Testosterone cypionate

Testosterone is the primary male sex hormone. It’s responsible for regulating sexual development and supporting healthy muscle mass, bone density, red blood cell production, and mood stability. Testosterone plays a crucial role in puberty, sperm production, and overall metabolic health. In adulthood, optimal testosterone levels are essential for libido, erectile function, cognitive function, and cardiovascular health. 

Testosterone levels naturally peak in a man’s late teens and early 20s, then gradually decline by about 1 percent per year after age 30. Factors such as aging, obesity, chronic illness (e.g., diabetes, cardiovascular disease), stress, poor sleep, and low physical activity can contribute to low testosterone (hypogonadism). Low testosterone may cause fatigue, reduced muscle mass, weight gain, depression, and decreased libido. Treatments for low testosterone include lifestyle modifications, resistance training, weight management, and testosterone replacement therapy (TRT) when necessary. 

Excessively high testosterone, whether from steroid use or hormonal imbalances, can lead to acne, aggression, cardiovascular risks, and infertility due to suppressed natural sperm production. 

Proper medical evaluation, including a medical history review and blood tests, can help determine whether testosterone levels are within a healthy range (typically between 300 and 1,000 ng/dL for adult males) and if treatment is needed.

There are many different forms of testosterone available as medication. The information below is about the brand name medication Depo-Testosterone^®, which is an injectable medication that contains the active ingredient testosterone cypionate.

Depo-Testosterone (testosterone cypionate) is indicated for:

• Replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous testosterone:

  • Primary hypogonadism (congenital or acquired) — testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome; or orchidectomy

  • Hypogonadotropic hypogonadism (congenital or acquired) — gonadotropin or LHRH deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation

Androgen

The following adverse reactions in the male have occurred with some androgens:

• Endocrine and urogenital: Breast tissue growth in men and excessive frequency and duration of penile erections. Oligospermia may occur at high dosages

• Skin and appendages: Hirsutism, male pattern of baldness, seborrhea, and acne

• Cardiovascular disorders: Heart attack, stroke

• Fluid and electrolyte disturbances: Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates

• Gastrointestinal: Nausea, cholestatic jaundice, alterations in liver function tests, rarely hepatocellular neoplasms and peliosis hepatis

• Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia

• Nervous system: Increased or decreased libido, headache, anxiety, depression, and generalized paresthesia

• Allergic: Hypersensitivity, including skin manifestations and anaphylactoid reactions

• Vascular disorders: Venous thromboembolism

• Special senses: Rare cases of central serous chorioretinopathy (CSCR)

• Miscellaneous: Inflammation and pain at the site of intramuscular injection

The price of testosterone may vary depending on the form and dosage, where you buy it, and your health insurance coverage. The average retail price of the most popular types of testosterone is about $400 per month, but manufacturer and pharmacy coupons may bring down the price as low as about $30 or $40, and insurance may cover the full cost. Other types of testosterone can cost between $100 and $1,000 per month depending on the form and whether you opt for a brand name or generic medication.

Testosterone is only available via prescription from a healthcare provider. If you’re interested in taking testosterone, make an appointment with your provider so they can assess your testosterone levels and discuss whether testosterone therapy is the right treatment for you and the symptoms you’re experiencing.

• Known hypersensitivity to the drug

• Males with carcinoma of the breast

• Males with known or suspected carcinoma of the prostate gland

• Women who are pregnant

• Patients with serious cardiac, hepatic or renal disease

• Drug interactions: Androgens may increase sensitivity to oral anticoagulants, concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone, in diabetic patients the metabolic effects of androgens may decrease blood glucose and insulin requirements

• Patients with benign prostatic hypertrophy may develop acute urethral obstruction

• Priapism or excessive sexual stimulation may develop

• Oligospermia may occur after prolonged administration or excessive dosage

• Testosterone cypionate should not be used interchangeably with testosterone propionate because of differences in duration of action

• Testosterone cypionate is not for intravenous use

• Patients should be instructed to report any of the following: nausea, vomiting, changes in skin color, ankle swelling, too frequent or persistent erections of the penis

• Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration

• Serum cholesterol may increase during androgen therapy

• Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4

• High blood calcium may occur in immobilized patients

• Prolonged use of high doses of androgens (principally the 17-α alkyl-androgens) has been associated with development of hepatic adenomas, hepatocellular carcinoma, and peliosis hepatis

• Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking

• There have been postmarketing reports of venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients using testosterone products, such as testosterone cypionate

• Long term clinical safety trials have not been conducted to assess the cardiovascular outcomes of testosterone replacement therapy in men

• Testosterone has been subject to abuse, typically at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids

• Edema, with or without congestive heart failure, may be a serious complication in patients with pre-existing cardiac, renal or hepatic disease

• Breast tissue growth in males may develop and occasionally persists in patients being treated for hypogonadism

• The preservative benzyl alcohol has been associated with serious adverse events, including the "gasping syndrome", and death in pediatric patients

• Androgen therapy should be used cautiously in healthy males with delayed puberty

• This drug has not been shown to be safe and effective for the enhancement of athletic performance

• Pregnancy: The use of testosterone in women who are pregnant is contraindicated

• Breastfeeding: Depo-Testosterone is not recommended for use in nursing mothers

There are other treatments for low testosterone or hypogonadism. Some treatments may be better suited to you than others. If you’re interested in an alternative to testosterone replacement therapy, consider connecting with a healthcare provider who can help you evaluate your options. 

Alternatives to TRT that may help manage low testosterone in men include the following, which can signal the body to have or make more testosterone:

• Aromatase inhibitors like Arimidex^® (anastrozole)

• Human chorionic gonadotropin (hCG) or Ovidrel^®, a synthetic form of hCG

• Selective estrogen receptor modulators like Clomid (clomiphene)

Your healthcare provider may also prescribe non-medication alternatives that can support healthy testosterone levels, including:

• Exercise

• Stress management

• Dietary improvements

• Getting enough sleep

• Weight loss

*This information is from the label for brand name Depo-Testosterone^®. See the Full Prescribing Information for more complete information. Testosterone cypionate, the active ingredient in Depo-Testosterone, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient testosterone cypionate.