Testosterone Cypionate vs. Enanthate: How Do They Compare?

What Are the Uses of Testosterone Cypionate?

Testosterone cypionate is a prescription drug (androgen hormone). It is prescribed for use as replacement therapy in males in conditions associated with symptoms of deficiency or absence of testosterone.

It is approved to treat:

• Primary hypogonadism (congenital or acquired) when the body’s sex glands do not produce enough hormones
• Hypogonadotropic hypogonadism (congenital or acquired). It is a condition in which the testes or ovaries are unable to produce enough sex hormones. It is caused due to a problem with the pituitary gland or hypothalamus.

Testosterone cypionate injection is a controlled substance under the Anabolic Steroid Control Act. and is categorized as a Schedule III. It should only be used when and as prescribed by a healthcare provider.

Testosterone cypionate also has a longer half-life (the time it takes for a drug to decrease by half of its blood concentration) than testosterone enanthate, meaning it lasts longer in the body.

It is available as a generic drug and marketed under the brand name Depo-Testosterone.

How to Use It

Administration

• Testosterone cypionate and Depo-Testosterone injections come as a solution that you or your healthcare provider can inject intramuscularly every two to four weeks.
• If self-injecting, ask your healthcare provider to show you how to administer the injection.
• Inject deep into the muscle. Before administration, check for any visible particulate matter and discoloration.

Dosage

• The dosage for testosterone cypionate injection varies depending on your age, sex, and medical condition. Your healthcare provider will adjust the dose according to your response to treatment.
• For replacement in males with hypogonadism, the dosage is 50 to 400 milligrams (mg) every two to four weeks.
• Children under 12 years old should not take testosterone cypionate.

What Are the Uses of Testosterone Enanthate?

Testosterone enanthate is also a prescription drug (androgen hormone). Along with its use for testosterone replacement therapy in males with low natural testosterone levels, it is also FDA-approved for other conditions.

Testosterone enanthate’s FDA-approved uses include:

• Primary hypogonadism (congenital or acquired)
• Hypogonadotropic hypogonadism
• Delayed puberty
• Metastatic mammary cancer (breast cancer): Women with advancing inoperable metastatic (skeletal) mammary cancer who are one to five years postmenopause.

Testosterone enanthate injection has also been assigned to Schedule III. It should only be used as prescribed.

It is also available as a generic drug and marketed under the brand name Xyosted. Xyosted (subcutaneous injection) is only approved to treat hypogonadism.

How to Use

Administration

• Testosterone enanthate is a solution that you or your healthcare provider can inject intramuscularly every two to four weeks.
• Xyosted injection comes as a solution that you or your healthcare provider can administer subcutaneously (under the skin) once a week.
• If injecting by yourself, ask your healthcare provider to show you how.

Dosage

• Male hypogonadism: 50 to 400 mg every two to four weeks.
• Delayed puberty: Dosage is 50 to 200 mg every two to four weeks for four to six months. X-rays should be taken at appropriate intervals to determine the amount of bone maturation and skeletal development.
• Mammary cancer in women: A dosage of 200 to 400 mg every two to four weeks is recommended.

Testosterone enanthate is not recommended for men with age-related hypogonadism.

Side Effects

Some mild side effects of testosterone injections include:

• Acne
• Breast enlargement, pain, or tenderness
• Hoarseness (low-pitch voice)
• Deepening of voice
• Injection site reaction (pain, redness, bruising, bleeding, or hardness)
• Red blood cell count increase
• Tiredness
• Sleep apnea (difficulty breathing for a short period during sleep)
• Mood swings
• Weight gain
• Headache
• Joint pain

Some other side effects can be severe and may include:

• Blood clot symptoms such as lower leg pain, swelling, warmth, or redness
• Nausea or vomiting
• Edema (swelling of the hands, feet, ankles, or lower legs with or without a heart attack)
• Priapism (erections that happen too often or that last too long)
• Urination problems (difficulty urinating, weak urine flow, frequent or sudden urge to urinate, blood in the urine)
• Liver problems such as yellowing of the skin or eyes and pain in the upper right part of the stomach
• Mood changes, including depression, anxiety, or suicidal thoughts such as thinking or planning about harming or killing oneself
• Decreased sperm production
• Early maturation of bones
• Prostatic-specific antigen (PSA) increases (increased risk of prostate cancer)

Call your healthcare provider right away if you have any of the serious side effects listed above.

Is Testosterone Safe for Me?

Testosterone is safe when taken as prescribed. However, taking some precautionary measures before initiating the therapy is best.

You must tell your healthcare provider if you are male and have breast cancer or have or may have prostate cancer.

Higher levels of testosterone may cause many problems. Those who have certain health conditions should not take it. Tell your healthcare provider if you have the following conditions:

Drug Interactions

Some of the most common drugs that interact with all testosterone formulations include:

• Insulin sensitivity or sugar control changes may occur in people treated with androgens. There may be a need for dose adjustment for medications such as Apidra, Humalog, and Humulin.
• Changes in anticoagulant activity may occur with androgens drugs. Monitor the blood clotting hormone levels frequently in people taking Jantoven (warfarin).
• Corticosteroids, such as dexamethasone, Medrol (methylprednisolone), and Rayos (prednisone), may result in increased fluid retention when taken with testosterone. Careful monitoring is required, particularly in people with heart, kidney, or liver disease.
• Elevated serum levels of oxyphenbutazone may occur.

Which One Should I Take?

Testosterone cypionate and enanthate are both FDA-approved for different indications and have limitations in their uses. They are both effective and have nearly the same half-life.

You should not start taking testosterone products on your own or switch between generics or brands.

Talk to your healthcare provider about which version of testosterone is right for you, depending on your age, gender, condition, and response to the drug.

Summary

Testosterone cypionate and enanthate are prescription drugs taken to treat symptoms of hypogonadism in males. Testosterone enanthate is also approved for use in females for treating mammary gland cancer.

Both these are available in intramuscular injectable solutions given into muscle. Testosterone enanthate is also available as a subcutaneous self-injectable drug.

Testosterone is a controlled substance regulated by the United States government and must only be taken when prescribed.

Testosterone cypionate and testosterone enanthate are both effective when taken for their approved indications. Only use the medication prescribed by you and do not switch between brands without asking a healthcare professional.