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The chemical name for testosterone enanthate is testosterone heptanoate. It is a type of anabolic androgenic steroid (AAS) used to treat low testosterone levels. Anabolic drugs function by increasing muscular mass, whilst androgenic drugs increase male sex characteristics.
Since the 1950s, this medication has been employed in medical treatments. It is accessible only by prescription and goes by several brand names, including Androfil, Depandro, Testrin, and Testro.
The purpose of this article is to describe how and why the medicine is used. It also provides information about side effects and drug interactions, as well as addresses queries about cancer risks associated with its use.
WHAT ARE THE INDICATIONS FOR TESTOSTERONE ENANTHATE?
Testosterone enanthate is a testosterone pro-drug as well as a synthetic medication developed from the testosterone hormone. This means that it encourages the body to produce its own testosterone. It has high androgenic and modest anabolic properties.
The medicine can be used for testosterone replacement treatment (TRT) in cisgender (cis) males who have hypogonadism, or a decrease in testosterone production.
The following are some of the causes of this condition:
- Testicular injury, infection, and malignancy
- Disorders such as Klinefelter syndrome and hypothalamic and pituitary gland illnesses
- Chemotherapy and radiation therapy
This medication can also be used for hormone therapy in transgender men.
Other applications include treatment for delayed puberty in cis boys3 and metastatic breast cancer in postmenopausal women.
The medicine is also controversially utilized as an anti-aging therapy in older cis men. After the age of 50, testosterone levels in cis men can drop precipitously, resulting in andropause.
WHAT IS THE DOSAGE FOR TESTOSTERONE ENANTHATE?
Testosterone enanthate is a 5-milliliter (ml) glass vial containing a clear or yellowish fluid. Every one to four weeks, it is injected into a buttock muscle. Lower doses are frequently used over shorter intervals to avoid substantial fluctuations in hormone levels and the mood swings that may accompany them.
The active medication, which is suspended in sesame oil, has a two to three-week sustained release time.
The dosage varies according on the individual, however it is commonly used as follows:
- Male hypogonadism: Every two to four weeks, take 50 to 400 milligrams (mg).
- Delayed male puberty: 5–200 mg every two–four weeks for four–six months
- Metastatic breast cancer: Every two to four weeks, take 200 to 400 mg.
- Hormone therapy for transgender people: 50-200 mg once a week or 100-200 mg every two weeks2
While testosterone enanthate and testosterone cypionate (depo testosterone) are commonly used interchangeably, the latter is exclusively approved for the treatment of hypogonadism.
WHAT ARE THE SIDE EFFECTS OF TESTOSTERONE ENANTHATE?
This medication is intended to change hormone levels, and it has both advantages and disadvantages. The adverse effects might range from minor to severe.
The most significant adverse effects are linked to testosterone abuse, which is becoming more common in the United States. As a result, the Food and Drug Administration (FDA) revised the product warning label in 2016.
Common Side Effects
The following are the most prevalent negative effects linked with testosterone enanthate use, according to the FDA:
- Pain and swelling at the injection location
- Headaches
- Tingling throughout the body
- Acne and oily skin
- Hair thinning
- Dizziness
- Changes in mood, especially hostility
- Anxiety or depression
- Sex drive can be increased or diminished.
- gaining weight
If the dose is lowered, the severity of the adverse effects may improve for some people.
Adverse Reactions
Long-term or excessive use of this medicine is connected with less common but potentially more dangerous side effects. Some are associated with its androgenic properties. The heart and liver can be harmed as a result of the side effects.
If you have any of the following symptoms while taking testosterone enanthate, contact your doctor right away:
- Hair loss in a male-pattern
- Male-pattern hair growth in people born as females (hirsutism)
- Enlargement of the male breast (gynecomastia)
- Amenorrhea and other menstrual irregularities
- Clitoral expansion
- Penile erections that are painfully long (priapism)
- Having difficulty urinating or urinating frequently at night in those with a penis
- Severe mental health symptoms, such as significant depression, paranoia, or psychosis
Some androgenic effects, such as clitoral growth and a deeper voice, are permanent in those assigned female at birth.
