TRT Medications FAQ
5 questions answered about medications for testosterone replacement therapy.
What medications are used for TRT?
The most common TRT medication is testosterone cypionate (weekly or biweekly injection). Other options include testosterone enanthate, testosterone propionate, HCG (for fertility preservation), enclomiphene (oral SERM to boost natural production), and anastrozole (aromatase inhibitor for estrogen management).
What is the difference between testosterone cypionate and enanthate?
Testosterone cypionate and enanthate are nearly identical. Cypionate has a slightly longer half-life (8 days vs 7 days) and is more commonly prescribed in the US, while enanthate is more common in Europe. Both are injected weekly, produce similar blood levels, and have the same effectiveness and side effect profile.
What is HCG and why is it used with TRT?
HCG (human chorionic gonadotropin) mimics luteinizing hormone to keep the testes functioning during TRT. Without HCG, the testes shrink and stop producing sperm because exogenous testosterone shuts down natural production. HCG preserves testicular size, fertility, and intratesticular testosterone.
What is enclomiphene and how does it work?
Enclomiphene is a selective estrogen receptor modulator (SERM) that stimulates the body to produce more testosterone naturally by blocking estrogen feedback in the brain. Unlike TRT, it preserves fertility and testicular function. It is taken as a daily oral pill and is available from compounding pharmacies.
Is enclomiphene better than TRT?
Enclomiphene and TRT serve different purposes. Enclomiphene preserves fertility and boosts natural testosterone production by 200-400 ng/dL, making it ideal for younger men or those planning children. TRT provides more predictable and higher testosterone levels. Most patients respond better to TRT for symptom resolution.