohol swab. Let it dry.
Draw the compound
Attach the drawing needle (18-21g) to the syringe. Draw air into the syringe equal to the volume you need. Insert the needle into the vial, push the air in (this equalises pressure), invert the vial, and draw the desired amount. Tap out any air bubbles and push a tiny amount of oil out to clear the needle.
Switch to injection needle
Remove the drawing needle and attach a fresh injection needle (23-25g). Never inject with the needle you used to draw — it is blunted and will cause unnecessary tissue damage.
Swab the injection site
Clean the skin at your chosen injection site with a fresh alcohol swab. Let it dry completely — injecting through wet alcohol stings and can push bacteria into the site.
Inject
Hold the syringe like a dart. Insert the needle smoothly at a 90-degree angle for IM (or 45 degrees for subQ). Do not slam it in — a firm, steady push is fine. Inject the oil slowly and steadily. Faster injection causes more post-injection pain.
Withdraw and apply pressure
Pull the needle out in a smooth motion. Apply light pressure with a clean cotton ball or swab. A small amount of blood is normal. Do not rub or massage the site.
Dispose of sharps safely
Place all needles in a sharps bin immediately. Do not recap needles if you can avoid it — recapping is one of the most common ways people stick themselves accidentally.
Aspirating — do you need to?
The practice of pulling back the plunger to check for blood before injecting is called aspiration. This was traditionally recommended to ensure you have not hit a blood vessel. However, most modern guidelines (including the WHO) no longer recommend aspiration for IM injections at standard sites, as the risk of hitting a significant blood vessel is extremely low at recommended injection sites. Some people still prefer to aspirate — it does not cause harm either way.
UK needle exchanges
Needle and syringe programmes (NSPs) are available throughout the UK. They provide free, sterile injecting equipment and sharps disposal. They are not just for people who inject drugs recreationally — steroid users are a growing proportion of NSP users, and staff are trained to provide non-judgemental support.
What needle exchanges provide (free)
How to find your nearest exchange
Search online
Search for “needle exchange near me” or “needle syringe programme” plus your area. Most local councils list their services online.
Pharmacies
Many pharmacies participate in NSP schemes. Look for the pharmacy needle exchange logo or ask at the counter. Major chains including Boots participate in some areas.
Drug services
Local drug and alcohol services typically run needle exchanges. Do not be put off by the name — many now specifically cater to steroid users and will not make assumptions about your drug use.
There is no judgement and no record. Needle exchange staff are trained to be non-judgemental. At most services, you do not need to give your real name. They exist to keep people safe, not to police what you are using.
When something goes wrong
Even with good technique, things can sometimes go wrong. Knowing what is normal, what is concerning, and when to seek medical help can prevent a minor issue from becoming a serious one.
Normal — do not panic
Post-injection pain (PIP)
Soreness at the injection site for 1-3 days is common, especially with certain compounds (testosterone propionate, higher concentration oils). Like a dead leg. First injection at a new site is usually the worst.
Small amount of blood
A drop of blood after withdrawing the needle is normal. You have put a needle through your skin — some bleeding is expected. Apply pressure.
Small bruise
Bruising at the injection site can happen. It is cosmetic and will resolve on its own.
Oil leaking back out (subQ leak)
Sometimes a small amount of oil tracks back along the needle path and leaks out or deposits under the skin. This can cause a temporary lump. It is not dangerous and will absorb over a few days.
Concerning — monitor closely
Swelling that increases after 48 hours
Some swelling immediately after injection is normal. If it is still getting worse after 2 days, or the area is warm to the touch, this could be the start of an infection.
Redness spreading outward from the site
A small red mark at the injection point is fine. If redness is spreading in a growing circle, this suggests infection is developing. Draw a line around the edge with a pen — if it spreads beyond that line, seek medical help.
Persistent pain beyond 5 days
PIP usually resolves within 3 days. If the area is still painful after 5 days and is not improving, get it checked.
Seek medical help now
Abscess forming
A hard, painful, swollen lump that is hot to the touch and may have a visible head of pus. This requires medical treatment — antibiotics at minimum, and possibly drainage. Do not try to drain it yourself.
Fever after injection
If you develop a fever (above 38C/100.4F) within 24-72 hours of injecting, this could indicate a systemic infection. Seek medical help. Do not assume it will resolve on its own.
Red line extending from the site
A red line tracking away from the injection site (towards the nearest lymph nodes) is a sign of lymphangitis — a spreading infection. This is a medical emergency. Go to A&E.
Difficulty breathing after injection
If you experience sudden difficulty breathing, chest tightness, or wheezing immediately after injection, this could be an allergic reaction or (with certain compounds like trenbolone) 'tren cough'. If it does not resolve within a few minutes, call 999.
Loss of feeling or function in the limb
If you experience numbness, tingling, or loss of movement in the limb where you injected, you may have hit a nerve. If it does not resolve within an hour, seek medical attention.
Do not be afraid to go to A&E
If you are worried about telling medical professionals what you were injecting — do it anyway. They need to know to treat you properly. A&E staff are not there to judge you and they are bound by confidentiality. An untreated abscess or infection is far more dangerous than any awkward conversation. In an emergency, call 999. For non-emergency medical advice, call 111.
Get Blood Work Done
Safe injection technique is essential, but it is only one part of harm reduction. Blood work tells you what is happening on the inside.
Read the Blood Work Guide