In cis men, a decreased sperm count can limit fertility.
The use of testosterone may raise the risk of certain medical issues, particularly among cis men.
They are as follows:
- Heart attack
- Stroke
- Congestive heart failure
- Deep vein thrombosis (DVT)
When treated with testosterone, people with severe untreated obstructive sleep apnea are at danger of abrupt death.
Severe liver damage is also possible. Fatigue, stomach pain, nausea, vomiting, dark urine, and jaundice are some of the symptoms (yellowing of the eyes and skin).
WHAT ARE THE TESTOSTERONE ENANTHATE DRUG INTERACTIONS?
Certain drugs interact with testosterone enanthate. While taking this drug, several things may need to be modified or amended.
Among the possible medication interactions are:
- When used with testosterone, anticoagulants ("blood thinners") such as warfarin frequently have greater effects. This increases the possibility of bleeding.
- Diabetes medication dosages may need to be modified. This is because testosterone has been shown to reduce both blood sugar and insulin requirements.
- In persons with heart, renal, or liver illness, corticosteroids and testosterone should be administered with caution. Combining them may result in fluid retention (edema) and an increased risk of congestive heart failure.
WHAT ARE THE CONTRAINDICATIONS OF TESTOSTERONE ENANTHATE?
There are some situations in which this medication should never be taken. This covers the usage of testosterone in patients with untreated prostate cancer or breast cancer, as well as during pregnancy.
If you are allergic to sesame oil or any of the drug's components, you should avoid using it.
RISK OF PROSTRATE CANCER
TRT has been shown to relieve urinary symptoms caused by benign prostatic hyperplasia (BPH) in men who were born male.
In people born male, the prostate gland is an organ. Its function is to secrete prostate fluid, which is one of the components of sperm. BPH, a common disorder, restricts urine flow and can lead to bladder stones and decreased kidney function.
The same may not be true for those born male who are diagnosed with prostate cancer. The link between testosterone usage and prostate cancer is still debatable, and there have been reports that testosterone use in older men with untreated prostate cancer caused the cancer to spread. This has not been duplicated in other investigations.
Even in cis men who do not have cancer, any increase in the prostate-specific antigen (PSA) test within the first three to six months after commencing testosterone would indicate discontinuing treatment until a full cancer investigation could be performed.
RISK OF MALE BREAST CANCER
A 2006 study found that TRT use increased male breast cancer risk by 11% over a 10-year period. This link's method is unknown, and it has not been validated.
The FDA maintains that testosterone use offers a risk to cis males with untreated breast cancer and should be avoided without exception. This is due to the natural conversion (aromatization) of testosterone into estradiol.
PREGNANCY RISK
Pregnant women should avoid using testosterone enanthate. When testosterone is administered during pregnancy, it can have an effect on the female fetus. Physical traits normally associated with those assigned male at birth are present in a fetus assigned female.
Some of the symptoms may be visible from birth, while others may not appear until puberty or later in life.
They are as follows:
- External genitals and an enlarged clitoris
- Childhood ovarian cysts
- Body or face hair that is excessive
- increased bone structure
- Breasts that are smaller
- Male pattern baldness-like hair thinning
- a deeper voice tone
The danger of virilism, the medical word for this disorder, in the infant is increased in pregnant women who have virilism as a result of testosterone use.
A breastfeeding baby appears to be unaffected by testosterone use. Before reaching the bloodstream, breast milk, or other body fluids, the drug's components are mostly broken down. However, because high levels of testosterone interfere with milk production, nursing may be impossible.
Testosterone use in cis men does not endanger pregnancy, either during conception or during gestation.
CONCLUSION
Testosterone enanthate may be beneficial for cis men with low testosterone levels. It may also be used to treat other illnesses, such as hormone therapy in transgender men.
However, it is not without potential side effects and health hazards. Some of them are rather dangerous, like as the increased risk of heart attack and stroke in cis men. Drug interactions are also a possibility, so if you're thinking about using it, be sure to tell your doctor about your entire medical history.