Testosterone Cypionate vs Testosterone Enanthate
Testosterone cypionate (Depo-Testosterone) and testosterone enanthate (Xyosted, Delatestryl) are the two long-acting injectable testosterone esters. They are nearly interchangeable in practice, with only small differences in how long each lingers.
Injectable testosterone ester
Injectable testosterone ester
The most common injectable testosterone in the U.S., a long-acting oil-based ester usually injected every one to two weeks.
A long-acting injectable testosterone ester very similar to cypionate; one branded form (Xyosted) is a weekly subcutaneous auto-injector.
Testosterone replacement (TRT)
Testosterone replacement (TRT)
- Testosterone replacement in men with primary hypogonadism
- Testosterone replacement in men with hypogonadotropic (secondary) hypogonadism
- Testosterone replacement in men with primary hypogonadism
- Testosterone replacement in men with hypogonadotropic (secondary) hypogonadism
- Typically 50–200 mg intramuscularly every 1–2 weeks, individualized to trough testosterone levels
- Some clinicians use smaller, more frequent (e.g. weekly or twice-weekly) doses to smooth levels
- Given by intramuscular or subcutaneous injection depending on the regimen
- Traditional intramuscular dosing: 50–200 mg every 1–2 weeks, individualized to levels
- Xyosted subcutaneous auto-injector: 75 mg once weekly, adjusted 50–100 mg based on levels
- Given by intramuscular or subcutaneous injection depending on the product
- Injection-site pain or swelling
- Acne
- Mood changes
- Fluid retention
- Increased red blood cell count
- Polycythemia (thickened blood) raising clot risk
- Worsening of untreated sleep apnea
- Increased blood pressure
- Edema in patients with heart, kidney, or liver disease
- Injection-site reactions
- Acne
- Mood changes
- Fluid retention
- Increased red blood cell count
- Polycythemia (thickened blood) raising clot risk
- Worsening of untreated sleep apnea
- Increased blood pressure
- Edema in patients with heart, kidney, or liver disease
- Adult men with a confirmed low morning testosterone level and symptoms of hypogonadism
- Men who prefer injections over daily topical application
- Adult men with a confirmed low morning testosterone level and symptoms of hypogonadism
- Men who want a weekly subcutaneous option (Xyosted)
- Known or suspected prostate or breast cancer in men
- Pregnancy or breastfeeding
- Known hypersensitivity to the ingredients, including the sesame-oil vehicle
- Known or suspected prostate or breast cancer in men
- Pregnancy or breastfeeding
- Known hypersensitivity to the ingredients, including the sesame-oil vehicle
- Can raise blood pressure, which may increase cardiovascular risk
- Monitor hematocrit; discontinue or reduce dose if it becomes elevated
- Not indicated for age-related 'low T' without documented hypogonadism
- Potential for abuse and dependence at supraphysiologic doses
- The Xyosted label warns testosterone can increase blood pressure, raising the risk of major cardiovascular events
- Monitor hematocrit; discontinue or reduce dose if it becomes elevated
- Not indicated for age-related 'low T' without documented hypogonadism
- Potential for abuse and dependence at supraphysiologic doses
Bottom line: which should I choose?
Choose cypionate for the most widely stocked, lowest-cost injectable, dosed every one to two weeks. Choose enanthate if you want the once-weekly subcutaneous auto-injector (Xyosted), which is convenient and friendly for needle-shy patients, noting that Xyosted carries a boxed warning about blood-pressure increases. Both raise hematocrit and require lab monitoring, and a clinician confirms hypogonadism before starting.
Common questions
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