Treatment adherence higher with testosterone undecanoate vs testosterone cypionate
Exercise capacity in men with chronic heart failure increased after 12 weeks (60), whereas the cardiac index (cardiac output related to body surface) had already increased after 180 min. In men with coronary artery disease flow-mediated vasodilatation was observed after 12 weeks (61). Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Changes in erections/ejaculations may require up to 6 months. Effects on quality of life manifest within 3–4 weeks, but maximum benefits take longer.
Dose adjustments were allowed for adverse effects or serum testosterone levels not within physiologic range. Twenty-seven transdermal subjects were eligible for PK analysis. Baseline serum testosterone was 55.4 ng/mL and increased to an average of 517 ng/dL. Transdermal administration allows testosterone to be continuously absorbed for 24 hours with no dose accumulations, mimicking normal testosterone and estrogen levels in men circadian pattern when applied nightly. The approximate half-life is 1.3 hours and hypogonadal concentrations are achieved within 24 hours of patch removal (26).
Testosterone belongs to a class of drugs known as androgens. It works by affecting many body systems so that the body can develop and function normally. In some studies a decline in diastolic blood pressure has been observed, after 3–9 months (22, 35, 41, 44) and in some studies in systolic blood pressure also (35, 44). A decrease in the resting heart rate occurred after 40–44 weeks (44). A decrease in arterial stiffness measured as pulse wave velocity was measurable after 48 h (58) and in large artery compliance after 3 months (58). Several studies have been conducted in men with heart disease. In men with chronic stable angina pectoris the increase in time to 1 mm ST segment depression was noticeable after 14 weeks (59).
It should only be used when and as prescribed by a healthcare provider. People can also use testosterone injections to treat delayed puberty or certain signs of menopause. Testosterone therapy is also part of gender affirming care. A 2022 article notes that it is more difficult for females to access testosterone therapy than it is for males. The FDA has approved more than 30 testosterone medications for males but none for females. Testosterone injections are a treatment for sexual dysfunction in males and for low testosterone in either males or females. Without insurance, testosterone cypionate will cost about $100 per month along with additional fees for the injection.
Evidence suggests that many people taking testosterone for hypogonadism have never had their testosterone levels checked or, if they have had their levels checked, do not meet the threshold for low testosterone. However, a significant number of these patients did not have low enough testosterone levels to receive a diagnosis of hypogonadism. Hypogonadism is when the testes are not producing enough testosterone or sperm. A 2019 review notes that testosterone therapy has become increasingly popular in the United States.
Additionally, some of these medications are available in low-cost generic formulations. Disadvantages generally include less of a rise in testosterone levels compared to testosterone-containing therapies. Some of these medications are used off-label to increase testosterone. Cylindrical pellets that are about the size of a grain of rice.
Both these are available in intramuscular injectable solutions given into muscle. Testosterone enanthate is also available as a subcutaneous self-injectable drug. 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. Testosterone enanthate injection has also been assigned to Schedule III.
Testosterone may cause allergic reactions, which can be serious. Stop using testosterone and get help right away if you have any of the following symptoms of a serious allergic reaction. DEPO-Testosterone Injection is available in two strengths, 100 mg/mL and 200 mg/mL testosterone cypionate. Drug dependence in individuals using approved doses of testosterone for approved indications has not been documented.
