Some have already answered part of the original post. I have completed Forteo treatment in fall of 2023. I went through 25 or so pens during my treatment. The pens only have one click. On the pens I used, the plunger did make some noise when it's pulled back before injecting. Perhaps that could be considered "clicks". The amount the interior part of the plunger that you see in the medication does not move enough on one dose to be able to tell how far it moved. It is pretty well not noticeable.