Testosterone Injections

An effective and economical replacement option

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Testosterone Injections

An effective and economical replacement option

Testosterone Replacement Therapy Defy Medical 04

Testosterone Shots: Affordable, convenient, and effective.

Testosterone injection therapy is one of the most commonly used and effective testosterone delivery systems. Testosterone injections allow for careful control of hormone levels and fast response to physician-guided adjustments.

Testosterone shots are administered using a small needle designed to deliver testosterone subcutaneously (under the skin) or intramuscularly (in the muscle). Testosterone is time-released and releases slowly from the injection site over a period of 2-14 days, depending on the type of injection used. Testosterone shots are usually given weekly and are easy to self-administer, and the timed release helps to maintain consistent testosterone levels.

When you become a Defy patient, you'll work with expert providers who are up-to-date on the latest testosterone injection therapy protocols. Defy patients also receive access to our online patient portal, which offers a full catalog of injectable options and supportive medications shipped directly to your door.

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What are your testosterone injection options?

Understanding testosterone esters and timed release.

Testosterone shots are available in a variety of strengths and combinations. There are also different types of testosterone that vary by their esters, which help create a timed release of the hormone. The testosterone is always the same – but the ester can change based on your individualized protocol and needs.

Learn more about the most common types of esters prescribed in the United States and the benefits of each below.

Ready to talk through your options? If you want to speak one-on-one with someone who is experienced and knowledgeable and can guide you through your options, our Patient Advocate team is here to help.

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Testosterone Esters

Testosterone Propionate

Testosterone Propionate is a faster acting ester which can peak in the blood within hours and metabolized over 3 days. Injections should typically be administered every 2-3 days. Propionate can also be co-administered with another testosterone ester, sometimes requiring less frequent injections.

Since it metabolizes so quickly and needs to be administered frequently when used as by itself (as a monotherapy), it is easy to stabilize levels and optimize blood-testosterone-levels quickly.

Some patients benefit from a faster metabolizing ester like propionate, especially those suffering from significant deficiency symptoms like erectile dysfunction or sarcopenia (muscle loss). Commercial testosterone propionate is no longer available; therefore, many compounding pharmacies offer this important ester.

Testosterone Cypionate

This is the most commonly prescribed testosterone ester, and it metabolizes in roughly 7-8 days. Testosterone cypionate is considered a long-acting testosterone. It is usually injected weekly and sometimes twice per week or more by subcutaneous injection. Compounded Testosterone cypionate in grapeseed oil is the most common form of cypionate prescribed for subcutaneous injection.

Testosterone Enanthate

Testosterone Enanthate is metabolized in roughly 4-5 days. It can even remain in the body (in very small amounts) for 2 weeks. Some patients report less water retention with enanthate when switched from cypionate. Enanthate is usually injected weekly and sometimes twice per week or more by subcutaneous injection.

Testosterone Undecanoate

Testosterone Undecanoate is a promising ester that allows for much less frequent injections. Unfortunately, it is currently only available as a commercial pharmaceutical product called AVEED®.

Without insurance coverage, AVEED® can be expensive and cost-prohibitive to maintain. When insurance does cover AVEED®, it often limits the dosage allowed, which results in most patients being underdosed or having to pay out of pocket for the remaining dose.

Studies support testosterone levels remaining elevated for roughly 3 months post injection when using testosterone undecanoate. However, as with other esters, not all patients will respond the same. Some may require more frequent injections of testosterone undecanoate to maintain testosterone blood levels, including injections every 30 days.

Insurance limitations also often prevent patients from receiving personalized care when using testosterone undecanoate. Until there are alternative products available and/or the cost reduces significantly, testosterone undecanoate will probably not be a commonly used for men who need testosterone injection therapy.

Compounded Testosterone Combinations

Defy Medical offers compounded injections that combine slow and fast metabolizing esters to provide more options for our patients.

