Indications
As a synthetic version of the naturally-occurring androgen (male sex hormone) that mimics its activities in the body, Depo-Testosterone is intended to elevate blood concentrations of testosterone to treat hormonal deficiencies.
The symptoms of low testosterone include:
- Unwanted fat accumulation (particularly around the abdomen)
- Low sexual desire (libido)
- Chronically low energy (chronic fatigue)
- Poor mental health (depression, anxiety, etc.)
- Body hair loss
- Loss of muscle mass
- Loss of bone density
- Erectile dysfunction
- Insomnia
Women, who can also experience testosterone deficiency, may also exhibit the following symptoms:
- Infertility
- Irregular menstrual cycles
- Vaginal dryness
- Painful intercourse
The presence of a deficiency of testosterone is determined based on the results of blood tests. If an individual falls below the threshold deemed to be necessary for optimal health, then he or she is diagnosed with testosterone deficiency, also called Low T.
In men, the typical range of normal testosterone is established thusly:
“Harmonized normal range in a healthy nonobese population of European and American men, 19 to 39 years, is 264 to 916 ng/dL.”
Source: The Journal of Clinical Endocrinology and Metabolism
What this means for the average man is that if his testosterone falls into this range, he is unlikely to require therapeutic intervention using Depo-Testosterone or another synthetic hormonal supplement to elevate his levels.
In the chart below, we break down healthy testosterone levels for men by age:
| Healthy Testosterone Levels By Age (Men) | ||
| Age | Average Testosterone Level (ng/dL) | Average Healthy Range |
| >25 | 692 | 376-1008 |
| 25-29 | 669 | 257-1081 |
| 30-34 | 521 | 233-1009 |
| 35-39 | 597 | 219-975 |
| 40-44 | 597 | 201-993 |
| 45-49 | 546 | 220-872 |
| 50-54 | 544 | 170-918 |
| 55-59 | 552 | 204-900 |
Accordingly, based on your age, if your blood levels fall below the “average” threshold per the chart above, you may be diagnosed with hypogonadism and likely qualify for testosterone replacement therapy (TRT) with Depo-Testosterone.
For women, testosterone levels typically range from 15 to 70 nanograms per deciliter (ng/dL). Similarly, women (usually those experiencing menopause or postmenopause) whose blood concentrations fall below the 15 ng/dL mark may also qualify for TRT with Depo-Testosterone.
Contraindications
Although hormone replacement therapy (HRT) is exceptionally safe and effective for the vast majority of patients, some people should not receive testosterone replacement therapy (TRT) based on their medical history or current medical status.
According to Pfizer’s medical literature on Depo-Testosterone, the following groups may not be eligible to receive Depo-Testosterone injections:
- “Known hypersensitivity to the drug”
- “Males with carcinoma of the breast”
- “Males with known or suspected carcinoma of the prostate gland”
- “Women who are pregnant (see PRECAUTIONS, Pregnancy)”
- “Patients with serious cardiac, hepatic or renal disease (see WARNINGS)”
Doses
Pfizer provides extensive information on proper dosing of Depo-Testosterone.
In cases of hypogonadism (insufficient testosterone production in the testes in men), doses of 50–400 mg are typically required every two to four weeks.
Your ideal dosage will depend on your age and sex, among other factors.
Depending on the extent of your deficiency and how you respond to therapy, your doctor may increase or decrease the Depo-Testosterone dose on a case-by-case basis. Additionally, the clinical manifestation of any adverse reactions may also require dose adjustment.
Depo-Testosterone should never be injected intravenously (directly into the blood vessels). Instead, it should be administered via intramuscular injection into the gluteal muscle.
Always inspect the medication before injection. Look for any discoloration or particulate matter that, if present, may indicate that the drug has been contaminated.
Do not use any Depo-Testosterone that you suspect may have been tampered with or contaminated without first consulting a healthcare professional.
Storage
To preserve the effectiveness of the medication, always store Depo-Testosterone Store at “controlled room” temperatures ranging from 20° to 25°C (68° to 77°F). When in doubt, refer to the United States Pharmacopeia guidelines:
“The USP sets public standards that intend to ensure the quality, safety, and benefit of medicines and foods. The primary USP controlled room standard for facilities to understand is USP 797, which specifies that clean rooms should be kept at a temperature of 68 °F (20 °C) or below, however, full compliance depends on the type of facility.”
