Estradiol cypionate/testosterone cypionate

Not to be confused with Depo-Estradiol, Femandren M, or Folivirin.

Estradiol cypionate/testosterone cypionate (EC/TC), sold under the brand names Depo-Testadiol and Femovirin among others, is an injectable combination medication of estradiol cypionate (EC), an estrogen, and testosterone cypionate (TC), an androgen/anabolic steroid, which is used in menopausal hormone therapy for women.^[1] It is specifically indicated for the treatment of moderate-to-severe vasomotor symptoms (i.e., hot flashes), but can also be used for other estrogen indications in women.^[1] The medication has also been used to suppress lactation in postpartum women.^[2]

Estradiol cypionate /
testosterone cypionate

Estradiol cypionate (top) and testosterone cypionate (bottom)
Combination of
Estradiol cypionate	Estrogen
Testosterone cypionate	Androgen; Anabolic steroid
Clinical data
Trade names	Depo-Testadiol, Femovirin, depAndrogyn, others
Other names	EC/TC
Routes of administration	Intramuscular injection
Identifiers
CAS Number	8055-33-2

Depo-Testadiol was provided in the form of 10 mL vials containing 2 mg/mL EC and 50 mg/mL TC in an oil solution and was administered by intramuscular injection once every 4 weeks.^[1] Conversely, Femovirin was provided in the form of 1 mL ampoules containing 3.5 mg/mL EC (2.4 mg/mL free estradiol) and 90 mg/mL TC (62.9 mg/mL free testosterone) in an oil solution and was administered by intramuscular injection once every 4 to 6 weeks.^[3]

^[4][5][6][7] The elimination half-life of EC in oil by intramuscular injection is approximately 5 days, while the elimination half-life of TC in oil by intramuscular injection is approximately 8 days.^[1] EC/TP reportedly has a duration of about 21 days.^[8]

EC/TC likely poses a considerably increased risk of endometrial hyperplasia and cancer in women with intact uteruses (i.e., women who are not hysterectomized) if it is not combined with a progestogen.^[1] This is due to the EC component.^[1] The concomitant use of a progestogen will abolish such risks.^[1] The medication can also cause masculinization, such as acne, deepened voice, hirsutism, and increased sex drive, due to its TC component.^[1] Some of these masculinizing symptoms, such as voice deepening, can be irreversible.^[1]

Depo-Testadiol was introduced for medical use in 1954,^[9] while Femovirin was introduced for medical use in 1956.^[10] An oral tablet product with the same brand name of Femovirin, containing ethinylestradiol and methyltestosterone, was marketed in 1958, and should not be confused with the injectable Femovirin.^[11][4] Depo-Testadiol was discontinued in the United States by 2013.^[12] Both Depo-Testadiol and Femovirin have been discontinued in most other countries, but formulations of EC/TC under other brand names continue to be marketed in Taiwan.^[13][14][15]

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Androgen replacement therapy formulations and dosages used in women

Route	Medication	Major brand names	Form	Dosage
Oral	Testosterone undecanoate	Andriol, Jatenzo	Capsule	40–80 mg 1x/1–2 days
	Methyltestosterone	Metandren, Estratest	Tablet	0.5–10 mg/day
	Fluoxymesterone	Halotestin	Tablet	1–2.5 mg 1x/1–2 days
	Normethandronea	Ginecoside	Tablet	5 mg/day
	Tibolone	Livial	Tablet	1.25–2.5 mg/day
	Prasterone (DHEA)b	–	Tablet	10–100 mg/day
Sublingual	Methyltestosterone	Metandren	Tablet	0.25 mg/day
Transdermal	Testosterone	Intrinsa	Patch	150–300 μg/day
		AndroGel	Gel, cream	1–10 mg/day
Vaginal	Prasterone (DHEA)	Intrarosa	Insert	6.5 mg/day
Injection	Testosterone propionatea	Testoviron	Oil solution	25 mg 1x/1–2 weeks
	Testosterone enanthate	Delatestryl, Primodian Depot	Oil solution	25–100 mg 1x/4–6 weeks
	Testosterone cypionate	Depo-Testosterone, Depo-Testadiol	Oil solution	25–100 mg 1x/4–6 weeks
	Testosterone isobutyratea	Femandren M, Folivirin	Aqueous suspension	25–50 mg 1x/4–6 weeks
	Mixed testosterone esters	Climacterona	Oil solution	150 mg 1x/4–8 weeks
		Omnadren, Sustanon	Oil solution	50–100 mg 1x/4–6 weeks
	Nandrolone decanoate	Deca-Durabolin	Oil solution	25–50 mg 1x/6–12 weeks
	Prasterone enanthatea	Gynodian Depot	Oil solution	200 mg 1x/4–6 weeks
Implant	Testosterone	Testopel	Pellet	50–100 mg 1x/3–6 months
Notes: Premenopausal women produce about 230 ± 70 μg testosterone per day (6.4 ± 2.0 mg testosterone per 4 weeks), with a range of 130 to 330 μg per day (3.6–9.2 mg per 4 weeks). Footnotes: a = Mostly discontinued or unavailable. b = Over-the-counter. Sources: See template.

See also

• List of combined sex-hormonal preparations