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Triptorelin

Sexual Health

Also known as: Decapeptyl, Trelstar, GnRH Agonist

Half-life: ~3 hours (aqueous); weeks (depot formulation)

Last reviewed:  ·  Published:

Sexual Health

Overview

Triptorelin is a synthetic decapeptide analog of gonadotropin-releasing hormone (GnRH) with a single amino acid substitution (D-tryptophan at position 6) that confers dramatically increased receptor binding affinity and resistance to enzymatic degradation. Because it is a long-acting GnRH receptor agonist, Triptorelin's effect on the hypothalamic-pituitary-gonadal (HPG) axis is biphasic: an initial "flare" of LH/FSH release and consequent rise in sex hormones lasting 1-2 weeks, followed by sustained receptor desensitization that suppresses gonadotropin release and produces a state of "medical castration" with sustained dosing.

Clinically, Triptorelin (brand names Decapeptyl, Trelstar, Diphereline) is FDA-approved as a long-acting depot injection for the treatment of advanced prostate cancer, where the sustained suppression of testosterone is therapeutic. It is also used for endometriosis, uterine fibroids, precocious puberty, and as part of IVF protocols.

In the bodybuilding and self-experimentation community, Triptorelin is used in a very different way: as a single low-dose injection at the end of an anabolic steroid cycle to leverage the initial "flare" of LH release for HPG axis restart (post-cycle therapy / PCT). This use leverages only the first part of Triptorelin's biphasic effect; chronic dosing in this context would produce the opposite of the desired effect by suppressing the HPG axis. A single 100-200 mcg injection is the typical PCT protocol. Long-term safety of this off-label use is reasonable to extrapolate from the much higher chronic doses used clinically, but the protocol itself is unstudied.

History

Triptorelin was developed in the early 1980s by Tulane University researchers (Andrew V. Schally's group, building on their Nobel Prize-winning GnRH work) and licensed to Ipsen for clinical development. The depot formulation (Decapeptyl LA) was approved for prostate cancer in Europe in the late 1980s and in the US (as Trelstar) in 2000. Subsequent approvals extended use to other gonadotropin-dependent conditions including endometriosis and precocious puberty.

Effects

  • Initial "flare" of LH/FSH release (week 1-2)
  • Sustained gonadotropin suppression with chronic dosing
  • Clinical: medical castration for prostate cancer
  • Clinical: hormone suppression for endometriosis, fibroids
  • Off-label (PCT): leverage initial flare for HPG axis restart after steroid cycle

Side Effects

  • Initial androgen "flare" (acute prostate symptom worsening)
  • Hot flashes (chronic dosing)
  • Decreased libido and erectile dysfunction (chronic dosing)
  • Bone density loss (long-term chronic use)
  • Mood changes
  • Possible PCT-specific: headache, mild nausea

Tolerability

Chronic clinical Triptorelin use produces the constellation of effects associated with castration-level testosterone suppression — hot flashes, libido loss, mood changes, and (with prolonged use) bone density loss. Single low-dose PCT use does not produce this side-effect profile because the chronic suppression phase is never reached; the main effects in PCT use are the headache and mild flu-like feelings sometimes associated with the acute LH surge. The single-dose PCT protocol has been used widely in self-experimentation for over a decade with no major safety signals reported, but lacks formal clinical study.

Dosing Ranges

Post-cycle therapy (off-label single dose)

Dose Range

100-200 mcg

Frequency

Single dose at cycle end (SubQ)

Duration

One-time

Prostate cancer (clinical, depot)

Dose Range

3.75 mg / 11.25 mg / 22.5 mg

Frequency

Monthly / quarterly / semi-annual depot IM

Duration

Long-term

Endometriosis (clinical, depot)

Dose Range

3.75 mg monthly depot IM

Frequency

Monthly

Duration

3-6 months typical

Dosing information is for educational purposes only. Consult a healthcare professional before using any peptide.

Reconstitution

Preparation Details

Typical Vial Size

2 mg

Water Type

Bacteriostatic water (BAC water) for research/PCT use; clinical depot has specific reconstitution

Mixing Volume

1-2 mL

Half-Life

~3 hours (aqueous); weeks (depot formulation)

Molecular Weight

1,311 Da

Store reconstituted vial refrigerated at 2-8°C. Use within 14-21 days. Clinical depot formulations have their own reconstitution and are designed for sustained release; PCT use of research-grade peptide is aqueous SubQ single-injection.

Calculate Triptorelin dose

Regulatory Status

FDA Status

FDA approved (Trelstar) for advanced prostate cancer. Other indications approved internationally (Decapeptyl, Diphereline).

Legal Status

Prescription drug in clinical formulations. Research chemical in vendor-sold form. Prohibited by WADA.

USA

Approved (Trelstar)

Advanced prostate cancer; depot IM

EU

Approved (Decapeptyl)

Prostate cancer, endometriosis, fibroids, precocious puberty

UK

Approved (Decapeptyl)

Multiple gonadotropin-dependent indications

Australia

Approved (Decapeptyl)

Prostate cancer, endometriosis

Canada

Approved (Trelstar)

Prostate cancer; depot IM

Cited Studies

Triptorelin: a review of its use as an adjuvant anticancer treatment in early breast cancer

Lambertini M, Boni L, Michelotti A, Gamucci T, Scotto T, Gori S, Giordano M, Garrone O, Levaggi A, Poggio F, Giraudi S, Bighin C, Vecchio C, Sertoli MR, Pronzato P, Del Mastro L

Drugs (2014)

Comprehensive review of Triptorelin's clinical pharmacology and use across multiple gonadotropin-dependent conditions, providing the clinical foundation that informs off-label PCT applications.

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Recovery of pituitary-gonadal function after a single dose of long-acting GnRH agonist in male subjects

Crowley WF Jr, Comite F, Vale W, Rivier J, Loriaux DL, Cutler GB Jr

Journal of Clinical Endocrinology & Metabolism (1981)

Foundational human pharmacology study showing that single-dose GnRH agonist administration produces a reliable initial gonadotropin surge with subsequent recovery — the pharmacology underlying the off-label PCT use of low-dose Triptorelin.

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Mechanism of action of GnRH analogues

Conn PM, Crowley WF Jr

Annual Review of Medicine (1994)

Classic mechanistic review of GnRH analog pharmacology including the biphasic flare-then-suppression response that defines both the clinical and off-label uses of Triptorelin and related compounds.

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