Keep Depo-Testosterone supplies away from any light source.
Also, because Depo-Testosterone is sensitive to moisture, ideally you should store your supply in a safe, cool, dry environment outside of the bathroom. Never refrigerate or freeze Depo-Testosterone. Be sure that your medication is not expired by checking the expiration date on the package before use. If the product has expired, throw it away and do not use.
Warnings
Pfizer has issued several warnings related to Depo-Testosterone supplementation that patients and providers should carefully consider before beginning therapy.
Bear in mind that your healthcare provider can walk you through the relative risks based on your personal medical status and history, so always rely on the guidance of experts when considering any new therapeutic protocol, including TRT with Depo-Testosterone.
Hypercalcemia
Hypercalcemia – defined clinically as “serum calcium concentration two standard deviations above the mean values (8.8 mg/dL-10.8 mg/d)” may develop in immobilized patients who receive TRT with Depo-Testosterone.
Blood monitoring on a regular basis can evaluate changes, if any, to calcium levels and cut the risk of complications caused by elevated calcium levels.
Liver Dysfunction
Long-term testosterone supplementation has been documented to rarely cause liver dysfunction. The most frequently reported liver-related complications associated with Depo-Testosterone are:
- hepatic adenomas
- hepatocellular carcinoma
- peliosis hepatis
Ongoing blood testing before, during, and after therapy can help healthcare providers catch any liver-related complications due to supplementation and correct course as needed.
Cardiovascular Risks
Certain cardiovascular events or conditions may develop following therapy with any form of testosterone cypionate, including Depo-Testosterone. Examples include deep vein thrombosis (DVT) and pulmonary embolism (PE) – potentially life-threatening conditions that require immediate intervention once diagnosed.
Pfizer, accordingly, cautions providers to “evaluate patients who report symptoms of pain, edema, warmth and erythema in the lower extremity for DVT and those who present with acute shortness of breath for PE.”
Abuse
Like any drug, Depo-Testosterone can be abused. Long-term abuse of any anabolic-androgenic pharmaceutical including Depo-Testosterone, is associated with multiple adverse psychiatric and physiological effects:
“Long-term use of supraphysiologic doses of AAS [anabolic-androgenic steroids] may cause irreversible cardiovascular toxicity, especially atherosclerotic effects and cardiomyopathy… High concentrations of AAS, comparable to those likely sustained by many AAS abusers, produce apoptotic effects on various cell types, including neuronal cells – raising the specter of possibly irreversible neuropsychiatric toxicity. Finally, AAS abuse appears to be associated with a range of potentially prolonged psychiatric effects, including dependence syndromes, mood syndromes, and progression to other forms of substance abuse. However, the prevalence and severity of these various effects remains poorly understood.”
As a prescription-only medication in the United States, “abuse” in the context of Depo-Testosterone constitutes any supplementation administered outside of the therapeutic protocols of a licensed healthcare provider.
Always rely on the guidance of a healthcare professional during therapy. Blood testing, which is necessary throughout the process, can ensure that testosterone levels remain within the medically-defined “therapeutic” range.
Gynecomastia
Gynecomastia – defined as “any condition in which the male breast volume is enlarged due to an increase in ductal tissue, stroma, or fat” and “associated with imbalances in the hormones estrogen and testosterone” – has been linked to Depo-testosterone supplementation.
Electrolyte Imbalances
Depo-Testosterone supplementation, in rare instances, may lead to disruption to levels of the electrolytes (sodium, chloride, water, potassium, and calcium) due to its potential effects on kidney function. Patients at risk of electrolyte imbalance or with a medical history of conditions related to electrolyte levels should be tested and monitored throughout therapy.
Allergies to Depo-Testosterone Ingredients
Some patients may experience adverse reactions due to allergies to any of the ingredients in Depo-Testosterone. In addition to testosterone-cypionate, the primary active constituent of the medication, the injections also contain:
- Benzyl benzoate
- Cottonseed oil
- Benzyl alcohol (as preservative)
In summary, the utmost caution should be exercised before beginning Depo-Testosterone therapy for patients with any of the following conditions:
- pre-existing cardiac (heart) disease
- pre-existing renal (kidney) disease
- pre-existing hepatic (liver) disease