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Testosterone injections: testosterone cypionate

by Chris Steidle, MD

Testosterone injections, most commonly available in the US as testosterone cypionate, are chosen for male hormone replacement by some men.  

Testosterone in any form may be able to improve erectile dysfunction, strengthen erections and improve all other symptoms of low testosterone. Testosterone for male hormone replacement is made in the laboratory from cholesterol and it tends to be more expensive than its female hormone counterparts. When it was first used as oral treatment, doctors discovered that the body absorbed testosterone from the intestine too rapidly and the liver broke it down into components that were not effective. New forms of testosterone were developed that resisted rapid absorption and new delivery methods were devised so that circulation of testosterone through the liver could be bypassed.

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The simplest way to get around the absorption and rapid breakdown problems is also the oldest way to administer testosterone. When testosterone is injected into muscle, usually in the buttocks, it is absorbed directly into the blood stream. The early forms of injectable testosterone broke down rapidly in the body so injections had to be given every two or three days to maintain the proper levels in the blood. Newer injectable testosterone products are both more reliable and longer acting, and some may even reduce the frequency of shots to one every two to four months.

Advantages of injectable testerosterone:

  • Infrequent dosing, every two to four weeks or longer
  • Dramatic physical feeling immediately after the injection; some men like the "boost"
  • Injection is one of the lower cost options available

Disadvantages of injectable testosterone:

  • Initial levels of testosterone are very high, usually much higher than the highest levels in non-treated men, and may have harmful effects.
  • At the end of an injection cycle, testosterone levels fall below normal levels.
  • The injection can be painful.
  • Scheduling of injections can be inconvenient.
  • The "roller coaster effect" can cause emotional and sexual highs and lows when the initial "boost" is followed by the "down." 

Injectable testosterone products and websites:

Product Manufacturer Dosing Administration
Delatestryl® (testosterone enanthate) Indevus
Pharmaceuticals
150-200 mg, every 10-21 days (Dosage and duration of therapy will depend on age and patient's response to treatment.) Intramuscular injection
Depo-Testosterone® (testosterone cypionate) Pfizer, Inc. 50-400 mg, every 10-21 days Intramuscular injection
Testorona® (testosterone propionate) Not available in US N/A N/A

References

Brawer, Michael K., MD. Androgen Supplementation and Prostate Cancer Risk: Strategies for Pretherapy Assessment and Monitoring. Rev.Urol. 2003;5 (suppl 1):S29-S33.

Caruthers, Malcolm, MD. The Testosterone Revolution. London: Thorsons; 2001.

Heaton, Jeremy, P.W., MD. Hormone Treatments and Preventive Strategies in the Aging Male: Whom and When to Treat? Rev.Urol. 2003;5(suppl 1):S16-S21.

Matsumoto, Alvin M., MD. Fundamental Aspects of Hypogonadism in the Aging Male. Rev.Urol. 2003;5(suppl 1):S3-S10.

McCulloch, Andrew, MD. Case Scenarios in Androgen Deficiency. Rev.Urol. 2003;5(suppl 1):S41-S48.

Nieschlag, E., Behre, H.M., Nieschlag, S. Testosterone: Action, Deficiency, Substitution. Berlin: 1998.

Steidle, Christopher P., MD. New Advances in the Treatment of Hypogonadism in the Aging Male. Rev.Urol. 2003;5(suppl 1):S34-S40.

Notes

1. Matsumoto, Alvin M. Fundamental Aspects of Hypogonadism in the Aging Male. Urology. Vol. 5, Supplement 1. 2003;S3-10.
2. Morley, JE. J Gend Specif Med. 2001;4:49-53.

Posted February 2004
Updated March 2013

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