Testosterone Cypionate Therapy

Pharmacokinetics and Dosing

The American Gastroenterological Association notes that standard dosing of testosterone cypionate is 100-200 mg every 2 weeks or 50 mg weekly, resulting in significant fluctuations in serum testosterone levels 1, 2
Weekly administration of testosterone cypionate provides more stable serum testosterone levels compared to biweekly administration, according to the American Gastroenterological Association 3
The American Gastroenterological Association recommends measuring testosterone levels midway between injections, targeting a mid-normal value 4

Testosterone cypionate therapy is associated with small but significant improvements in global sexual function (SMD, 0.35 [95% CI, 0.23 to 0.46]) and erectile function (SMD, 0.27 [95% CI, 0.09 to 0.44]), as reported by the American College of Physicians 5, 6
The American College of Physicians notes that testosterone cypionate therapy may provide small improvements in objective physical function, as measured by gait speed (SMD, 0.14 [95% CI, 0.02 to 0.27]) 6
Testosterone cypionate therapy is associated with weight loss, improvements in fasting plasma glucose, insulin resistance, triglyceride levels, HDL cholesterol, lean body mass, and waist circumference in men with obesity and hypogonadism, according to the American Gastroenterological Association 3

The American Gastroenterological Association notes that testosterone cypionate therapy may be associated with a greater risk of cardiovascular events compared to gels, possibly related to fluctuating testosterone levels 1
Local injection site reactions, including pain, soreness, bruising, erythema, swelling, nodules, or furuncles, can occur with testosterone cypionate therapy, as reported by the New England Journal of Medicine 7
Testosterone cypionate therapy can cause testicular size and consistency to diminish, and fertility to be greatly compromised during therapy, according to the New England Journal of Medicine 8

The New England Journal of Medicine recommends initial follow-up at 1-2 months to assess efficacy, and subsequent monitoring every 3-6 months for the first year, then yearly 7
The American Gastroenterological Association recommends measuring testosterone levels midway between injections, and monitoring hematocrit/hemoglobin and PSA levels 4, 7

The American Gastroenterological Association notes that IM testosterone cypionate is relatively inexpensive compared to other formulations 1
The fluctuating testosterone levels with IM injections may contribute to adverse effects, according to the American Gastroenterological Association 1
The FDA required a labeling change in 2015 to inform about possible increased risk of heart attack and stroke with testosterone preparations used for age-related hypogonadism, as reported by the American Gastroenterological Association 1