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Testosterone enanthate, sold under the brand name Delatestryl among others, is an androgen and anabolic steroid (AAS) medication which is used mainly in the treatment of low testosterone levels in men.[2][3][4] It is also used in hormone therapy for transgender men.[5] It is given by injection into muscle usually once every two to four weeks.[4][6][1] Side effects of testosterone enanthate include symptoms of masculinization like acne, increased hair growth, voice changes, and increased sexual desire.[4] The drug is a synthetic androgen and anabolic steroid and hence is an agonist of the androgen receptor (AR), the biological target of androgens like testosterone and dihydrotestosterone (DHT).[7][4] It has strong androgenic effects and moderate anaboliceffects, which make it useful for producing masculinization and suitable for androgen replacement therapy.[4] Testosterone enanthate is a testosterone ester and a long-lasting prodrug of testosterone in the body.[6][2][3] Because of this, it is considered to be a natural and bioidentical form of testosterone.[8] Testosterone enanthate was introduced for medical use in 1954.[9][3] Along with testosterone cypionate, testosterone undecanoate, and testosterone propionate, it is one of the most widely used testosterone esters.[7][3][4] In addition to its medical use, testosterone enanthate is used to improve physique and performance.[4] The drug is a controlled substance in many countries and so non-medical use is generally illicit.[4] Medical uses[edit] See also: Androgen replacement therapy § Medical uses, and Anabolic steroid § Medical Testosterone enanthate is used primarily in androgen replacement therapy.[3] It is the most widely used form of testosterone in androgen replacement therapy.[3] The medication is specifically approved, in the United States, for the treatment of hypogonadism in men, delayed puberty in boys, and breast cancer in women.[10] It is also used in masculinizing hormone therapy for transgender men.[5] Side effects[edit] See also: Anabolic steroid § Adverse effects, and Androgen replacement therapy § Adverse effects Side effects of testosterone enanthate include virilization among others.[4] Pharmacology[edit] Pharmacodynamics[edit] See also: Testosterone § Mechanism of action, and Anabolic steroid § Pharmacology Testosterone enanthate is a prodrug of testosterone and is an androgen and anabolic–androgenic steroid (AAS). That is, it is an agonist of the androgen receptor (AR). Pharmacokinetics[edit] Testosterone enanthate has an elimination half-life of 4.5 days and a mean residence time of 8.5 days when used as a depot intramuscular injection.[1] It requires frequent administration of approximately once per week, and large fluctuations in testosterone levels result with it, with levels initially being elevated and supraphysiological.[1] Chemistry[edit] See also: Androgen ester and List of androgen esters Testosterone enanthate, or testosterone 17β-heptanoate, is a synthetic androstane steroid and a derivative of testosterone.[11][12] It is an androgen ester; specifically, it is the C17β enanthate (heptanoate) ester of testosterone.[11][12] History[edit] Testosterone enanthate was first introduced for medical use in the United States in 1954 under the brand name Delatestryl.[9][3] Society and culture[edit] Generic names[edit] Testosterone enanthate is the generic name of the drug and its USAN and BAN.[11][12][13][14] It has also referred to as testosterone heptanoate.[11][12][13][14] Brand names[edit] Testosterone enanthate is marketed primarily under the brand name Delatestryl.[11][12][13][14] It is or has been marketed under a variety of other brand names as well including Andro LA, Andropository, Depandro, Durathate, Everone, Testrin, Testostroval, and Testro LA among others.[11][12][13][14] Availability[edit] See also: List of androgens/anabolic steroids available in the United States Testosterone enanthate is available in the United States and widely elsewhere throughout the world.[15][12][14] Legal status[edit] Testosterone enanthate, along with other AAS, is a schedule III controlled substance in the United States under the Controlled Substances Act and a schedule IV controlled substance in Canada under the Controlled Drugs and Substances Act.[16][17] Research[edit] As of October 2017, an auto-injection formulation of testosterone enanthate is in preregistration for the treatment of hypogonadism in the United States.[18]