Dorsogluteal vs Ventrogluteal: Which Injection Site Is Best for TRT?

Last Updated On March 26, 2025

The debate between dorsogluteal vs ventrogluteal injection sites remains one of the most contested topics in the testosterone replacement therapy (TRT) community. If you’re administering TRT injections, choosing the right site can significantly impact your comfort, safety, and overall treatment experience

Many TRT patients aren’t even aware there are two distinct gluteal injection options. Like many, you might have assumed there was just a general “glute injection” without realizing the important anatomical differences between these two sites.

Today, we’ll compare the dorsogluteal and ventrogluteal injection sites, examine what medical research tells us, and help you determine which option might be best for your individual TRT protocol.

Understanding the Two Gluteal Injection Sites

Before diving into the pros and cons of each method, it’s important to understand the basic differences between these two injection sites:

• Dorsogluteal: Located on the upper, outer quadrant of the buttocks
• Ventrogluteal: Located on the side of the hip, between specific bony landmarks

Both sites allow for intramuscular (IM) injections, which are crucial for testosterone administration. However, they differ significantly in terms of anatomy, accessibility, and safety profile.

The site you choose can impact everything from pain levels to absorption rates and safety risks, making this decision an important part of optimizing your TRT protocol.

Dorsogluteal Site: Overview

The dorsogluteal site is the traditional “buttock injection” that most people are familiar with. It’s located in the upper outer quadrant of the buttock, in the gluteus maximus muscle.

Key Advantages

• More familiar to most patients and practitioners
• Larger injection area makes it easier to locate
• Established history of use in medical settings
• Preferred by many long-term TRT users

Primary Concerns

• Closer proximity to the sciatic nerve and major blood vessels
• Requires aspiration technique to ensure safety
• Can be difficult to reach for self-administration
• Often has thicker subcutaneous fat layer, potentially affecting absorption

Who Might Prefer This Site

The dorsogluteal site may be preferable for patients who:

• Have been using this site successfully without complications
• Have difficulty locating the more specific landmarks of the ventrogluteal site
• Have specific anatomical considerations that make the ventrogluteal site challenging

Ventrogluteal Site: Overview

The ventrogluteal site is located on the side of the hip in the gluteus medius muscle, bounded by several bony landmarks that create a triangular injection zone.

Key Advantages

• Further from major nerves and blood vessels (safer)
• Typically less subcutaneous fat, allowing better access to muscle
• No aspiration required in most cases
• Often recommended as the preferred site by modern medical guidelines

Primary Concerns

• More challenging to locate, especially for beginners
• Less familiar to many patients
• Requires understanding specific anatomical landmarks
• May feel more exposed or awkward for self-administration

Who Might Prefer This Site

The ventrogluteal site may be better for patients who:

• Are new to TRT injections
• Have had complications with dorsogluteal injections
• Have higher body fat percentage
• Prioritize reduced risk of nerve or vessel injury

Dorsogluteal vs Ventrogluteal: Evidence-Based Comparison

After reviewing the available research, it’s clear that the medical community remains somewhat divided on this topic, similar to the TRT community. However, several key differences emerge when directly comparing these sites:

Safety Profile

Ventrogluteal Advantage: The ventrogluteal site is generally considered safer due to its distance from major nerves and blood vessels. The dorsogluteal site’s proximity to the sciatic nerve and gluteal artery poses a higher (though still small) risk of injury.

According to a 2018 study published in Psychopharmacology Bulletin: “The ventrogluteal site is preferred because it provides the greatest thickness of gluteal muscle, is free of penetrating nerves and blood vessels, and has a narrower layer of fat.”

Pain and Comfort

Research suggests that ventrogluteal injections may be less painful than dorsogluteal injections. A Turkish study specifically examining pain differences between the two sites found that patients reported lower pain scores with ventrogluteal injections.

However, individual experiences vary considerably. Some patients report the opposite, finding dorsogluteal injections more comfortable, highlighting the importance of personal preference.

Accessibility and Ease of Use

Dorsogluteal Advantage: For self-administration, the dorsogluteal site can be more challenging to reach but easier to visually locate.

Ventrogluteal Advantage: The ventrogluteal site is easier to reach but requires more precise landmark identification.

Your flexibility, body composition, and comfort with anatomical landmarks will influence which site you find more accessible.

Absorption and Effectiveness

Both sites generally provide effective absorption for testosterone. However, differences in fat thickness and blood flow can potentially affect absorption rates:

• The ventrogluteal site typically has less subcutaneous fat, which may reduce the risk of inadvertently administering the injection subcutaneously rather than intramuscularly
• The dorsogluteal site has extensive blood supply, which can theoretically affect drug distribution

Clinical studies specifically comparing testosterone absorption between the two sites are limited, and individual physiological differences likely play a significant role.

Making the Right Choice for Your TRT Protocol

When deciding between dorsogluteal and ventrogluteal injection sites for your TRT protocol, consider these factors:

For TRT Beginners

If you’re new to TRT injections, the ventrogluteal site is often recommended as the default choice by medical professionals due to its safety profile. However, this comes with a learning curve:

1. Work with your healthcare provider to properly identify the landmarks
2. Consider having a healthcare professional demonstrate the technique
3. Use our detailed Ventrogluteal Injection Guide for reference

When to Stick With What Works

If you’ve been successfully using dorsogluteal injections without complications or discomfort, there may be no compelling reason to change. The best injection site is ultimately the one that:

• You can consistently access correctly
• Causes minimal discomfort
• Results in no complications
• Delivers effective testosterone absorption

When to Consider Switching

Consider switching your injection site if:

• You experience persistent pain or discomfort
• You have difficulty consistently locating the correct spot
• You notice signs of poor absorption (inconsistent testosterone levels)
• Your healthcare provider recommends a change based on your individual circumstances

The Importance of Professional Guidance

While this article provides evidence-based information, your healthcare provider remains the best resource for personalized guidance. Individual anatomy, medical history, and specific TRT protocol can all influence the optimal injection site for your needs.

Discuss your preferences and concerns with your provider, especially if you’re considering changing your injection technique.

Conclusion

In the dorsogluteal vs ventrogluteal debate, current medical literature tends to favor the ventrogluteal site for safety reasons, particularly for those new to injections. However, both sites remain viable options for TRT administration when performed correctly.

The “best” site ultimately depends on your individual circumstances, comfort level, and physical considerations. Some patients may even benefit from alternating between sites to prevent tissue damage from repeated injections in the same location.

If you’re currently using one site successfully without issues, there may be no need to change. If you’re experiencing difficulties or just starting TRT, the ventrogluteal site might offer advantages worth exploring with your healthcare provider’s guidance.

References

• A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry: https://link.springer.com/content/pdf/10.1007%2Fs42242-018-0018-x.pdf
• The dorso-ventro debate: in search of empirical evidence: https://www.ncbi.nlm.nih.gov/pubmed/26653514
• Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome: https://www.ncbi.nlm.nih.gov/pubmed/28273627
• The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study: https://www.ncbi.nlm.nih.gov/pubmed/26868292
• Which site is more painful in intramuscular injections? The dorsogluteal site or the ventrogluteal site? A case study from Turkey: http://www.sciedupress.com/journal/index.php/cns/article/view/2759