Testosterone enanthate, also known as testosterone heptanoate, is an anabolic and androgenic steroid (AAS) drug used to treat low testosterone levels. Anabolic drugs work by building muscles, while androgenic refers to the enhancement of male sex characteristics.
Used in medical procedures since the 1950s, testosterone enanthate is marketed under numerous brand names, including Androfil, Andropository, Cernos, Delatestryl, Depandro, Durathate, Everone, Sustrone, Testanon, Testanova, Testrin, Testostroval, Testoviron, and Testro.
As a schedule III drug, testosterone enanthate is available by prescription only and is classified as a prohibited substance by the World Anti-Doping Agency.
Testosterone enanthate is classified as an AAS because it is both a synthetic derivative of testosterone and a testosterone pro-drug, meaning that it stimulates the body to produce testosterone on its own. With that being said, it has stronger androgenic effects and only moderate anabolic effects.
The drug is suitable for testosterone replacement therapy (TRT) in men with hypogonadism (the diminished production of testosterone in the testes). Causes of hypogonadism include testicular injury, infection, and cancer. Radiation and chemotherapy can also cause hypogonadism, as can congenital disorders such as Klinefelter syndrome and diseases of the hypothalamus and pituitary gland (both of which stimulate testosterone production).
Testosterone levels in men can often decline steeply after the age of 50, leading to a condition known as andropause in which vigor and sexual desire are affected. Older men with symptoms of andropause (including fatigue and low libido) will often benefit from TRT.
Testosterone enanthate can also be used for hormone therapy in transgender men, to treat delayed puberty in boys, to ease menopause symptoms, and to manage inoperable metastatic breast cancer (breast cancer that has spread) in postmenopausal women.
The drug is also sometimes used, controversially, as an anti-aging therapy in older men.
Signs and Symptoms of Low Testosterone in Men
Testosterone enanthate is a clear or yellowish viscous fluid supplied in a 5-milliliter (mL) multi-use glass vial. It is injected intramuscularly into the buttocks every one to four weeks. To avoid the fluctuating hormone levels (and the associated mood swings), lower dosages are often prescribed over shorter intervals.
The active drug, which is suspended in sesame oil, has a sustained release period of two to three weeks. The dosage may vary by individual but is typically prescribed as follows:
Male hypogonadism: 50 to 400 milligrams (mg) every two to four weeks
Delayed male puberty: 5 to 200 mg every two to four weeks for four to six months
Metastatic breast cancer: 200 to 400 mg every two to four weeks
Transgender hormone therapy: 50 to 200 mg per week or 100 to 200 mg every two weeks
While testosterone enanthate is sometimes used interchangeably with testosterone cypionate (depo testosterone), the latter is not approved to treat delayed male puberty, to manage metastatic breast cancer, or for transgender hormone therapy.