Testosterone enanthate is also known as testosterone heptanoate. It is an anabolic and androgenic steroid (AAS) drug used to treat low testosterone levels. Anabolic drugs work by building muscles, while androgenic means it enhances sex characteristics usually associated with males.
This drug has been used in medical procedures since the 1950s. It is known by a number of brand names, including Androfil, Depandro, Testrin, and Testro, and it is available by prescription only.
This article will explain how and why the drug is used. It also offers information about side effects and interactions with other drugs, and answers questions about related cancer risks from using it.
Testosterone Enanthate is a long-acting intramuscular form of the androgen testosterone. Testosterone inhibits gonadotropin secretion from the pituitary gland and ablates estrogen production in the ovaries, thereby decreasing endogenous estrogen levels. In addition, this agent promotes the maintenance of male sex characteristics and is indicated for testosterone replacement in hypogonadal males, delayed puberty, and metastatic mammary cancer. (NCI04)
Testosterone enanthate is an esterified variant of testosterone that comes as an injectable compound with a slow-release rate. This slow release is achieved by the presence of the enanthate ester functional group attached to the testosterone molecule. This testosterone derivative was first approved on December 24, 1953. In 2017, about 6.5 million retail prescriptions for testosterone therapy were filled. The majority of the prescriptions written were for injectable (66%) and topical (32%) testosterone products. As recent as 1 October 2018, the US FDA approved Antares Pharma Inc.’s Xyosted – a subcutaneous testosterone enanthate product for once-weekly, at-home self-administration with an easy-to-use, single dose, disposable autoinjector. As the first subcutaneous autoinjector product designed for testosterone replacement therapy, this innovative formulation removes transfer concerns commonly associated with testosterone gels and potentially reduces the need for in-office/in-clinic injection procedures that may inconvenience patients with frequent visits to the clinic.
Testosterone enanthate in males is indicated as a replacement therapy in conditions associated with a deficiency or absence of endogenous testosterone. Some of the treated conditions are 1) primary hypogonadism, defined as testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome or orchidectomy; 2) hypogonadotropic hypogonadism due to an idiopathic gonadotropin or luteinizing hormone-releasing hormone deficiency or due to a pituitary-hypothalamic injury from tumors, trauma or radiation, in this case it is important to accompany the treatment with adrenal cortical and thyroid hormone replacement therapy; 3) to stimulate puberty in patients with delayed puberty not secondary to a pathological disorder. If the conditions 1 and 2 occur prior to puberty, the androgen replacement therapy will be needed during adolescent years for the development of secondary sexual characteristics and prolonged androgen treatment might be needed it to maintain sexual characteristics after puberty. In females, testosterone enanthate is indicated to be used secondarily in presence of advanced inoperable metastatic mammary cancer in women who are from one to five years postmenopausal. It has also been used in premenopausal women with breast cancer who have benefited from oophorectomy and are considered to have a hormone-responsive tumor.
Testosterone enanthate injections that are currently formulated for subcutaneous use are specifically indicated only for primary hypogonadism and hypogonadotropic hypogonadism. The use of such formulations is limited because the safety and efficacy of these subcutaneous products in adult males with late-onset hypogonadism and males less than 18 years old have not yet been established. Moreover, subcutaneously administered testosterone enanthate is indicated only for the treatment of men with hypogonadal conditions associated with structural or genetic etiologies, considering the medication could cause blood pressure increases that can raise the risk of major adverse cardiovascular events like non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death.
Compared Side Effects
Compared with other steroid compounds, Testosterone enanthate can be thought to have only mild side effects risks as is the case with other testosterone esters.
This is a hormone that the male body is naturally used to and it is just the higher dose for bodybuilding and performance purposes that introduce possible adverse effects as the effect of testosterone in the body is amplified.
Testosterone naturally aromatizes at a relatively mild level compared with other steroids, and this is where we see the side effects developing as a result of estrogen conversion.
The higher the dosage, the greater the estrogen related effects will be. Individual reactions to the steroid will also vary which is why beginners should always use Testosterone Enanthate as a sole compound in a cycle to gauge side effects.
Potential side effect risks include all the familiar adverse effects such as possible hair loss and acne, gyno, high blood pressure and in some people nausea and headaches can occur.
Water retention, when left to advance, can lead to high blood pressure and this is the more serious aspect of side effects you need to think about.
It will also cause your gains to not be as made of as much solid muscle as you’d like, and these mass gains can dissipate following a cycle if water retention is high – therefore controlling estrogen side effects when using Testosterone Enanthate at higher doses is important not only for your health but for your longer term results.
Some users report irritation at the injection site when using Testosterone Enanthate and this does not necessarily occur when using other esters like Testosterone Cypionate, but this should be considered an individual response with tolerance levels to injections varying widely between people.
This drug is designed to alter hormone levels, and it has benefits and risks. The side effects can range from mild to intolerable.
The most serious side effects are associated with testosterone abuse, an increasing problem in the United States. This led the Food and Drug Administration (FDA) to change the product warning label in 2016.6
Common Side Effects
According to the FDA, the most common side effects associated with testosterone enanthate use include:
- Injection site pain and swelling
- Mood changes, including aggression
- Depression or anxiety
- Increased or decreased sex drive
- Generalized tingling
- Oily skin and acne
- Thinning hair
- Weight gain
The severity of the side effects may improve for some people if the dose is reduced.