Testosterone Propionate Side Effects
Testosterone is not without potential side effects.
However, it is thanks to our near-complete understanding of this compound that we can effectively understand and deal with testosterone propionate side effects.
Estrogenic side effects
Testosterone itself has a moderate level of estrogenic activity, meaning it has a moderate affinity for binding to the aromatase enzyme (the enzyme that converts testosterone to estrogen).
Therefore, a moderate level of aromatization is expected with testosterone use.
The conversion of testosterone to estrogen can result in a significant increase in estrogen levels, especially when testosterone propionate is used in the doses required for bodybuilding and enhancement of athletic performance and physique.
For this reason, estrogenic Testosterone Propionate side effects should not be ignored, and the rate of aromatization is usually and always directly correlated to the dose used.
It stands to reason that as the dose increases, the rate at which testosterone aromatizes into estrogen increases.
Therefore, it is important to understand that bodybuilding testosterone doses often result in a significant amount of aromatization that must be dealt with in some way.
Individuals can use aromatase inhibitors, which work by neutralizing the aromatase enzyme, preventing testosterone from being converted to estrogen, effectively controlling the underlying cause of increased estrogen.
Another possible option is to use a selective estrogen receptor modulator (SERM) like Nolvadex, which works by blocking estrogen from attaching to receptor sites in breast tissue.
SERMs like Nolvadex only help to address estrogen-induced gynecomastia, they do not actually lower serum estrogen levels in the body, which requires an aromatase inhibitor to do so.
Estrogenic side effects include water retention and bloating, increased blood pressure (due to water retention), increased likelihood of fat retention/gain, and gynecomastia.
Androgenic side effects
Since testosterone is the primary male hormone, testosterone propionate side effects also include the androgenic side effects aspect.
Testosterone is also converted to dihydrotestosterone (DHT), a more potent androgenic metabolite.
Testosterone has an androgenic strength rating of 100, which indicates a significant amount of androgenic activity in the body.
However, testosterone propionate side effects have more to do with the fact that testosterone is converted into the aforementioned stronger and more potent androgen dihydrotestosterone (DHT) via the 5-alpha reductase (5AR) enzyme.
5-alpha reductase is present in large amounts in certain tissues such as the scalp, prostate, and skin.
When testosterone reaches these tissues, it is rapidly reduced to DHT, the more potent androgenic metabolite.
It is DHT that is responsible for the more severe androgenic side effects.
Ancillary medications such as proscar or dutasteride can be used to effectively inhibit 5-alpha reductase, essentially eliminating DHT.
However, even if the testosterone itself has an androgenic strength rating of 100 and the potential for conversion to DHT is eliminated or reduced, it will still act as an androgen in many tissues of the body, so androgenic side effects cannot be completely eliminated.
As an alternative (or adjunct) to a 5AR inhibitor like Proscar, topical use of Nizoral 2% Shampoo can effectively reduce the chance of androgens causing male pattern baldness and alleviate acne breakouts caused by increased oily skin by allowing the active ingredient ketoconazole to act as a topical DHT blocker on the skin and scalp.
Androgenic side effects include increased sebum secretion (oily skin), increased acne breakouts (associated with increased sebum secretion), body and facial hair growth, benign prostatic hyperplasia (BPH), and an increased risk of developing male pattern baldness (MPB) in individuals who have the genetic traits necessary to develop androgenic alopecia.
HPTA and Endogenous Testosterone Production Side Effects
All anabolic steroids can cause the well-known side effect of suppressing and/or shutting down endogenous testosterone production.
Testosterone propionate side effects are no exception with any anabolic steroid in existence.
They can even cause a complete and permanent shutdown of the endocrine system, especially with excessively long cycles.
A thorough and proper post cycle therapy (PCT) program is always required after the end of a cycle, which should utilize HPTA and testosterone stimulating ancillary compounds such as Nolvadex and/or HCG to normalize endogenous testosterone production as quickly as possible.
PCT protocols and programs typically run for 4-6 weeks after the end of a cycle, after all anabolic steroids have been eliminated from the body.
Failure to participate in a proper PCT program can permanently damage the HPTA, resulting in low or deficient testosterone (a medical condition known as hypogonadism) and may require treatment in the form of testosterone replacement therapy (TRT) for the rest of your life.
