Testosterone, like many anabolic steroids, was classified as a controlled substance in 1991. Testosterone is administered parenterally in normal and delayed-release (depot) forms. In September 1995, the FDA approved testosterone transdermal patches (Androderm), and many transdermal forms and brands are now available including implants, gels, and topical solutions. A testosterone buccal system, Striant, was FDA-approved in July 2003; Striant is a mucoadhesive product that adheres to the buccal mucosa and provides a controlled and sustained release of testosterone. In May 2014, the FDA approved an intranasal gel formulation of testosterone (Natesto). A transdermal patch (Intrinsa) for hormone replacement in women is under investigation; the daily dosages used in women are much lower than for products used in males. The FDA refused approval for Intrinsa in 2004 stating that more data regarding safety, especially in relation to cardiovascular and breast health, were required.
The side effects of Androderm can include high blood pressure due to high levels of water retention. However, water retention is highly unlikely due to the low level dosing plans that will be prescribed and easily combatable with anti-estrogen medications if needed. The use of exogenous testosterone can also have a negative impact on cholesterol, particularly in the suppression or reduction of HDL cholesterol. However, therapeutic doses of testosterone to even moderate performance doses do not appear to have a strong, negative statistical impact on cholesterol when testosterone is used alone. When the use of an AI is conjoined with testosterone, this does appear to create a notable impact on HDL reductions. A negative impact cannot occur with the use of a SERM; in fact, SERM’s will actually improve cholesterol levels due to their estrogenic activity in the liver.
While cholesterol issues are possible, they are also easy to avoid. AI’s should not be used unless necessary, but even if necessary healthy cholesterol levels can be maintained with a healthy lifestyle. Limiting saturated fats and simple sugars is a good place to start along with plenty of omega fatty acids. Daily fish oil supplementation is recommended as is daily cardiovascular activity.
Injectable steroids are injected into muscle tissue, not into the veins. They are slowly released from the muscles into the rest of the body, and may be detectable for months after last use. Injectable steroids can be oil-based or water-based. Injectable anabolic steroids which are oil-based have longer half-life than water-based steroids. Both steroid types have much longer half-lives than oral anabolic steroids. And this is proving to be a drawback for injectables as they have high probability of being detected in drug screening since their clearance times tend to be longer than orals. Athletes resolve this problem by using injectable testosterone early in the cycle then switch to orals when approaching the end of the cycle and drug testing is imminent.