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Aims To determine adverse effects of ventrogluteal intramuscular injections versus dorsogluteal intramuscular injections. Design A systematic review and meta‐analysis. Methods MEDLINE, EMBASE, CINHAL, CENTRAL, LILACS(BVS), BDENF (BVS), WoS, IRCTP(WHO), ClinicalsTrials.gov and PROSPERO databases were searched with no restriction on year or language. Preferred Reporting items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results A total of 1429 participants from 17 studies were included. The meta‐analysis found that ventrogluteal injection site had significant relation to lower pain in 9 studies (SMD = −0.63, 95% CI = −0.87, −0.39), bleeding in 4 studies (SMD = −3.46, 95% CI = −6.07, –0.86) and hematoma in 2 studies; after 48 h (SMD = −0.25, 95% CI = −0.39, −0.11), and after 72 h (SMD = −0.16, 95% CI = −0.26, –0.06), if it was compared with dorsogluteal site injection. No differences were found when comparing the possibility of intramuscular injections given into de subcutaneous tissue. In three studies, ventrogluteal site did not significantly reduce the risk of subcutaneous injection (OR 0,62, 95% CI = 0.16, 2.41).

Testosterone deficiency in males has the potential to lead to serious chronic health issues and may significantly impair quality of life. Although oral and transdermal forms of testosterone replacement are available, they may not be the best option for all males. Intramuscular testosterone delivery by injection is another form of testosterone replacement therapy that can be offered to patients who are unable to use or have not responded to oral and transdermal therapies. This chapter will provide step-by-step instruction on how to safely train patients to perform self-injections with intramuscular testosterone and will discuss management of patients receiving this form of treatment.