For the shortest of answers, no it’s not normal to bleed after an HRT injection. A successful administration causes minimal pain, does not bleed, and the liquid being injected does not come back out of the hole.

However, it’s pretty common when self administering to experience bleeding, pain, and/or liquid coming back up out of the hole. So how do we stop these things from happening?

The first thing to know is the differences between Intramuscular (IM) and Subcutaneous (SubQ) injections. The needles and the methods of delivery are very different. If you’re using a 1″ or insulin needle, you’re meant to be injecting into your fat cells at an angle. If your needle is 1.5-2″ it’s an IM needle and should be given at a 90 degree angle directly into specific muscles at specific locations.

Fenway Health, a leader in HRT and Transgender Healthcare research recommends giving IM shots into your Iliac Crest or your Vastus Lateralis – Where are those?

IM Injection Sites

The Vastus Lateralis is the long muscle on the side of your thigh. If you notice in the diagram there is a large muscle on the top (Rectuc Femoris) and some pretty important veins and nerves running through your thighs. This is why it’s important that you administer your dose into the correct muscle and avoid thinking of your entire thigh as a pin cushion.

Now check out how many veins and arteries are pumping through that area. This is why it’s common for bleeding to occur. If the needle hits a vein or a blood vessel it’ll cause bruising and bleeding but barring any blood clotting deficiencies, your body should patch the wound and just be sore for awhile. Some guys have reported quite a bit of blood, if it doesn’t stop bleeding within 5 minutes, call your doctor.

The Iliac Crest is the preferred location recommend by most doctors. Folks that prefer the thigh to this location may choose so because of limited mobility or easy access to their own back-side. The risk of hitting a nerve or blood vessel however, is decreased exponentially.

In this location what you’ll need to be watching for is your Sciatic Nerve. Again, making sure you’re injecting into the correct muscle is important to minimize the risk of hitting anything important. However, veins and blood vessels are at a minimum in this location and it’s uncommon for bleeding to occur.

Rub it Out

Both locations can cause a clumping of the substance if you don’t rub the injection area and spread the liquid out. Again, the buttock is recommended, as the thigh can cause severe pain and discomfort when walking if administered incorrectly or not rubbed out. A warm shower after your shot can also help relieve that discomfort.


If you’re experiencing the an amount of T coming back up out of the injection hole, on your next shot try the Z-Tracking method to ensure that this no longer happens.

When self administering, pull your skin to the side before you inject. Once your dose is in, letting go of your skin will cause the hole made by the needle to close and the T will not be able to come back out.

For SubQ Injection Methods READ MORE

Jacob is an East Coast loving, coffee-drinking, binge-watching, Millennial with thoughts and opinions suited for this wonderful Magazine and it's beautiful readers. Don't forget to subscribe to the website, the newsletter, the print issue, and that #ftmmagazine life as we take it to the next level.