Dorsogluteal VS Ventrogluteal – Which gluteal injection site should you use? This is a hotly debated topic in both the medical and the TRT community. Let’s look at both and find out the best option for YOU.
There is an abundance of highly contested topics in the TRT community. The dorso/ventro gluteal debate is certainly one of them.
Personally, I wasn’t even aware that there were two glute injection sites. I thought it was just a “glute injection”.
Like many times before, I was wrong!
Until recently, I was only aware of the dorsogluteal injection site. I didn’t even know It was called that.
It was only when my community mentioned it and my doctor sent me some general literature on intramuscular injections, that I learnt there were two gluteal injection sites – the dorsogluteal and ventrogluteal.
I pored through information and studied the research to clarify everything.
Today we’ll break down the difference between the two methods, the pros and cons of each, and figure out the best option for you.
What The Research Says
I have gone through a lot of the studies and research and was hoping to have a definitive answer for you on this matter.
Unfortunately the medical community is just as divided on this topic as the TRT community.
NOTE: All references used can be found at the end of this article.
This is somewhat understandable, as when it comes to health and our bodies, we are all different and one size does not fit all.
In some cases, depending on the type of person and procedure, they may recommend/choose the dorsogluteal site. In other situations they may select the ventrogluteal site.
Many factors are taken into consideration, including sex, the amount of fat and the amount of muscle in the area.
Other factors include the nurse’s and patient’s preferences when it comes to injections.
When it comes to safety, medical practitioners prefer the ventrogluteal site as it is devoid of any major blood vessels. The dorsogluteal site is much closer to the sciatic nerve and artery.
Many doctors are nurses prefer and recommend the ventrogluteal site. This is despite the research stating that intramuscular injections should be based on an individual clinical assessment.
It is for this reason that I believe we should defer to the medical community’s judgement as an initial starting point and stick to the ventrogluteal injection by default.
However, let’s take a closer look at both, so that from here, you and your doctor can decide on the best approach for you.
Dorsogluteal injections are performed on the upper, outer region of the buttocks.
Locating The Dorsogluteal Injection Site
The most common approach to finding the injection location is to divide the buttocks into quarters and target the upper outer quadrant. See the picture.
I have also done a video on how to locate this sweet spot on the TRT Hub YouTube Channel.
According to the research, this injection site is still fine for adults, provided you take precautions.
The dorsogluteal site is much closer to the sciatic nerve and artery. This puts you a slightly higher risk of complications when performing the injection. It’s still low-risk, do don’t worry!
Make sure you have a good idea of where you should be injecting. Then, aspirate before you inject your medication.
NOTE: To aspirate, pull back on the plunger for 5 to 10 seconds and check to see if any blood has entered the syringe. If you see blood in the syringe, you may have hit a vein or blood vessel. Discard the needle and syringe and start over with fresh supplies. For more on aspirating, please see this video.
Pros And Cons Of Dorsogluteal Injections
Dorsogluteal injections are easier to locate than ventrogluteal injections, due to the larger area.
However, they are harder to reach, and you have to twist and turn behind to reach the buttocks when performing the injection.
While the dorsogluteal may be easier to locate, injections can be painful if you don’t get the exact location right.
Also, there is research that suggests that dorsogluteal injections may be more painful than ventrogluteal injections.
Due to the close proximity of the sciatic nerve, you also need to aspirate, which is an extra step in the process.
The skin and fat may also be thicker on this part of the glute, increasing the risk of the medication being injected under the skin, rather than in the muscle.
A ventrogluteal injection is an intramuscular injection into an area on the side of your hip known as the ventrogluteal site.
Locating The Ventrogluteal Injection Site
It is slightly more complex to locate this exact injection site. Please use the diagram as a reference.
- Ventrogluteal injections are usually performed with you/the patient laying down, with the side of your body you’ll be injecting into facing upward.
- Place the palm of your hand on the greater trochanter of the femur. This is the bony part that sticks out of your upper thigh near your hip.
- Locate the anterior iliac crest and place your index finger on it. Your thumb should be pointed toward the front of your leg. If you can’t touch your iliac crest with your index finger, slide your hand up until you can.
- Spread your middle finger away from you index finger so that your fingers create a “V” shape.
- The injection site is in the middle of this “V” and should be at the level of the knuckles of your index and middle finger.
NOTE: I also find these recommended instructions complicated. I will do my best to simplify these in a video in future once I am more experienced with ventrogluteal injections.
Pros And Cons Of Ventrogluteal Injections
The Ventrogluteal site is far from any major blood vessels or nerves, including the sciatic nerve. The tissue surrounding your ventrogluteal site is also thick .
This makes it one of the safest types of intramuscular injections and greatly reduces the risk of any complications.
While they may be easier to reach than the dorsogluteal site, finding the exact injection location can be challenging, particularly in the beginning.
Where possible, try and work with a medical professional at first, to get familiar with the procedure.
No aspiration is necessary for the ventrogluteal injection, making it slight faster than dorsogluteal injections.
Which Is Better – Dorso Or Ventro?
If you’re new to TRT and starting from the beginning, I would suggest following medical guidelines and using the ventrogluteal injection, with assistance from your medical practitioner.
That way you can get familiar with the procedure and injection location, so that if you begin self-administering, you are comfortable with the process.
You also put yourself at much less risk of complications and will enjoy a less-painful injection.
If you are already performing dorsogluteal injections successfully and have never done ventrogluteal injections before, then it might be best just to stick with what works.
It is up to you whether you switch though, so if you do decide to switch to ventrogluteal injections, simply follow the recommendations listed above for TRT beginners.
Ultimately the choice is up to you, with the guidance of your doctor.
Ventrogluteal injections should be the default choice, unless otherwise indicated or preferred.
While the studies were mixed, ventrogluteal injections still seem to be the best approach, including for testosterone replacement therapy. At least by default.
It can be difficult to locate the site though, so work with your doctor to find the best solution for you, based on your individual needs.
If you currently administer dorsogluteal injections successfully without any pain or complications, then it may be better to stick with those. If you’d like to switch to ventrogluteal injections, then do so with the guidance of your medical practitioner.
Do you currently perform gluteal injections? If so, which site do you use and why? And do you plan on switching in future? Do you currently struggle with your glute injections? Let us know in the comments below.
A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry:
The dorso-ventro debate: in search of empirical evidence:
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:
The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study:
Which site is more painful in intramuscular injections? The dorsogluteal site or the ventrogluteal site? A case study from Turkey: