Testosterone propionate

How it works

After injection the ester is hydrolysed to release testosterone, which acts on androgen receptors to support development and maintenance of male secondary sexual characteristics and related metabolic effects.

Prescribing in practice

• It is contraindicated in known or suspected prostate or male breast cancer; assess prostate health before starting, as testosterone can stimulate growth of existing prostate cancer.
• Being a short-acting ester, it requires frequent injections compared with longer-acting depot testosterone preparations.
• Androgen therapy can cause polycythaemia, fluid retention, mood changes and worsening of sleep apnoea, and is inappropriate in pregnancy.

Monitoring

Monitor haematocrit/haemoglobin, prostate-specific antigen and prostate status, lipids and serum testosterone to guide dosing.

Counselling the patient

• Regular blood tests and prostate checks are needed during treatment.
• Report difficulty passing urine, headaches, or unusual mood changes.
• This treatment is not for use during pregnancy and women should avoid skin contact with injection sites.

Evidence & guidelines

Testosterone replacement is an established treatment for confirmed male hypogonadism, with monitoring of haematocrit and prostate-specific antigen reflecting standard endocrine practice.