What Is Testosterone Cypionate?

Chemically speaking, cypionate is an eight-carbon (8C) ester form of the androgenic hormone, testosterone, known as 17beta-cyclopentanepropionate. Medically, testosterone cypionate is administered as a compound to people needing testosterone replacement therapy, in the form of intramuscular and subcutaneous injections. Being an 8C ester makes the compound more stable with a greater half-life (the time taken by any active substance to reduce to half its initial dosing amount). The half-life of testosterone cypionate is approximately 8 days when injected intramuscularly. This makes the compound release free testosterone for a longer period, reduces the aromatization of testosterone and production of dihydrotestosterone and estrogen as metabolites. This in turn reduces risks of side effects like gynecomastia and fluid retention.(1) (2) (3) The frequency of testosterone cypionate injections can vary between two to four weeks depending on the prescribed dosing.

The brand names for testosterone cypionate in the United States are depAndro, Depo-Testosterone, Depotest, and Virilon.(4) (5)Testosterone Enanthate and Testosterone Cypionate are two of the most prevalent ester-based formulations used in the present day to treat low-T conditions.(1) Other esters are Undeconate, Propionate, Sustenol, and Nebido. (6) (7)

What Are The Uses Of Testosterone Cypionate Injection?

Testosterone cypionate is one of the key players in testosterone replacement therapy (TRT). Men with hypogonadism are given the injection when their bodies cannot produce the clinically optimal levels of testosterone (300-1000 ng/dL). (8) This level can differ for senior men whose testosterone levels should ideally be between 500 and 800 ng/dL, while for young adults the levels should be between 600 and 900 ng/dL.

Testosterone is one of the key endogenous androgens (sex hormones) secreted by the testes in males and is responsible for the development of primary and secondary sexual characteristics in males across adolescence and adulthood. The key sex-specific functions include growth and maturation of the prostate gland, seminal vesicles, penis, and scrotum, determining male hair distribution in the beard, pubic, chest, and axillary regions; laryngeal enlargement, vocal cord thickening (deepening of the voice), maintaining lean muscle mass, protecting bone mineral density and joint health, cognitive functions, stress control, and cardio-protection. Hence, at any stage in life when testosterone secretion is lower than the clinically accepted levels, men are predisposed to several risks like lower sex drive (sometimes coupled with lower ejaculation volumes and erectile dysfunction), mood swings, cognitive failures, osteoporosis, central adiposity, weak joints, mood swings, irritation and myocardial ischaemia, to name a few.(5) (9) (10).

Testosterone cypionate injection is used in two cases, as prescribed by a licensed practitioner,

• Primary hypogonadism: Any abnormality in the testes leading to abnormal amounts of testosterone released in blood is known as primary hypogonadism. The primary hypogonadism in men can be due to hereditary causes or externally induced by medications or routines. The genetic conditions include Klinefelter's syndrome (where there are two X and one Y chromosome instead of the usual one X and one Y chromosome, leading to irregular formation of the testes), undescended testes (an abnormality during birth), and having excess iron in blood (leading to hemochromatosis). Externally induced causes include chemotherapy and radiotherapy treatments during cancer, injuries to the testes, and mumps orchitis (having mumps infection in the testes).(11) Low testosterone symptoms specific to primary hypogonadism include significantly reduced spontaneous erections and nocturnal penile tumescence (sexual excitement), low libido, sparse beard growth, and shrinking testes.(8)
• Secondary hypogonadism: As suggested by the name, secondary hypogonadism refers to the condition where the primary concern is damage or abnormality in the hypothalamus or the pituitary gland, which makes the testes secret sub-optimal levels of testosterone. The main reasons behind secondary hypogonadism include improper development of the hypothalamus (Kallmann Syndrome), disorders of the pituitary gland, severe brain trauma or brain surgeries, immunological and inflammatory disorders like HIV/AIDS, sarcoidosis, histiocytosis, and tuberculosis, stress, obesity, and some forms of pain medications.(11)

The Use Of Testosterone Cypionate As A Performance-Enhancing Drug

Testosterone cypionate (Depa-Testosterone) is an anabolic androgenic steroid and is one of the more common compounds sold under the category (albeit only regulated for clinical hypogonadism), along with Anadrol (oxymetholone), Oxandrin (oxandrolone), Dianabol (methandrostenolone), and Deco-Durabolin (nandrolone decanoate).(12) However, such anabolic steroids are often abused as performance enhancers by athletes and to bulk-up in skeletal muscle mass by public figures.

These compounds are sometimes prescribed or sold as dietary supplements although they are not any food product. The major risk running in the use of anabolic steroids is overdose, which may lead to adverse effects like development of male breasts, back acne, risks of becoming impotent, and having an enlarged prostate gland. Abnormally high amounts of testosterone can also lead to multiple cardiovascular risks, addiction to consuming steroids for every form of performance, mood swings and depression and even breast cancer in males. Since the use of testosterone cypionate involves needles, there are chances of contaminated needles passing off infections like HIV/AIDS or hepatitis. (13)

The use of any form of steroid for any recreational or athletic activity is not regulated and is not endorsed by any manufacturer. It is dependent on the individual and their doctors. A valid prescription is needed to buy any of these steroids for any use (hypogonadism or others). It is advised to refrain from using any testosterone ester for any form of athletic or recreational purpose unless strictly prescribed by the doctor for clinical purposes. (14)

The Benefits Of Testosterone Cypionate Injection

Testosterone cypionate is given as 50 to 400 mg intramuscularly once to 4 times a month for primary hypogonadism and hypogonadotropic hypogonadism.(14) The benefits of testosterone cypionate injection, when taken under the prescribed dosing regimen and monitored regularly, include,

• Improved sexual stimuli, sexual daydreams, reactions to sexual stimuli, sleep-entrained penile erections, and overall well-being (also depending on age and medical history)
• Improved skeletal muscle strength and joint health
• Reduced risks of osteoporosis, with improved spinal and vertebral bone health
• Improved mood, reduced irritability, and improved cognition
• When coupled with regular strength training, there is a gradual reduction in weight and central adiposity

Interactions With Other Medications

Testosterone cypionate is indicated with extra caution to anyone who has had liver issues, renal problems or is prone to risk factors for cardiovascular diseases, stroke, and a family history of cancer (Especially breast and prostate).

Interactions that increase your risk of side effects include (1) (5)

• Patients with known hypersensitivity to the drug
• Males with breast cancer
• Males with prostate cancer or those genetically susceptible to it
• Women who are planning to get pregnant
• Constant use can increase sensitivity to oral anticoagulants
• If administered with of oxyphenbutazone, any androgen may result in elevated serum levels of oxyphenbutazone
• Some diabetic patients may need insulin as testosterone cypionate may lower blood glucose levels

How To Take Testosterone Cypionate?

Testosterone cypionate can be taken both intramuscularly or subcutaneously. If following the intramuscular dosing regimen, for testosterone cypionate, administration of 50–400 mg every 2–4 weeks will lead to supratherapeutic testosterone levels 4–5 days after dosing and subtherapeutic levels on day 14 post-dosing.(16) Depending on the patient’s will to take injections, he might be prescribed either subcutaneous or intramuscular injections. However, the formulation of the injection (preservatives, carrier oil) is a determinant of adherence to the prescribed norm. SC injections are less painful than intramuscular (IM) injections and ensure a more stable release of the compound (testosterone). (3)

Remember…

Testosterone cypionate will only show visible benefits when continued long-term. It is not meant for everyone and is only to be taken under the prescribed dosing of a licensed practitioner. Adherence and regular monitoring are the keys to a successful therapy.