Breast cancer, metastatic: IM injection (enanthate): Secondary treatment in women with advancing inoperable metastatic (skeletal) mammary cancer who are 1 to 5 years postmenopausal. Use may be considered in premenopausal women with breast cancer who have benefited from oophorectomy and have a hormone-responsive tumor.
Delayed puberty: IM injection (enanthate); pellet: To stimulate puberty in carefully selected males with delayed puberty.
Hypogonadism, hypogonadotropic (congenital or acquired): Buccal; Capsule (oral) [Canadian product]; Gel (nasal, transdermal); IM injection (cypionate, enanthate, undecanoate); Patch (transdermal); Pellet; Solution (transdermal); SubQ injection (enanthate): Gonadotropin or luteinizing hormone-releasing hormone deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation.
Hypogonadism, primary (congenital or acquired): Buccal; Capsule (oral) [Canadian product]; Gel (nasal, transdermal); IM injection (cypionate, enanthate, undecanoate); Patch (transdermal); Pellet; Solution (transdermal); SubQ injection (enanthate): Treatment of testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome, orchiectomy, Klinefelter syndrome, chemotherapy, or toxic damage from alcohol or heavy metals.
Limitations of use: Safety and efficacy in men with age-related hypogonadism (or late-onset hypogonadism) has not been established (manufacturer’s labeling). However, the Endocrine Society recommends offering testosterone therapy to patients with symptoms of testosterone deficiency and consistently and unequivocally low morning testosterone concentrations. In men >65 years of age, treatment should only be initiated on an individual basis and after consultation with the patient regarding risks and benefits (Endocrine Society [Bhasin 2018]).