Depot testosterone for the treatment of testosterone deficiency
Testosterone enanthate is a long-acting, esterified form of the body's own sex hormone testosterone. It is primarily used in medically indicated testosterone replacement therapy (TRT) , i.e., when the body no longer produces sufficient natural testosterone. Due to its depot effect, testosterone enanthate is particularly suitable for men who require a continuous, reliable supply of hormones and do not wish to use it daily.
The substance is usually injected intramuscularly, mostly at one- to two-week intervals, and ensures a steady release of testosterone over several days to weeks. The aim is to stabilize hormone levels within the physiological range and alleviate typical symptoms of testosterone deficiency such as lack of energy, loss of libido, muscle loss, or depressive moods.
How does testosterone enanthate work?
After injection, the active ingredient is slowly released from the muscle tissue and converted into active testosterone. This leads to a continuous increase in testosterone levels , with less pronounced fluctuations than with short-acting preparations. The biological half-life is approximately 4–5 days, and the clinical duration of action is between 2 and 3 weeks.
Typical effects of a well-adjusted TRT with testosterone enanthate include:
- Increase in muscle strength and mass
- Increased libido and sexual function
- Improvement in mood and motivation
- Reduction of body fat, especially visceral fat
- Stabilization of bone density
- Improvement of insulin sensitivity and metabolism
Important: The effects usually occur gradually. Initial effects on libido or energy levels become apparent after a few weeks, while physical changes such as muscle gain or fat loss take several months.
When is testosterone enanthate used?
Testosterone enanthate injections are used in men with a clearly diagnosed hypogonadism , i.e., those with clinically relevant symptoms and repeatedly confirmed low testosterone levels (e.g., below 12.1 nmol/l). This diagnosis should always be made in conjunction with a comprehensive hormone profile .
Here, the TRT check from Adon Health can be an important first step: It measures, among other things, total and free testosterone, SHBG, LH, albumin and PSA, and enables an initial telemedicine assessment by doctors specializing in men's health.
In certain cases, such as early testosterone decline, functional hypogonadism, or as part of medically supervised therapy for late effects of undescended testicles, testosterone enanthate can also be used.
Application & Dosage
The usual starting dose is 125–250 mg intramuscularly every 1–2 weeks. The dose is adjusted depending on individual response, laboratory values, and side effects. The goal is to maintain testosterone levels in the upper third of the physiological range (e.g., 20–30 nmol/l) .
An experienced doctor regularly checks:
- Testosterone (total + free)
- SHBG
- Hematocrit (to prevent blood thickening)
- PSA (prostate cancer screening)
- Lipid profile and liver values
What side effects can testosterone enanthate have?
As with any hormone therapy, side effects can occur with testosterone enanthate, especially with excessively high doses or inadequate monitoring. These include:
- Fluid retention (edema)
- Acne, oily skin, hair loss due to genetic predisposition
- Increased hematocrit → possible risk of blood thickening
- Increased estradiol levels (e.g., breast tenderness, mood swings)
- Suppression of the body's own testosterone production
- Reduction in sperm production with long-term use
Therefore, it is essential not to start TRT "on your own," but to have it medically supervised, with regular blood tests and laboratory diagnostics. Adon Health offers not only the appropriate at-home testosterone test , but also accompanying medical consultations via video call.
What is the difference to other forms of TRT?
Besides testosterone enanthate, there are other dosage forms such as:
- Testosterone gel: Daily application, transdermal
- Testosterone undecanoate (e.g., Nebido®): Depot preparation with a very long duration of action (every 10–12 weeks)
- Tablets or capsules: Less established due to lower bioavailability and greater strain on the liver.
Testosterone enanthate is considered a proven intermediate solution: not daily like gel, but more flexibly controllable than the very long-acting depot injections.
For whom is testosterone enanthate suitable?
- Men with confirmed hypogonadism who require long-term TRT
- Patients who prefer flexible dosage adjustment
- Men for whom transdermal applications (gel, patch) are not practical
Conclusion
Testosterone enanthate is a key component of modern hormone therapy for men. When used correctly, it can contribute to a sustained improvement in energy, libido, muscle strength, and psychological well-being, provided it is administered under medical supervision and with a clear indication.
If you want to know if testosterone enanthate is an option for you, start with a TRT check from Adon Health and learn about other men's experiences on the men's health blog or the men's health podcast .
