Injectable Testosterone: 3 Options You Should Know About

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Low testosterone ("T") levels can lead to erectile dysfunction (ED), hair loss, and depression, among other symptoms. This can have a sizable impact on confidence and your day-to-day life.

Thankfully, there's good news. Many testosterone-based medications help boost testosterone to ideal levels. These medications come in many forms, including gels, pills, and injections. They're also helpful for certain people seeking gender-affirming hormone therapy.

Here, we'll discuss the three main types of testosterone injections. They're a go-to dosage form for many people who want or need testosterone.

What are the different types of testosterone injections?

Testosterone is an important sex hormone, especially for men. Your body makes it naturally, but it can also be given as a medication. Many people inject testosterone under their skin or into a muscle.

Injectable testosterone has been modified to last for days or weeks in your body. These modified versions of testosterone are called testosterone esters. Testosterone cypionate, enanthate, and undecanoate are testosterone esters that boost your testosterone levels.

These testosterone esters differ in many ways. The most important difference is how long they last in your body. Testosterone enanthate lasts for the shortest time; it has the shortest half-life. The half-life of a medication is how long it takes your body to remove 50% of the medication. Testosterone cypionate lasts longer than testosterone enanthate, but testosterone undecanoate lasts the longest.

Other differences are logistical. For instance, some products must be injected by a healthcare professional. Others can be safely injected at home. Regardless, they're all options to consider. Let's look at each one in more detail.

1. Testosterone cypionate

Testosterone cypionate (Depo-Testosterone) is a common form of injectable testosterone. It's available as a brand-name and generic product, and it's injected into your buttock muscle every 1 to 4 weeks. You may inject it at home, or a healthcare professional can give it to you.

The recommended dose of testosterone cypionate ranges from 50 mg to 400 mg. Your healthcare professional will pick and adjust your dose. It will depend on your age, how you respond to the medication, and side effects you experience.

Testosterone cypionate, like all testosterone injections, doesn't work right away. It can take a few weeks for your testosterone levels to increase and symptoms of low T to improve.

2. Testosterone enanthate

Testosterone enanthate is another version of injectable testosterone. It's administered in two ways.

Testosterone enanthate (Xyosted) is an under-the-skin injection. Other versions are intramuscular (IM) injections.

• Under-the-skin injection: The recommended Xyosted dosage is 75 mg every week. You can inject it into your stomach at home. Your healthcare professional may adjust your dose depending on how you respond.

• IM injection: Many generic versions of testosterone enanthate are injected into the buttocks. You may receive 50 mg to 400 mg every 1 to 4 weeks.

Your testosterone enanthate dosage will depend on your response, age, and side effects. But your body may break down testosterone enanthate slightly faster than testosterone cypionate.

Approved uses for testosterone enanthate

Generic testosterone enanthate is an IM injection. It has more approved uses than other forms of injectable testosterone. Testosterone enanthate can treat:

• Adolescents experiencing delayed puberty

• Adult men with low testosterone (hypogonadism)

• Adult women with metastatic breast cancer

Xyosted, testosterone cypionate, and testosterone undecanoate are approved only to treat adult men with low testosterone.

3. Testosterone undecanoate

Testosterone undecanoate (Aveed) is a newer brand-name injectable testosterone product. It's an IM injection administered into your buttocks by a healthcare professional.

You can receive testosterone undecanoate less often than the other injections. Once your body is used to it, you can go 10 weeks (2.5 months) between doses.

The recommended dose of testosterone undecanoate is 750 mg. After your first dose, another shot is given 4 weeks later. You can receive doses every 10 weeks after your third dose.

Compounded testosterone injections

In some cases, a commercially available testosterone product may not be appropriate. Your healthcare professional may recommend a specific strength or form of testosterone. This is made by a process called compounding.

If your healthcare professional prescribes a customized testosterone product, you can get it at a compounding pharmacy. They can tell you more about what to expect.

What are some side effects of injectable testosterone?

Testosterone levels can be effectively raised, but not without risks. Testosterone injections can cause many side effects.

Common injectable testosterone side effects include:

• Injection site reactions, such as pain, bruising, and redness

• Headache

• Worsening of an enlarged prostate (benign prostatic hyperplasia)

Testosterone can also cause more serious side effects, including:

• High blood pressure

• A higher risk for blood clots

• Increased risk of death from stroke or heart attack

Testosterone undecanoate and POME

Some risks are specific to testosterone undecanoate. One of these risks is pulmonary oil microembolism (POME). POME is a rare complication caused by small droplets of oil from the medication that can enter the lungs.

Signs or symptoms of POME include:

• Cough

• Difficulty breathing

• Dizziness

• Throat tightening

This lung condition can be life-threatening. Your healthcare professional should monitor you for 30 minutes after each testosterone undecanoate dose as a precaution. They can watch for symptoms of POME, as well as serious allergic reactions, such as anaphylaxis.

Can testosterone injections cause erectile dysfunction?

No, testosterone injections do not typically cause erectile dysfunction (ED). In fact, they may cause more frequent and longer-lasting erections.

ED is a common symptom of low testosterone. Testosterone replacement therapy has been shown to improve libido, erectile function, and sexual activity. It's unlikely that testosterone injections would cause ED.

How do you receive testosterone injections?

You can receive testosterone injections in a medical office or clinic. Testosterone is injected deep into your muscle, usually your buttocks. So it's difficult to administer on your own. But this can vary depending on the product.

Some testosterone injections, such as Aveed, must be administered by a healthcare professional. This is because side effects (POME, anaphylaxis) can happen soon after your injections.

Your healthcare professional may let you administer testosterone cypionate or enanthate at home. These injections don't have the same postinjection risks as Aveed. They're also given more frequently, making at-home use more convenient.

Xyosted is another exception. You can safely use this auto-injector at home. Self-administering under-the-skin medications is easier than self-administering IM medications.

How do I choose the best testosterone shot?

One testosterone injection isn't better than another. Choosing a testosterone injection requires many considerations. This includes safety risks, your preferences, and the best injection site. Insurance coverage also plays a big role.

Testosterone is a controlled substance and prescription medication. Your prescriber will decide which testosterone injection is right for you.

Can I combine injectable testosterone with other forms of testosterone?

You should not combine products (i.e., testosterone injections and oral testosterone). Your testosterone levels may jump too high. This can lead to dangerous side effects without added benefit.

Frequently asked questions

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