Testosterone Cypionate and Testosterone Enanthate are the two most commonly prescribed injectable testosterone compounds in male testosterone replacement therapy. While very common, they are also the most effective means to treat a low level condition. There is no transdermal cream, gel or patch, oral mediation or implant pellet that will be as effective as Testosterone Cypionate and Testosterone Enanthate. One question many have is which one is more effective? The two primary testosterone compounds are virtually identical, and you should be able to receive the same results from either one.
Synthetic testosterone was first developed in in the 1930’s and first hit the commercial market in 1937 in the form of Testosterone Propionate under the trade name Testoviron. The pharmaceutical giant Schering would push the product heavily, but in the early 1950’s they would release Testosterone Enanthate once again using the same Testoviron name. The difference in the two compounds simply revolves around time release. Propionate is a short ester, whereas Enanthate is a long ester. When Testosterone Propionate is used, it must be injected frequently due to its short half-life. By introducing Testosterone Enanthate, the individual can now receive the same testosterone benefits with far less frequent injections.
With Testosterone Enanthate owning the European market, Upjohn released Testosterone Cypionate in the United States under the trade name Depo Testosterone a few years later. Quickly, Testosterone Cypionate’s popularity would grow, and currently, it remains the most commonly prescribed injectable testosterone in the U.S. Although virtually identical to Testosterone Enanthate, some men report Testosterone Cypionate to be a little more comfortable. This is due to cypionic acid being a little less irritating than enanthoic acid.
Testosterone Cypionate vs. Testosterone Enanthate:
Regardless of the form of testosterone you choose, you have the same testosterone hormone. Esters, such as Cypionate or Enanthate are simply attached to the hormone to help control its release time. Esters do not affect the hormone’s functions or effects. This not only applies to Testosterone Cypionate and Testosterone Enanthate, but it applies to all injectable testosterone compounds regardless of the attached ester.
When testosterone is injected, as time passes the ester begins to detach. The hormone testosterone does not become active until the ester detaches and the hormone is released. Once the ester is removed, regardless of the ester in question, you now have nothing left but pure testosterone. With both forms of testosterone, blood levels will peak approximately 48-72 hours post injection and will fall back to baseline by day 7. However, some men may find they are slightly below baseline by this stage, which would necessitate more than one injection per week. We’ll discuss these factors in the dosing section.
Functions & Traits:
Testosterone Cypionate and Testosterone Enanthate are both single large ester base testosterones. Both are a pure synthetic testosterone, and have a carboxylic acid ester attached in enanthoic acid (Testosterone Enanthate) and cyclopentylpropionic acid (Testosterone Cypionate). In both cases, the ester is attached to the hormone at the 17-beta hydroxyl group. Once injected, there will be a sharp spike in testosterone levels within the first 24-48 hours with peak levels being reached in 48-72 hours.
Both Testosterone Cypionate and Testosterone Enanthate have an active half-life of approximately 7-8 days. This should not be confused with the physical half-life, which is 10.5 days for Enanthate and 12 days for Cypionate. The active half-life represents the total time there is active testosterone activity, which in essence is the only half-life we should be concerned with.
Although synthetic in nature, Testosterone Cypionate and Testosterone Enanthate are identical to the testosterone our body naturally produces. The only difference is the ester that is attached. Testosterone can be administered without an attached ester; however, ester free testosterone will peak and dissipate fast and requires 1-2 injections per day in order to maintain stable blood levels. For this reason, most will prefer large ester base testosterones; in fact, ester free or what is known as Testosterone Suspension is only used in medical emergencies.
Injectable Testosterone vs. Other Forms:
When we inject Testosterone Cypionate and Testosterone Enanthate, the absorption rate is 100%. There is no man that will not respond to either form of testosterone. The same cannot be said of all other forms. Transdermal creams or gels will only carry an approximate 10% absorption rate; patches will be a little more. Oral testosterone will be similar; however, most oral forms are highly toxic to the liver, with the exception of Andriol Testocaps. Transdermal forms as well as any type of oral testosterone must also be administered 1-2 times per day, whereas injectable Cypionate or Enanthate will only need to be administered 1-2 times per week. Then we have implant pellets such as Testopel. These are small rice size pellets comprised of testosterone that are inserted subcutaneously under the skin through a small surgical procedure. While it is easy to maintain stable blood levels with injectable testosterone, pellets present a very suitable alternative in this regard and are far superior to transdermal or oral forms. Unfortunately, you must undergo a small surgical procedure and have the pellets inserted 3-4 times per year, and some men report a fair amount of discomfort at the applied area. This is not a painful discomfort as much as an irritation as they can feel the pellets the entire time.
Injectable Testosterone vs. Natural Testosterone:
Although synthetic in nature, injectable testosterone is identical to the hormone your body naturally produces. Once in the body, the human body will make no distinguishing difference. This is a hard concept for many to understand much less accept, but keep in mind this is not a foreign substance to the body. Testosterone is something we have been producing all of our lives; unfortunately, for the low testosterone man, he no longer has the ability to produce enough on his own, and the only thing that will remedy the situation is testosterone.
The best way to look at it is how we look at gas in our car. Gas is essential; without it our car will not work. When we run out of gas, the only thing that will help is putting gas into the tank. You can put water in the tank; soda or anything else you can fit in there, but nothing works but gas. You can also do things to your car that will help improve your gas mileage, but no matter what you do, if you’re out of gas all the improvements in the world won’t mean a thing. The same can be said of testosterone. Without testosterone, we can’t go or rather, we cannot work properly. Our wellbeing begins to suffer, and this can affect a host of areas from physical, sexual and even our mental wellbeing.
