safety of testosterone therapy

Testosterone Injections

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Testosterone Injections

Intramuscular testosterone has been used for years due to its effectiveness and low cost. Whereas free testosterone has a half-life of only 10 minutes, the esterification process renders testosterone less polar and more lipid soluble, thereby prolonging its duration of action. Delivery of these esters through an oil-based depot injection allows their slow release.

Testosterone injections are used in men with conditions associated with deficiency or absence of endogenous testosterone (Low T). Blood tests should be run before treatment begins, and periodically throughout treatment to check hemoglobin and hematocrit levels when receiving long-term testosterone injection treatments. Your doctor typically administers testosterone injections, usually given in the upper buttock, every 1 – 4 weeks. There have been no reports of acute over dosage with testosterone injections. Some of the most common formulas are listed below.

Testosterone Cypionate/Estradiol Cypionate

Testosterone Cypionate/Estradiol Cypionate is used for intramuscular testosterone injections containing testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. The testosterone esters in these compounds are injected so that testosterone is slowly released over a period of weeks. Testosterone Estradiol (TE) and Testosterone cypionate (TC) similarly create an initial peak in testosterone level, higher than would occur naturally, within 2 to 3 days of injection and decline slowly, often to subnormal levels in 1 to 2 weeks. This cyclical nature of highs and lows can be minimized by shortening the interval between injections and lowering the dose.

The most widely recommended dosage for TE or TC is 100 to 200 mg every 2 weeksor, as the American Association of Clinical Endocrinologists recommends, when testosterone levels are just above the lower limit of normal, in the range of 250 to 300 ng/dL. Injections are formulated in such a way that a person can receive 200 mg every 2 weeks or 300 mg every 3 weeks, etc.

Placebo-controlled data show that sexual functioning, which closely follows variations in circulating testosterone levels, has a dose-related response to TE therapy. Although there is no placebo-controlled evidence that mood swings and energy levels vary more with testosterone injections than with other modalities, the notion is generally held to be true. Higher dosing lengthens the interval between consecutive injections, but also creates higher peaks and lower nadirs in circulating testosterone, thereby increasing the severity in symptom fluctuation.

The Endocrine Society recommends measuring levels midway between injections and adjusting dose or frequency to achieve levels in the midnormal range.

Testosterone Propionate

Testosterone propionate is rarely used in an injectable form because its pharmacokinetic profile requires administration every 2 to 3 days.

 

Testosterone Enanthate

Testosterone enanthate is another form of testosterone injections prescribed for men with no or low testosterone. It is a slow-acting ester with a release time between 8-10 days. The name brand of T-enanthate available in the United States is called “Delatestryl,” which is suspended in sesame oil. Testosterone enanthate is typically injected anywhere between once a week to once every three weeks. Generic testosterone enanthate can also be obtained through a compounding pharmacy for bioidentical hormone replacement therapy. These pharmacies can mix T-enanthate in sesame, cottonseed, or any other appropriate oil.

 

Testosterone Cypionate

Testosterone cypionate is a slow-acting ester with a release time between 8-10 days, similar to that of enanthate. The name brand available in the U. S. is called “Depo-Testosterone,” which is suspended in cottonseed oil. Testosterone cypionate is typically injected between once a week to once every three weeks. Generic testosterone cypionate can also be obtained through a compounding pharmacy for bioidentical hormone replacement therapy.