Hepatotoxic side effects
Testosterone propionate is not a C17-alpha alkylated anabolic steroid and therefore does not exhibit liver toxicity.
Confirmation of this fact comes from a study that examined the potential for hepatotoxicity in a number of male subjects after 20 days of high doses of testosterone (400 mg daily, equivalent to 2,800 mg weekly), which was administered orally rather than by intramuscular injection.
The idea of oral administration rather than the traditional intramuscular injection is to saturate the liver with a large amount of testosterone (all orally ingested substances make a 'first pass' through the liver, interacting with it at a much faster rate than the injection route of administration).
No changes were observed in the study [1].
It is also important to note that even if hepatotoxicity of testosterone propionate had been measured, its route of administration is by injection, which avoids the aforementioned first pass through the liver (a phenomenon that only occurs when a substance is ingested orally).
Therefore, liver toxicity is not a concern when it comes to testosterone propionate side effects.
Cardiovascular Side Effects
Cardiovascular tension and negative cholesterol changes are both peripheral side effects that fall under the category of testosterone propionate side effects.
This is one of the side effects seen with all anabolic steroids in existence and is inherent in the nature of anabolic steroids, especially oral anabolic steroids.
They include a decrease in HDL (good cholesterol) and an increase in LDL (bad cholesterol).
As a result of these changes, the risk of atherosclerosis increases, and the degree to which these changes are exacerbated is generally dose dependent (higher doses increase the negative changes and risk).
Other factors that influence these negative cholesterol changes include duration of use and route of administration.
Testosterone itself actually has a much smaller effect on cholesterol levels than all other anabolic steroids, due in part to the liver's ability to metabolize testosterone freely and the fact that it is not very resistant to hepatic breakdown and metabolism.
Most of the problems associated with hepatotoxicity stem from certain anabolic steroids that are more resistant to hepatic metabolism than testosterone.
This is one of the main reasons why oral anabolic steroids exhibit varying degrees of hepatotoxicity; C17-alpha alkylation makes anabolic steroids more resistant to being metabolized or broken down by the liver.
The concern about whether an anabolic steroid is more or less resistant to hepatic metabolism is a factor in how much a particular anabolic steroid affects the liver's ability to manage cholesterol.
Testosterone, in particular, was shown in one clinical study to have only a minor effect on HDL cholesterol when 280 mg of testosterone enanthate was administered weekly for 12 weeks.
Subsequent administration of an aromatase inhibitor resulted in a worse cholesterol profile, resulting in a 25% decrease in HDL cholesterol [2].
Conversely, another study using 300 mg of testosterone enanthate weekly for 20 weeks without the use of an aromatase inhibitor showed a 13% reduction in HDL cholesterol, but when the testosterone dose was increased to 600 mg weekly, the HDL cholesterol reduction dropped to 21% [3].
It is very clear from the data examined that the increase in estrogen through aromatization and hepatic metabolism actually helps to offset the negative cholesterol changes caused by the use of supraphysiological amounts of anabolic steroids.
This is not surprising considering that estrogen itself is known to have a positive effect on cholesterol levels.
Therefore, the use of aromatase inhibitors and their effect on cholesterol levels should always be kept in mind when considering adding an aromatase inhibitor to your cycle.
Therefore, it is recommended to use the lowest dose of aromatase inhibitor for a cycle aimed at controlling estrogen rather than eliminating overall estrogen levels.
The idea in this case is to keep estrogen levels within the normal range, preventing them from spiking due to aromatization, while at the same time preventing them from dropping to near zero due to the use of a full dose of an aromatase inhibitor.
Testosterone Propionate References
[1] Induction of enzymes by oral testosterone. Johnsen SG, Kampmann JP, Bennet EP, Jorgensen F. 1976 Clin Pharmacol Ther 20:233-237
[2] Administration of aromatized androgens does not decrease high-density lipoprotein cholesterol. Friedl K, Hannan C et al. Metabolism 39(1) 1990;
[3] Testosterone dose-response relationship in healthy young men. Bhasin S, Woodhouse L. et al. Am J Physiol Endocrinol Metab 281:E1172-81, 2001
