Types of Testosterone Injections for Men

The most effective way for men to increase testosterone levels is with injectable testosterone. To date, there are five primary types of testosterone injections, but only two are recommended by our doctors at Greenberg Health for regular use.

Why are there different types of testosterone injections, and why are only two recommended?

Through the years, medical science has come up with new ways to introduce testosterone into the body. The earliest methods have been improved upon by some of the “newer” kinds of testosterone injections. However, new does not always mean better, as we will show below. Testosterone therapy has two primary purposes for men: increasing testosterone levels in men diagnosed with Low T and for use by trans men. These medications are not recommended as steroids for use by athletes or bodybuilders as they can promote many unwanted side effects when used for those purposes.

Of the five primary types of testosterone injections, our doctors at Greenberg Health recommend two for regular use.

What Are Testosterone Esters?

Most types of testosterone injections contain an ester, a carbon and hydrogen atom chain that attaches to the testosterone molecule to control its absorption into the bloodstream. The list of testosterone esters is too long to include here, mainly because most are not used in regular testosterone replacement therapy. Cypionate, enanthate, propionate, and undecanoate are the most common esters used in the different types of testosterone shots. The ester chain attaches to the testosterone molecule at the 17th carbon position. The longer the carbon chain, the longer the testosterone half-life in the body. The ester lowers the water-solubility of the testosterone, which is why it takes more time for the testosterone to reach its full amount in the bloodstream. One of the types of testosterone shots, aqueous testosterone suspension, does not contain an ester. We will explain that in more detail below. The benefit of different esters allows the doctor to target the needs of the patient. Slow-release increases the activity level of testosterone, reducing the need for frequent injections. While the ester is attached to the testosterone molecule, it renders it unavailable to the body’s androgen receptors. Esterase enzymes in the body cleave off the ester chain, allowing the testosterone to enter the receptor cell. The faster that the testosterone enters the bloodstream, the greater the chance of it undergoing conversion into estradiol. Short-chained esters increase the likelihood of a man experiencing a higher estrogen to testosterone ratio due to this conversion.

Testosterone Cypionate

Of the two types of testosterone injections most recommended, testosterone cypionate is the primary choice of our doctors. With a ten to fourteen-day total release cycle, many men can administer it once every two weeks. However, we have found that smaller dosages, once a week, provide superior results without the highs and lows that sometimes accompany a two-week testosterone cypionate cycle. As with the other different kinds of testosterone injections, testosterone cypionate also contains a preservative. Both the 100 mg/mL and 200 mg/mL versions of testosterone cypionate contain benzyl alcohol as a preservative, as well as cottonseed oil and benzyl benzoate. The half-life of testosterone cypionate is approximately eight days. A medication’s half-life is the time it takes for only half of the drug to be left in the body. As with the other types of testosterone replacement therapy injections, administer the treatment into one of the large muscle groups, such as the buttocks, thighs, or deltoids. Testosterone injections are intramuscular and should not be administered intravenously.

Testosterone Enanthate

The second of the most prescribed types of testosterone injections is testosterone enanthate. With a release time of eight to ten days and a half-life of approximately five days, it does not last as long as testosterone cypionate. Most men will need weekly injections of testosterone enanthate. Unlike testosterone cypionate, which is suspended in cottonseed oil, testosterone enanthate uses sesame oil. Some patients do best with a personalized blend of testosterone enanthate and testosterone cypionate. Used in this manner, the testosterone enanthate provides the faster absorption into the bloodstream with its shorter carbon ester but then lasts longer due to the cypionate ester.

Testosterone Propionate

Of the various types of testosterone injections listed here, testosterone propionate has the shortest ester, with only a three to four-day release time. For that reason, a man would need to administer testosterone propionate shots a few times a week to avoid the lows. Testosterone propionate shots are more painful and increase swelling around the injection site as compared with the previously mentioned options. They are not recommended for long-term use to treat low testosterone levels. Today, we find that testosterone propionate is used most often in cattle.

Testosterone Undecanoate

The newest of the different types of testosterone injections, testosterone undecanoate (Aveed) is not available for home use. It is the longest-lasting version of testosterone therapy. However, this medication carries a high risk of dangerous side effects, including allergic reactions and severe breathing problems, including pulmonary oil microembolism (POME). For that reason, patients can only receive testosterone undecanoate in an approved medical setting as part of a special program. Greenberg Health does not recommend or prescribe Aveed as a treatment for low testosterone.

Aqueous Testosterone Suspension

Unlike the four types of testosterone injections previously mentioned, aqueous testosterone suspension does not contain an ester. It is rapidly absorbed into the bloodstream, making it short-acting within a few hours. Frequent, painful injections would be necessary, so this medication is not recommended for use.

Which Types of Testosterone Injections Are Best?

When choosing between the different types, testosterone injections as a whole provide the same benefits you get from giving the body more of the androgen hormone to use. However, both testosterone cypionate and testosterone enanthate do so at the lowest cost and with the least amount of side effects. To discuss which of these types of testosterone injections are best for you, please contact Greenberg Health for a free telephone consultation.