Testosterone is a very familiar hormone to the human body; however, there are possible side effects of Testosterone Cypionate and Testosterone Enanthate. While naturally produced by the human body, when administering the hormone we are applying larger amounts at once than the body can produce. The good news is side effects should not occur with proper therapy. Where side effects abound primarily is with supraphysiological doses (performance enhancement doses). Many uneducated physicians overlook an important factor; the key to good testosterone therapy is maintaining a solid balance between testosterone and estrogen. As men, we do need estrogen, but there must be a balance.
The primary side effects of Testosterone Cypionate and Testosterone Enanthate are estrogenic in nature. This is due to the testosterone hormone’s ability to convert to estrogen via the aromatase enzyme. As estrogen levels rise, this can lead to gynecomastia and excess water retention. If water retention gets out of hand, it can also lead to high blood pressure.
Due to the potential increase in estrogen, many men will need to supplement with an Aromatase Inhibitor (AI) such as Anastrozole or Letrozole. An AI functions by inhibiting the aromatase process, thereby lowering estrogen levels. If estrogen levels go too high, this will bring them down each and every time. Most will not need a lot; normally, 0.5mg per week to 0.5mg two times per week will suffice. Some will need more, but this is a good average. Approximately 25-30% of all men who are undergoing testosterone replacement therapy will not need an AI. If you take an AI and do not need it, you will lower your estrogen levels below their optimal state, which can result in numerous symptoms and effects. AI’s should only be used when needed and as little needed as possible.
Androgenic side effects of Testosterone Cypionate and Testosterone Enanthate are also possible. This isn’t surprising when we consider testosterone is the primary anabolic androgenic steroid, and it is equally anabolic and androgenic. The androgenic side effects are due to the hormone’s ability to convert to dihydrotestosterone (DHT) due to it being metabolized by the 5-alpha reductase enzyme. Androgenic side effects can include acne, hair loss in those predisposed to male pattern baldness and body hair growth. Fortunately, such effects are highly dependent on genetic predispositions and doses. There is no reason for a man on testosterone therapy to show such side effects if his therapy is proper. If a doctor prescribes high doses, this will be what can create a problem. Some doctors will prescribe large yet infrequent doses, and this is no way to administer testosterone therapy. In the event that such doctor is at hand, some men will turn to 5-alpha reductase inhibitors such as Finasteride as it will inhibit the conversion to DHT. However, such medications come with a host of side effects and can severely cause total androgen imbalance. Staying away from such medications and finding a doctor that understands proper therapy will best serve you.
The use of Testosterone Cypionate and Testosterone Enanthate has also been said to adversely affect lipids, primarily HDL cholesterol (good cholesterol). It is not uncommon for HDL cholesterol to reduce slightly due to therapy, but the story does not end there. Most men who have high cholesterol will find their levels improve with testosterone therapy. Further, simply by consuming healthy fats on a regular basis, we can ensure our HDL cholesterol is where it needs to be. An important note – when considering cholesterol and testosterone therapy, total cholesterol is not as important as the volume or size of the cholesterol. Live a healthy lifestyle with a diet rich in Omega Fatty Acids and limited in saturated fats and sugars and most all men will be fine. There are also many quality cholesterol antioxidant supplements available. Simply walking on a daily basis can also do a lot to improve lipid and total cardiovascular health.
The use of testosterone, any form, will also promote natural testosterone suppression, which in turn will lead to testicular atrophy (loss of fullness in the testicles). For the low testosterone patient, natural suppression is of no concern; after all, he is not producing enough testosterone to begin with. As for testicular atrophy, if the man suffers from secondary hypogonadism and supplements with hCG, his testicles will remain full as hCG will keep what little natural testosterone production he has going while supplementing with exogenous testosterone. If a man suffers from primary hypogonadism, hCG will not help, but his testicles have often already atrophied before therapy. Even if no prior atrophy exist, a little is far better than suffering from low testosterone.
Prostate Cancer – There is no link between the use of testosterone and prostate cancer. For decades, many physicians have made this claim without any backing or substantial support. However, in recent years, well-documented data has shown us that men who undergo testosterone therapy are far less likely to develop prostate cancer. Harvard University professor Abraham Morgentaler’s findings on this matter have been undisputable.
Doses & Administration:
Testosterone Cypionate and Testosterone Enanthate doses for the purpose of male testosterone replacement therapy can fall anywhere in the 50mg-200mg per week. Where the individual will fall in this dosing range is impossible to predict; however, 100-150mg per week is perhaps the most common. Regardless of the dose, one injection per week will suffice; however, splitting the weekly dose into two smaller yet equal size injections will prove to be the most efficient. For the individual prescribed 100mg per week, his dosing schedule might be as follows: 50mg on Monday and 50mg on Thursday.
When many men see or hear of a 50-75mg per week dose, they often assume this is very low and that it will have very little effect, but that simply isn’t true. The goal of testosterone therapy is to get the individual into the optimal range, which is 700-1100ng/dl Total Testosterone, 20-30ng/dl Free Testosterone and 20-30ng/dl estradiol (LabCorp scale range) as well as symptom free without any adverse side effects. For some men, a mere 50mg per week will accomplish this, but others will need more and as much as 200mg per week. We are all unique individuals and all respond differently. Less than 1% of all men will need more than 200mg per week of Testosterone Cypionate or Testosterone Enanthate.