TESTOSTERONE CYPIONATE
Long-acting testosterone ester injected weekly or biweekly for testosterone replacement therapy.
Testosterone cypionate is well-established for treatment of male hypogonadism, with IM 100-200mg every 1-2 weeks being the standard regimen. A PK/PD model (PMID 29436172) showed dose-dependent suppression of LH and spermatogenesis, with 250mg and 500mg weekly causing more severe and prolonged suppression. IM administration causes supraphysiological peaks associated with increased hematocrit, estradiol, and PSA compared to subcutaneous delivery (PMID 34694927). Dose reduction to 100mg biweekly preserved therapeutic testosterone levels while modestly reducing hematocrit in trans men with erythrocytosis (PMID 41052128). Animal studies at supraphysiological doses show cardiac morphology changes including left ventricular lumen enlargement (PMID 30772437). Evidence for non-TRT performance or anti-aging use remains weak and controversial.