elilla&’s tips on injecting yourself with estrogen

Probably works for other injectable stuff, too, but I never tried anything other than estradiol. (I swear, officer.) Content warning for medical stuff, drug jokes, and feminine terms of address.

Subcutaneous or intramuscular?

There are two places you can inject hormones into: The fat under the skin (“subcutaneous”, SubQ) or directly into the muscle (“intramuscular”, IM). Both work for all hormones. Subcutaneous is less painful (basically painless if you’re lucky). Intramuscular may help prevent leaking hormones, and avoid allergies. There doesn’t seem to be a difference in hormone levels or efficacy between the two (doi:10.1016/j.eprac.2023.02.006 ; PMID 4034296).

I always did SubQ, so the rest of the article focus on that. Testosterone users seem to prefer IM; I'm told this is because their hormone is more diluted, so they need to inject larger quantities of liquid, and then SubQ risks more leakage.

You won’t be injecting into blood vessels. That makes it harder to mess it up. Lots of people are scared of injecting air bubbles; we’ll tap out air bubbles, but if you accidentaly inject a small bubble on SubQ/IM, exactly nothing happens. You should still take seriously all considerations of hygiene, and follow instructions to the letter.

I go into minute detail here, which makes it look complicated, but the whole thing is pretty simple! Done properly, it’s low-risk too! You can do it!

Studying the technique

The method I use is from the harm-reduction videos from Howard Brown Health:

They also provide instructions for intramuscular (Step 2a: https://www.youtube.com/watch?v=FgCCO9Gqt1Q ). Each video is about three minutes; watch them attentively, then refresh your knowledge by rewatching them right before doing an injection. If Youtube ever takes these videos down, or for privacy, here's an archive:

Materials

A typical dose will be around 0.375mL, so you want a very small syringe. Usually you can find those marketed for tuberculin (TB) users. 2mL insulin syringes are doable, but 1mL is ideal (easier to measure). Do not reuse syringes.

Some syringes come with 40 markings per mL, rather than 100 (“U-40”). This is an insulin thing, but what it boils down to is that if you ended up with one of these by mistake, be sure to do the math to convert your hormone dose in mL to the “units” markings of the syringe. You want to know in advance which tick of the syringe you want to fill up to.

For SubQ, the needles need to be short. You also want them to be thin, to avoid pain and leakage. I get good results with 0.40mm×12mm (27G, ~half-inch length) (Sterican light gray, PZN 02499682, currently some 7€ for a hundred needles). Never reuse needles.

You need to use a separate needle to draw the hormones from the vial. Injectables come with a rubber seal that you have to pierce, and that blunts the needle a bit. If you reused the same needle, it would pierce your skin badly. Just use 2 needles per application, one for the vial, one for you. 0.40mm will take a while to draw most hormone oils; be patient. You can also use thicker needles (say, 0.56mm/24G) for the drawing, if you want (but not super thick or you may damage the seal).

You can buy dedicated sharps containers, but you can also use any old PET bottle, tupperware or the like. Just label it as a sharps container and biohazard. The whole container should be thrown into incinerated trash when full.

Part 1: Drawing the hormone into the injection

Or, as I like to call it, “drawing down the moon”.

In a nutshell, what you'll do here is to inject a volume of air into the hormone vial, turn it upside down, then pull out the same volume of liquid. Some air comes mixed in, so you separate the two and push the air back into the vial, til the dose is just right. It helps me to have a list of very, very detailed steps to make sure I don’t forget anything. This is my list:

