Testosterone enanthate

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Testosterone enanthate: a long-acting testosterone medicine

What it is
- A synthetic form of the hormone testosterone, attached to an enanthate (heptanoate) ester. The ester makes it slow-release, so it remains active in the body longer than plain testosterone.

What it does
- It activates androgen receptors to produce male-typical effects. It’s a prodrug: once in the body, the ester is removed and free testosterone acts on tissues.
- Some testosterone is converted to other substances in the body (DHT and estradiol). DHT can enhance masculine traits, while estradiol can cause estrogen-related effects.

What it’s used for
- Men with low testosterone (hypogonadism)
- Delayed puberty in boys
- Some breast cancer treatment in women
- Masculinizing hormone therapy for transgender men
- Sometimes used to improve physique and performance (usually illegal without medical reason)

How it’s given
- By injection: into a muscle (intramuscular) or under the skin (subcutaneous)
- Dosing is typically every 1 to 4 weeks, depending on the preparation and the treatment plan
- The oil-based form acts as a depot and releases drug slowly, causing fluctuations in testosterone levels

How it works in the body
- It’s converted to testosterone, providing both the androgen (masculine) and anabolic (builds tissue) effects
- Some testosterone becomes DHT or estradiol; this can lead to side effects unless managed

Common side effects
- Virilization signs: acne, more body hair, deeper voice, increased sex drive
- Possible breast tissue changes (gynecomastia) due to estrogen conversion
- Other risks linked to hormone therapy; talk to a clinician about monitoring

Brand names and availability
- Brand examples include Delatestryl and Xyosted (the latter approved for subcutaneous use in adults in 2018)
- Available in various countries; it is a controlled substance in many places

A few notes
- It’s one of the most widely used testosterone esters for replacement therapy
- Like all hormone therapies, it’s important to use under medical supervision and follow dosage instructions

History
- Introduced for medical use in the 1950s and remains a common treatment in androgen replacement therapy today.