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Testosterone Enanthate: Full Instructions

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Тestosterone enanthate (TE) is one of the two primary injectable forms of treating male hypogonadism (Low T, low testosterone). Men can administer testosterone enanthate from the comfort and privacy of their homes. In this review, we look at testosterone replacement therapy (TRT) and explore critical facts about TE, including its uses, benefits and side effects, how it is supplied, contraindications, and when it is necessary.

We often refer to TRT as a complex therapy due to the very nature of balancing hormone levels in the body. Because of the interconnected nature in the way that many hormones influence the function or secretion of others, there is a delicate balance that the prescribing doctor must understand. For that reason, finding a doctor who specializes in hormone replacement therapy (HRT) is crucial.

Can anyone use testosterone enanthate?

Only men who receive a diagnosis of low testosterone based on a combination of blood test results and symptoms qualify for TE. Women should only use testosterone enanthate if prescribed this medication by an oncologist for the treatment of metastatic breast cancer. Females should not use testosterone if they are pregnant. For those females with Low T, our hormone doctors prescribe pharmacy compounded testosterone cream.

How do doctors determine candidacy for testosterone enanthate therapy?

The following steps lead to a diagnosis and treatment for testosterone deficiency:

  • Consultation
  • Blood testing
  • Physical examination
  • Medical history review
  • Follow-up consultation

Our medical advisors also offer help navigating the sea of assistance programs offered by some pharmaceutical companies.

Why is testosterone therapy necessary for adults?

The body uses testosterone to maintain a healthy metabolism, heart, red blood cell, and brain functions. Aside from its purpose of supporting sexual functions, libido, and fertility, testosterone also protects the bones and muscles from decline.

Why do doctors recommend injectable testosterone over other forms?

Testosterone injections (cypionate and enanthate) provide the fastest absorption into the bloodstream. They are also the lowest in treatment costs and bring the fewest side effects. Unlike topical (transdermal) testosterone preparations, they do not have the cross-contamination risk that you get with gels and patches.

Testosterone enanthate administration depends on the brand or injection type selected for use.

Testosterone Enanthate Description

Testosterone enanthate, in the form of brand name XYOSTED, is a colorless to pale yellow solution. A benefit of XYOSTED is that it is the first autoinjector for testosterone enanthate. Testosterone enanthate is also available in generic form from a compounding pharmacy at a lower cost.

How does testosterone enanthate work?

When the body no longer produces enough testosterone for the needs of the androgen receptor cells (RCs), testosterone enanthate steps in by providing an exogenous source of the hormone. Upon injection into one of the body’s large muscles (thigh or gluteal), TE is slowly absorbed into the bloodstream. As it is an oil-soluble hormone, it cannot move through the blood the way water-soluble hormones do. Instead, TE binds to either sex hormone-binding globulin or albumin (two proteins) for transport to the various RCs located throughout the body and the brain. Upon reaching an RC, a testosterone molecule breaks free and enters the receptor cell to initiate the corresponding action.

How long does testosterone enanthate last?

The half-life of testosterone enanthate is roughly 4 to 5 days, and most men will inject it on average of once a week.

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Testosterone Enanthate

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Testosterone Enanthate Instructions

Low testosterone levels can interfere with daily life. They can cause a decline in motivation, focus, productivity, and performance. Many males report insomnia, depression, fatigue, and sexual dysfunction as symptoms of their Low T. Weekly testosterone enanthate injections can reverse those symptoms, improving a person’s overall quality of life and outlook.

Ignoring the situation or forgoing treatment can put a man at further risk of developing more serious health issues such as:

  • Obesity
  • Metabolic syndrome
  • Type 2 diabetes
  • High blood pressure
  • Cardiovascular disease
  • Atherosclerosis
  • Osteoporosis
  • Dementia

The information provided below highlights essential facts about testosterone enanthate treatment:


These are the most common signs of low testosterone in men:

  • Sluggish metabolism and weight gain (especially abdominal fat)
  • Sleep issues or insomnia
  • Fatigue, low stamina
  • Muscle mass decline
  • Weakness
  • Stiffness and joint pains
  • Bone density loss
  • Impaired cognitive functions, including slow learning and memory loss
  • Poor concentration
  • Depression
  • High total and LDL cholesterol
  • Thinning or loss of hair
  • Mood changes, including stress, irritability, and anxiety
  • Reduced sex drive
  • Erectile dysfunction
  • Anemia
  • Lack of drive

Dosage & Administration

Generic testosterone enanthate is an intramuscular injection. Do not administer as an intravenous or subcutaneous shot. For those men who self-administer the TE injection, the thigh muscle provides the optimum location, alternating legs each week. If someone else is giving the shot, the gluteal muscles are another excellent choice.

