@zelahglasson's Nebido injection claims, fact-checked

What did @zelahglasson actually say?

The creator is a trans masculine person about seven months into testosterone therapy using Nebido (testosterone undecanoate), injected roughly every 12 weeks. They said they only need injections "about four times a year," showed their partner administering a gluteal injection, and noted the injection takes "about two minutes" to push in. They also joked about losing a small amount of the dose due to spillage, calling it "R.O.P." They framed the whole thing as a couples activity that requires being "in a good place" before attempting.

The video is personal documentation, not a medical tutorial. But health claims slipped in anyway, including the dosing interval and the implication that a non-clinician partner routinely administers intramuscular injections at home. Those are worth examining.

Does the science back this up?

The 10-14 week dosing interval for Nebido is real and well-documented, so the "every 12 weeks" claim is broadly accurate. The injection duration claim of about two minutes is also realistic for this formulation.

Nebido (testosterone undecanoate 1000mg/4mL) is a long-acting intramuscular formulation specifically designed to reduce injection frequency. The standard licensed dosing schedule is an initial injection, a second injection six weeks later, then injections every 10-14 weeks, adjusted based on serum testosterone levels. This is supported by the prescribing literature and by clinical data including Zitzmann et al. (2006, European Journal of Endocrinology), which confirmed stable testosterone levels within physiological range using this interval in hypogonadal men. The slow injection requirement, typically over 2 minutes, is a real clinical instruction to reduce the risk of pulmonary oil microembolism, a rare but serious adverse event associated with oily injectable testosterone preparations.

What did they get wrong (or right)?

They got the dosing interval right. They got the slow injection requirement right, even if unintentionally. Where things get complicated is the home administration by a non-clinician partner.

There is nothing inherently wrong with trained home administration of intramuscular injections, and it is increasingly common in self-managed trans healthcare. However, gluteal IM injections carry real risks when technique is poor: sciatic nerve injury, inadvertent intravascular injection, hematoma, and infection. The European Medicines Agency flagged pulmonary oil microembolism as a specific risk with Nebido, typically presenting as coughing, dizziness, or fainting within minutes of injection. Neither the creator nor their partner mentioned any post-injection observation period, which is actually recommended in clinical settings for Nebido specifically. Losing a small volume to spillage, the "R.O.P." joke, is also not trivial with a 1000mg dose where even 0.5mL represents a meaningful portion of the total testosterone delivered.

What should you actually know?

If you are on or considering Nebido, the dosing interval this creator describes is real, but the administration context matters a lot more than this video suggests.

• Nebido requires a genuinely slow injection, typically over 2 minutes, not as a preference but as a safety requirement. The European Medicines Agency and prescribing guidelines specify this explicitly to reduce pulmonary oil microembolism risk.
• Post-injection observation is recommended, usually 30 minutes in a clinical setting, because pulmonary oil microembolism symptoms can be delayed slightly. Home administration removes that safety net.
• The gluteal injection site shown is a high-skill site. Many clinicians prefer the ventrogluteal site for large-volume oil-based injections because it avoids major nerves and blood vessels more reliably than the dorsogluteal site.
• Spillage during an IM injection is not just a minor inconvenience. With a 1000mg/4mL preparation, losing 0.5mL means losing roughly 125mg of testosterone. This affects pharmacokinetics and your testosterone levels at the next scheduled interval.
• Trans masculine patients using Nebido may have different pharmacokinetic responses than cisgender hypogonadal men, and the evidence base for this specific population is still thin. Hembree et al. (2017, Journal of Clinical Endocrinology and Metabolism) provide the main clinical guidelines for gender-affirming hormone therapy.

The bottom line

This video is not dangerous, but it is incomplete. The creator accurately reflects the real-world experience of long-acting testosterone therapy, and there is genuine value in that kind of visibility. The 12-week interval and the slow injection requirement are both grounded in how this drug actually works. What is missing is any mention of the specific risks attached to this particular formulation, risks that are serious enough that some countries restrict Nebido to clinical administration settings only. If you are self-managing or partner-administering Nebido at home, make sure you and your injector have received proper training, know the signs of pulmonary oil microembolism, and have a plan if something goes wrong.