  1. Clean and disinfect surface.
  2. Wash hands with full technique (over, under, between fingers, nails, wrists). (Avoid touching your cellphone after this step; having a friend around to check on things helps.)
  3. Lay out all your magic transformation tools on the clean surface.
  4. Pre-open the packaging for the syringe, two needles, and an alcohol wipe, for easy access. Leave them still inside the packages, without touching.
  5. Disinfect hands and/or put on disposable gloves.
  6. Grab the alcohol wipe and use it to rub the rubber seal of the hormone vial.
  7. Grab a needle's package. Grab the syringe and insert into it. Pressure and twist so that it locks, and pull out the needle cap. Reserve the cap, you'll use it later.
  8. Draw the equivalent of your dose, in air. For example, if you’re drawing the Otokonokopharma recommended 0.375mL (15mg E2EN/14 days), pull air until it hits the 0.375mL tick.
  9. Pierce the rubber band of the hormone vial. (Don’t repeat locations from last time; rotate as much as you can.) Inject the air inside the vial.
  10. Now invert the vial upside-down. (It won’t leak, don’t worry!) Pull hormone until you have some more liquid than your dose. Air will come mixed in; that’s normal. If the needle is thin, this will take a while.
  11. Let the air/juice mixture settle, then tap it with your middle finger to dislodge air bubbles like a hot drug girl from a movie.
  12. Now push it back into the vial until all the air is gone, then keep pushing until the quantity of juice is exactly your dose.
  13. Turn the vial back up and pull out the needle.
  14. Now we want to discard the needle, but there is some hormone oil still inside the needle. So we have to pull more air, until all juice drops into the body of the injection.
  15. Carefully place the needle cap on the used needle, then twist it off. Dispose of the needle into the sharps container.
  16. Twist in the second, thin needle, and reserve the needle cap again.
  17. We still have some air in the injection. Push it out carefully, until you see a tiny lil droplet ooze out the needle (cf. hot drug girl from movies).

Part 2: Injecting (SubQ)

  1. Choose a location on your belly where you can pinch fat, it’s not red or inflamed, and not a hair root. Don’t repeat locations; rotate as much as you can.
  2. Disinfect the skin in the target location. (This isn’t actually needed but everyone does it.)
  3. Pinch the skin.
  4. Insert the needle into the pinch, vertically at 90°. You can go quick & all the way.
  5. Let go of the pinch.
  6. Push the girljuice in, slowly but surely.
  7. Make sure you pushed as far as it goes, then count to 3 slowly, then pull out.
  8. If any hormone oil is leaking, wait a while til it dries.
  9. Optionally, cover the injection area with a cute band-aid. (Band-aids are pointless, but they look cute.)
  10. Dispose of the needle like before.
  11. Take it easy and relax.

Minimising leakage

One of the problems with injections is leaking: a bit of the liquid may ooze out rather than be absorbed directly into the fat. In small amounts this is normal, but too much and it will reduce your dose. (You still get some absorbed through the skin, but less.) The medical literature has mixed advice on how to minimise leakage, but one article (https://doi.org/10.1080/17425247.2016.1232247 ) recommends:

  1. Inject perfectly vertically, at a 90° angle;
  2. Inject into the belly, not thighs or other locations;
  3. After you finish injecting, wait 3 seconds before pulling out.

To that I’ll add: hang out for a while lying down, belly up, to have gravity on your side. I usually do my hormones late night so I just stay in bed for the day. Bigger doses leak more; if injecting a lot of anything, consider doing 2 separate injections instead.

Harmless but annoying common problems

Sometimes you will accidentaly pierce a small blood vessel in the skin. This is harmless, but it will leak a droplet of blood when you pull out. This is of no consequence.

Sometimes you will accidentaly hit a nerve. Injections with this type of needle are painless, unless you hit hit a nerve. If that happens, there will be a low-key, dull pain. It’s not super painful or anything, but it’s enough to be annoying, so be prepared for the case it happens. It’s normal that this pain persists for a couple days.

Some people develop allergy to the injections. This is not from the hormones themselves, but from the carrier oils. The allergy typically isn’t severe, but it will create an annoying, itchy red bump for a few days to a week or so (in my experience/hearsay). Sometimes a fluid will work fine for the first few tries before you develop an allergy. Allergies are harmless but, sadly, incurable; if this is being an issue you might need to switch to intramuscular, or switch to a different injection medium. If you have a rash and itchiness, be on the lookout for infection (see below). As long as all you get is the red itch, you’re safe; go see a doctor if it’s still there after a couple weeks, or if it seems to be getting noticeably worse.

Unlikely but serious complications

I asked medical professionals about what could go wrong. They told me the biggest risk is infection; if you took all measures it’s unlikely to happen, but if it does, then it needs medical attention. Infection should be distinct from a mere allergy by symptoms like swollenness, pus, discharge, foul smell, fever, nausea etc. If you have any of that go see a doctor immediately. Be honest about injecting yourself. Don’t worry, doing hormones is legal and the cops can’t get you for it.

If you feel sick and the timing seem suspiciously, that can be an infection too. Go see a doctor immediately, and mention that you did self-injection.

Infections are treatable if you have access to modern healthcare, can be prescribed antibiotics, and you aren’t immunocompromised. If that’s not true, then consider checking out if there’s a harm reduction or queer support clinic where professionals can apply your injections for you.