About
Sustanon is a blend of 4 different estered testosterones. Depending on the maker, it can contain: testosterone propionate 30 mg/ml, testosterone phenylpropionate 60 mg/ml, testosterone isocaproate 60 mg/ml and testosterone decanoate 100 mg/ml. The idea behind this and other testosterone blends is that the different esters will be released during a period of several weeks. Testosterone Propionate is a fast-acting ester, and will therefore be released during the first 24 hours. Testosterone isocaproate on the other hand, is a long-acting ester, and will therefore be released during a twelve day period.
Testosterone is the principal endogenous hormone essential for normal growth and development of the male sex organs and male secondary sex characteristics. During adult life testosterone is essential for the functioning of the testes and accessory structures, and for the maintenance of libido, sense of well-being, erectile potency, prostate and seminal vesicle function.
Treatment of hypogonadal males with Sustanon 250 results in a clinically significant rise of plasma concentrations of testosterone, dihydrotestosterone and androstenedione, as well as a decrease of SHBG (sex hormone binding globulin). In the males with primary (hypergonadotropic) hypogonadism treatment with Sustanon results in a normalisation of pituitary function.
Use
The drug was developed as a hormone replacement therapy (HRT) such as:
- after castration;
- eunuchoidism;
- hypopituitarism;
- endocrine impotence;
- male climacteric symptoms like decreased libido;
- certain types of infertility due to disorders of spermatogenesis.
Testosterone therapy may also be indicated for the prevention and treatment of osteoporosis in hypogonadal males.
Testosterone administration may also be used as supportive therapy for female-to-male transsexuals.
Dosage
In general, dosage should be adjusted to the individual response of the patient.
Adults:
Usually, one injection of 1ml per three weeks is adequate.
Elderly:
It should be noted that smaller and less frequent doses may achieve the same response.
Children:
It should be noted that smaller and less frequent doses may achieve the same response.
Female-to-male transsexuals:
Different specialist centres have used doses varying from one injection of 1ml every two weeks to one injection of 1ml every four weeks.
Administration
Deep intramuscular injection
Overdose
The acute intramuscular toxicity of Sustanon 250 is very low. Priapism in men is a symptom of chronic overdose. If this occurs, Sustanon treatment should be interrupted and, after disappearance of the symptom, be resumed at a lower dose.
Side Effects
Balding, acne, oily skin and unwanted hair growth are typical side effects. It can also cause breast tissue growth in men, fat gain, a loss of sexual desire and increased blood pressure. This can lead to a weakening of the blood vessels
Warning signs requiring medical attention
Urinary problems are a result of the drug's impact on the prostate.
Special Warnings
Patients, especially the elderly, with the following conditions should be monitored:
- ischaemic heart disease, since androgens may produce hypercholesterolaemia.
- latent or overt cardiac failure, renal dysfunction, hypertension, epilepsy or migraine (or a history of these conditions), since androgens may occasionally induce fluid and sodium retention.
- skeletal metastases, since androgens may induce hypercalcaemia or hypercalciuria in these patients.
Long term monitoring should include measurement of haemoglobin.
The use of steroids may influence the results of certain laboratory tests.
Androgens should be used cautiously in prepubertal boys to avoid premature epiphyseal closure or precocious sexual development.
If androgen-associated adverse reactions occur, Sustanon 250 treatment should be interrupted and, after disappearance of the symptoms, be resumed at a lower dosage.
Sustanon 250contains Arachis oil (peanut oil) and should not be taken / applied by patients known to be allergic to peanut. As there is a possible relationship between allergy to peanut and allergy to Soya, patients with Soya allergy should also avoid Sustanon 250.
Female-to-male transsexual supportive therapy
Before initiating Sustanon for female-to-male transsexuals, specialist assessment should be undertaken, including psychiatric assessment. A complete personal and medical history should be taken. During treatment, periodic check-ups are recommended of a frequency and nature adapted to the individual. The following should be monitored:
- signs of osteoporosis,
- changes in lipid profile.
In patients with a personal or family history of breast cancer and with a personal history of endometrial cancer, careful monitoring should be undertaken.
Subject to specialist advice, hysterectomy and bilateral oophorectomy should be considered after 18-24 months of testosterone treatment, to reduce the possible increased risk of endometrial and ovarian cancer.
Continued surveillance is required to detect osteoporosis in patients who have undergone oophorectomy, as testosterone may not fully reverse the decline in bone density in these patients.
Continued surveillance is required to detect endometrial and ovarian cancer in patients on long term treatment who have not proceeded to hysterectomy and bilateral oophorectomy.