There are some patients who respond better to a combination of two or more esters, usually consisting of esters with different timed releases. This can result in an immediate increase in testosterone followed by a delayed release of a longer ester. In short, you get the benefit of fast-acting and slow-acting esters in one injection.

The most prescribed combination products are:

Testosterone cypionate/propionate
Testosterone cypionate/enanthate/propionate

Testosterone can also be combined with other androgenic hormones like nandrolone decanoate, creating a single injection that allows for the convenient administration of two or more hormones. Androgenic anabolic therapies can often supplement a TRT protocol and add their own unique benefits. Learn more about androgenic anabolic therapies.

Grapeseed oil: For more comfortable injections

Testosterone and its esters need to be suspended in an oil in order to be injected. Commercial testosterone injections typically contain cottonseed oil, but this type of oil is thick and difficult to inject subcutaneously (into the fatty layer of the skin). This results in deeper intramuscular injections that can be uncomfortable for some patients.

To make injections more comfortable, compounding pharmacies offer testosterone injections with grapeseed oil (GSO). GSO is thinner and allows the testosterone to pass through a smaller needle for subcutaneous injection. Patients reported reduced pain and irritation with GSO, particularly those who are sensitive to injections.

Testosterone cypionate

Testosterone enanthate

Testosterone propionate

testosterone cypionate propionate 160 40 5ml

Testosterone Combination Esters

Which type of Testosterone injection is the right one?

The right injection option for you can depend on many factors, including:

What's most effective for you
Your individual levels and responses to TRT
Your goals for treatment
Your comfort level with different injection schedules
and more

Once you become a patient at Defy Medical, you'll work closely with your provider to discuss all your options and find the best and most effective TRT plan for your unique needs and goals. We don't offer "cookie-cutter" plans because our providers understand that every patient is unique and requires an individualized approach. Our providers are also experienced with testosterone injection therapy and are current in the latest protocols.

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Why choose Defy Medical?

A TRT protocol you can trust, designed by Men's Health experts.

Many men try to access testosterone injections via their Primary Care doctor or endocrinologist. Unfortunately, these doctors often are not up-to-date on the latest delivery systems and protocols and do not truly understand the necessities of Testosterone Replacement Therapy.

Defy Medical is a concierge clinic specializing in Men's Health and hormone restoration, with experienced providers who have worked with more than 15,000 patients over nearly a decade. We offer protocols tailored to each patient's comprehensive lab results, and we monitor and provide support so that you can achieve optimal levels for symptom relief and overall wellness.

We also offer our TRT program via convenient telehealth, delivered to the comfort of your own home.

With Defy Medical, you get access to:

Telemedicine consultations with experienced physicians and practitioners.
A convenient online patient portal where you can order medications, plus find a wide variety of supplements and injectable nutrition.
Medications and supplements delivered directly to your door — no face-to-face contact needed.

Benefits of compounded testosterone injections

Defy Medical uses FDA-registered outsourcing facilities and 503b compounding pharmacies that manufactures sterile testosterone products in a variety of strengths and combinations while following usp 797, 800, and cGMP standards. Every batch of injectable testosterone is independently tested for sterility, potency, and endotoxins before becoming available for dispensing.

By partnering with compounding pharmacies, we are able to offer a wider variety of options for patients with more closely tailored medications for maximum benefit.

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Access to a variety of testosterone esters not available at retail pharmacies

Access to compounded ester combinations (ex. Cypionate + propionate)

Use of less viscous Grapeseed oil which is better for subcutaneous injections and reportedly causes less irritation than commercial cottonseed oil

Custom strengths and concentrations make it easier to use in off-label therapies including replacement therapy in women

Access to additional androgen therapies including nandrolone decanoate

By using a 503a/503b outsourcing facility that follows USP and cGMP quality control standards, we can guarantee the highest level of quality assurance

Medications can be shipped most US states directly to the patient, delivering true concierge service for convenient managed care

Access to robust selection of support medications like HCG, FSH, anastrozol, PDE5 inhibitors, and Trimix

Injection Support

Patients prescribed testosterone will have access to everything needed to administer a testosterone injection.

