Testosterone Enanthate: What It's For, How to Take & Side Effects

Testosterone enanthate is an anabolic steroid medication that is indicated for the treatment of hypogonadism in men. This is a that is associated with reduced testosterone production in the testicles. Although there is no cure for male hypogonadism, symptoms can be managed with hormone replacement therapy.

This medication has androgenic action that is taken for medicinal purposes. But because it is a synthetic anabolic steroid, it is often misused by competitive and amateur athletes to achieve greater muscular performance, promote muscle gains and improve appearance for cosmetic purposes.

The use of testosterone enanthate to optimize athletic performance can be harmful to health, and therefore is not recommended for this use. This medication should be used if prescribed to ensure safety.

What it's for

Testosterone enanthate is indicated for the treatment of:

• Primary hypogonadism in men
• Hypogonadotropic hypogonadism in men

Testosterone enanthate should only be used as prescribed by a doctor or an endocrinologist to treat male hypogonadism. The doctor will first order tests to evaluate testosterone levels in the body and confirm they are low, as taking this medication for other purposes can cause serious side effects and liver dysfunction.

How to take

Testosterone enanthate is administered as an IM injection by a doctor, nurse or a trained healthcare professional.

Dosing of testosterone enanthate to treat male hypogonadism should be adapted to each person, depending on their individual need for testosterone in the body.

It is important that testosterone is administered slowly to avoid immediate adverse reactions, such as difficulty breathing.

Possible side effects

The most common side effects that may occur include pain, swelling and itching at the injection site, as well as coughing and shortness of breath.

People who use these medications inappropriately and frequently may experience more serious adverse effects, such as:

• Severe headache
• Nausea and vomiting
• Weight gain
• Decrease in the size of the testicles
• Gynecomastia (breast enlargement)
• Decrease in sperm production and count
• Frequent or prolonged and painful erection of the penis, also referred to as priapism
• Benign prostate hypertrophy
• Impotence
• Infertility
• Early baldness
• Stretch marks
• Increased blood pressure
• Increased cholesterol levels
• Cardiovascular problems, such as coronary disease or cardiomyopathy
• Acne
• Blisters on the skin
• Itch
• Decreased urine production
• Fatigue
• Confusion

Furthermore, testosterone enanthate, as well as other anabolic steroids derived from testosterone, can cause liver problems that can present with symptoms such as nausea, pain in the upper right side of the belly, excessive fatigue, loss of appetite, itching in the body, dark urine, light stools, yellow skin or eyes.

These side effects should be reported to the prescriber immediately to reassess treatment and to order testing to evaluate your health status.

Testosterone injections in adolescents can also cause premature closure of the epiphyses, which are structures present in the bones that allow growth. Therefore, testosterone administration in adolescence can interfere with normal growth.

Testosterone enanthate can also cause serious allergic reactions and lead to symptoms such as difficulty breathing, a feeling of a closed throat, a hoarse voice, swelling in the mouth, tongue or face, or severe itching or hives. Therefore, use should be monitored by a healthcare professional that trained to provide first aid immediately if needed. 

Why do these side effects happen?

1. Acne

The probable cause of acne as an adverse effect is related to the stimulation of the sebaceous glands, by testosterone, causing them to produce more oil. The places that are usually affected are the face and back.

2. Stretch marks

The appearance of stretch marks on the arms and legs is associated with rapid muscle growth caused by steroids.

3. Joint changes

The abusive and inappropriate use of anabolic steroids can increase the risk of tendon injuries. Osteoarticular structures may not be able to keep up with rapid muscle growth, which can inhibit collagen synthesis in ligaments and tendons.

4. Testicular atrophy and decreased sperm count

When testosterone levels are very high, the body starts to inhibit the production of this hormone. This phenomenon, called negative feedback, consists of the inhibition of gonadotropin secretion due to excess testosterone. Gonadotropins are hormones secreted in the brain, which stimulate the production of sperm in the testicles. Therefore, if they are inhibited by testosterone, they will stop stimulating the testicles to produce sperm, which can cause testicular atrophy and infertility.

5. Changes in libido and impotence

Generally, when you start using anabolic steroids, libido increases as testosterone levels increase. However, due to the negative feedback mechanism, the body can inhibit the production of testosterone once testosterone levels reach a certain level, which can end up resulting in impotence.

6. Breast enlargement in men

Breast enlargement in men, also known as gynecomastia, occurs because excess testosterone and derivatives are converted into estrogens, which are female hormones that can cause the enlargement of the mammary glands.

7. Masculinization of women

In women, the use of anabolic steroids can cause clitoral hypertrophy, increased facial and body hair and changes in voice tones, which are male sexual characteristics caused by testosterone.

Furthermore, the use of testosterone can affect a woman's menstrual cycle and, in some cases, can cause the cycle to stop completely.

8. Increased risk for cardiovascular disease

Anabolic steroids can lead to a decrease in HDL cholesterol, as well as an increase in LDL cholesterol, blood pressure and left ventricle pressure. These are risk factors associated with cardiovascular disease. Additionally, enlargement of the heart's left ventricle may lead to ventricular arrhythmia and sudden death.

9. Liver problems

The improper use of testosterone injections can be toxic to the liver and can affect metabolism. They can also also increase in the levels of some enzymes that are related to liver toxicity, which can cause further liver damage, or even liver tumors.

10. Hair loss

Hormonal hair loss, also known as androgenetic alopecia or baldness, occurs due to the action of dihydrotestosterone, a testosterone derivative, on hair follicles. In people with a genetic predisposition, this hormone binds to receptors present on the scalp, leading to thinning and hair loss. Therefore, the use of testosterone and derivatives can aggravate and accelerate this process, by increasing the amount of dihydrotestosterone that binds to the follicles.

Contraindications for use

Testosterone injections and derivatives should not be used in people with:

• An allergy to the active substance or any other component of the medication
• Androgen-dependent cancer or suspected prostate cancer
• Liver tumors or a history of liver tumors
• High calcium levels 
• Kidney inflammation
• Porphyria
• A history of anticoagulants use

Furthermore, this medicine should also not be used by children or women.