XYOSTED is a subcutaneous injection administered to the abdomen – about two inches away from the belly button. The abdomen is the ONLY area to inject XYOSTED. Do not administer to areas where the skin has stretch marks or scars, or if it is bruised, tender, red, hard, or scaly.

The hormone doctor will determine the dosage of medication based on the level of testosterone deficiency, health, body composition, and age. Patient response, side effects, and results may alter the dosage at any point during the treatment.

Storage and Use

Store testosterone enanthate in a cabinet away from heat, humidity, and light. Do not place TE in the refrigerator or freezer. Avoid leaving your medications in a hot car.

Before each use, check the expiration date and inspect the medication for crystals or particles. Do not use if expired or any particles are present. You may gently shake the vial to see if the crystals dissolve. If not, discard as directed.

Drug Interactions

  • Insulin – TE may lower blood glucose levels requiring changes to insulin dosages
  • Corticosteroids – joint use with testosterone may lead to fluid retention (patients with cardiac, hepatic, or renal disease require extra monitoring)
  • Anticoagulant – androgen use may alter anticoagulant activity, requiring more frequent monitoring of prothrombin time and international normalized ratio
  • Report all medication use ahead of treatment as some medications that could increase blood pressure levels may interact with TE

Warnings & Precautions

Testosterone enanthate is for use by men with clinically diagnosed testosterone deficiency. It is not for use by athletes or bodybuilders. Using TE when not prescribed, can result in significant side effects and health risks, including but not limited to, the following:

  • High blood pressure
  • Deep vein blood clots and pulmonary embolism
  • Heart attack
  • Sleep apnea
  • Infertility
  • Testicular atrophy (shrinkage)
  • Hostility or aggressive behaviors
  • Worsening of BPH symptoms
  • Polycythemia
  • Depression or suicidal behavior
  • Decreased total T4 serum levels

Contraindications for testosterone enanthate include:

  • Breast or prostate cancer
  • Hypersensitivity to ingredients in TE
  • Hypogonadal conditions not associated with genetic or structural etiologies
  • Pregnant women


Testosterone enanthate treatment offers many benefits to men with Low T, including:

  • Improving sleep
  • Increasing energy
  • Strengthening bones and muscles
  • Reducing fat storage
  • Sharpening brain functions and memory
  • Supporting healthy heart functions (lowering blood pressure and cholesterol levels)
  • Enhancing sexual desire and performance
  • Decreasing body pains
  • Reducing feelings of depression and anxiety
  • Improving mood and outlook

Generic testosterone enanthate may cause some redness, tenderness, pain, or swelling at the injection site. XYOSTED may lead to some bruising. Other side effects from TE are rare, and are most likely caused by too high a dosage of testosterone (especially when used illegally):

  • Headaches
  • Oily skin
  • Acne
  • Gynecomastia (male breast enlargement)
  • Prolonged or more frequent erections
  • High blood pressure
  • Increased red blood cell count
  • Elevated PSA (prostatic specific antigen)
  • Edema (fluid retention)
  • Depression
  • Changes in libido
  • Vomiting or nausea
  • Changes in hair growth
  • Weight gain
  • Fatigue
  • Mood changes


The most common cause of overdosage is illegal use. Do not ignore the warning signs of side effects listed above. Too much testosterone can increase the risk of cardiovascular events and blood clots. Men with high levels of testosterone may experience a low sperm count and infertility.

How Supplied

As the brand name XYOSTED, testosterone enanthate comes in 3 dose strengths: 50, 75, and 100 mg. Generic testosterone enanthate may also be available, typically in 5 ml of 200 mg/mL.

Testosterone Enanthate Clinical Pharmacology

Androgen hormones are crucial for many functions in the adult body, of which testosterone enanthate can support those with testosterone deficiency. Primary hypogonadism may result from testicular issues associated with genetics such as Klinefelter’s syndrome, testicular failure, tumors, injury, surgery, or chemotherapy. Secondary or tertiary hypogonadism may result from problems with the pituitary gland or hypothalamus.

Our hormone clinic provides free, confidential consultations to men and women who believe they may have some form of hormonal imbalance. Following the consultation, we provide information for low-cost blood testing, examination, and our online health history form completion.

Men diagnosed with low testosterone will discuss the course of treatment with their medical advisor. Most males receive either testosterone cypionate or testosterone enanthate injections. Compounded testosterone cream is the treatment of choice for women.

Please contact us today for a free consultation.

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