Our pharmacy will ship testosterone and all necessary supplies directly to the patient in most US states. Each package contains storage and injection instructions. Additional injection references including videos will be provided.

Every patient has access to dual support from a clinical pharmacist or medical provider. Our support team is always available to assist with patient injections or the storage of medications.

Local patients can also visit the Tampa-based Defy Medical clinic to receive injections by a medical provider. Testosterone will be supplied at the clinic. It takes less than 5 minutes to receive an injection.

Learn more about how to inject testosterone.

More Information About Testosterone Shots

The primary goal of testosterone replacement therapy is to improve and maintain physiologic serum concentrations of the hormone and its active metabolites, without significant side effects or safety concerns.

There are different testosterone replacement options approved by the U.S. Food and Drug Administration (FDA). Some are sold under a brand name in retail pharmacies and others can be compounded in unique dosage forms by compounding pharmacies.

Self-administered subcutaneous injections

Testosterone injections are easy to administer and typically require less than 5 minutes.

Evidence shows that small subcutaneous (under the skin) testosterone injections may also be effective to increase testosterone in hypogonadal men.

For a long time, it was thought that oil-based testosterone medications could only be administered intramuscularly (IM) using a longer 1” to 1.5” needle. Over the years, physicians who specialize in prescribing testosterone therapies noticed that testosterone levels still increased when patients administered their testosterone under the skin using a smaller needle. Multiple studies support subcutaneous administration of testosterone.

Testosterone cypionate in grapeseed oil is commonly preferred for subcutaneous injections due to low viscosity of grapeseed oil compared to other common oils. Testosterone enanthate can also be administered subcutaneously.

In 2019, the FDA approved a new testosterone drug called Xyosted which is the first subcutaneous testosterone auto-injector pen for symptomatic patients with low testosterone levels. Xyosted contains testosterone enanthate in three strength options.

Testosterone propionate might be too irritating to the injection site due to the propionic acid. A 5/8” min needle is recommended for injections containing propionate.

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Can women benefit from Testosterone Replacement Therapy?

Testosterone therapy can be incredibly beneficial for women, as well. Women typically produce less testosterone than men, but the hormone still plays many important functions throughout the female body. Women of all ages can experience a testosterone deficiency, in the same way that men of all ages can experience hypogonadism.

Compounded testosterone options include injectable testosterone in lower strengths (50mg/ml) for use in women who need replacement therapy. Testosterone cypionate can be injected once per week using a small subcutaneous needle.

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The history of injectable testosterone: a timeline

1849

(Berthold)

Transplanted the testes from roosters into abdomens of capons

1931

(Butenandt)

Steroidal androgen first isolated from urine

1935

(David)

Testosterone was obtained in crystalline form from bull testicles

1935

(Butenandt and Hanish)

Testosterone chemically synthesized

1936

Testosterone Propionate discovered

1937

(Schering)

Testosterone Propionate marketed

1938

(Deanesley)

The use of testosterone pellets is first reported

1951

(Upjohn)

Testosterone cypionate introduced

1954

(Squibb)

Testosterone enanthate introduced

1950s

(Junkmann)

Longer acting testosterone esters prepared

1986, 1992

(Coert and Nieschlag)

Transdermal testosterone patches applied to scrotal or non-scrotal skin

2000

(Wang)

Transdermal testosterone gel

Timeline highlights

Berthold noted that capons (castrated roosters) who were supplemented with testosterone behave liked normal roosters again “They crowed quite considerably and showed a normal inclination towards other hens.”
After its chemical isolation and synthesis, testosterone was introduced into clinical medicine and used to treat hypogonadism
1935 -1954 produced the most commonly used timed release esters including propionate, cypionate, and enanthate.
1938 — Pellet implants containing testosterone were first reported.
From the late 1950s to 1970s, interest in chemically modified androgen preparations was abandoned.
In various preparations, testosterone has been available for over 6 decades. It is one of the oldest drugs that remain in clinical use today.