Testosterone Replacement Therapy

Testosterone is an androgenic hormone responsible for the development and maintenance of male secondary sex characteristics.

Testosterone levels peak in adolescence and early adulthood, decreasing steadily with age.

Many men experience a natural decline in testosterone production as they grow older, leading to several negative effects.

These changes are perfectly normal and similar declines are seen in other mammals.

However, not all men experience this same degree of decline, so many older men remain virile and vibrant well into their golden years.

Testosterone replacement therapy (also known as TRT) is a safe and effective way to restore normal testosterone levels in the body.

Read the full article to know more about the process, benefits, and side effects of Testosterone Replacement Therapy.

What Is Testosterone Replacement Therapy?

Testosterone replacement therapy (TRT) is a treatment in which men who have low testosterone levels are given synthetic or bioidentical testosterone to achieve their target levels.

Testosterone replacement therapy is often done^[1] with men who have low testosterone levels because of aging, autoimmune disease, genetics, injury, or a medical condition.

Men with low testosterone levels may have a hard time walking, increased body fat, decreased muscle mass, decreased sexual function, or trouble making decisions.

Hypogonadism is the term called for the condition^[2] when there is little to no production of hormones in the body. Men experience it in the form of lower testosterone levels.

Normal aging causes a gradual and sustained drop in testosterone levels, primarily due to declining production by the testicles as well as a decrease in the responsiveness of muscle and skin cells to the hormone.

As per this study^[3], lower testosterone levels may disturb sleep quality but could be able to be improved by replacement therapies.

Medical conditions that can cause low testosterone levels include certain types of chronic illness, major surgery, or chemotherapy.

Treatment with medications^[4] such as glucocorticoids, hereditary androgen deficiency, pituitary disorders, or gonadal disease can also cause low testosterone levels.

How Does TRT Work?

The human body has two different types of hormones: androgens (like testosterone) and estrogens (Estradiol).

Androgens are responsible for male^[5] characteristics, like increased muscle mass and strength, improved bone and skin health, and sex drive.

Estradiol is responsible for female^[6] characteristics, like fat distribution and breast development.

What Is The Best Testosterone Replacement Therapy For Men?

Men who need testosterone replacement therapy will likely have different needs depending on their age, sex drive, health condition, and other factors.

General tips for testosterone replacement therapy for men include-

Seeking medical advice before beginning treatment to ensure that your specific needs are being met.
Consulting with a healthcare provider who specializes in treating low testosterone levels.
Take medications prescribed by your doctor rather than taking unregulated supplements or illegal products.
Maintain a healthy^[7] weight and avoid overconsumption of food and drinks with testosterone replacement therapy.

Process Of Testosterone Replacement Therapy

The process of testosterone replacement therapy involves^[8] taking a dose of T every four weeks for about three years until your T level reaches your desired setting (usually around 500 ng/dL).

After three years you can then stop taking any T at all or wait until your T level falls below 200 ng/dL again before starting TRT again.

If you have any concerns about your T level, talk with your doctor immediately after you experience any noticeable symptoms.

Issues related to low testosterone levels such as muscle cramps, loss of libido, increased breast size, or weight gain should get checked by a medical professional.

The physiological effects of testosterone on the body are complex, and it’s important to talk with your doctor about how you can safely use testosterone therapy.

Several conditions could affect^[9] your T levels, including cardiovascular disease, certain cancers, and some types of cancer.

You should always consult with your doctor before starting any new medical treatment or drug.

Testosterone is the primary sex hormone^[10] in men, but it also plays a role in the development and maintenance of male sexual characteristics.

Testosterone is produced by the testes, which are located in the abdomen (the scrotum) and pelvis (the pubic region).

The testes produce testosterone for three to eight years following puberty (when they are aged 18-24).

Benefits Of TRT

These TRT benefits are examined by specialists as well. The replacement therapy has lots of benefits and some of them^[11] are as follows:

Increased Energy And Mood
Increased Libido
Improved Muscle Mass And Strength
Improved Bone Health
Increased Mental Clarity
Reduced Body Fat
Reduced Risk Of Cardiovascular Disease
Reduced Risk Of Diabetes
Improved Sleep
Improved Quality Of Life

Side Effects Of TRT

You might have been wondering about the testosterone replacement therapy side effects. The therapy does have^[11] some side effects, which are as follows:

High Bood pressure
Prostate Enlargement
Testicular Atrophy
Hair Loss
Mood Swings
Liver Damage
Increased Risk Of Heart Disease
Prostate Cancer
Depression
Increased Risk Of Prostate Cancer
Decreased Libido

Who Should be on TRT?

The fact that testosterone levels naturally decline with age does not mean that everyone needs TRT.

There is no evidence that TRT works for people who are simply aging, except for those who have the testicular disease.

If you are experiencing some of the symptoms^[12] of low testosterone, you should be evaluated by a doctor.

They will perform a blood test to measure your testosterone levels, as well as other important health markers like your cholesterol and PSA levels.

You may be a candidate for TRT if your levels are low enough to cause negative health effects.

Why Should I Be On TRT?

There are several reasons to be on TRT. Some people choose to avoid the procedure because of the side effects, while others want the benefits of hormone therapy.

For those who want to avoid TRT, you will likely need to find a doctor who understands your medical history and needs your permission to do so.

However, if you want to be on TRT, you will need medical insurance coverage to pay for it.

The cost may be prohibitive but it is something that will still come down over time if you take care of yourself and remain vigilant about taking care of your health.

Trimming off some unwanted fat can help with weight loss.

Warnings For Men Considering TRT

While testosterone replacement therapy is an effective treatment^[12] for low levels of free-floating testosterone, it is not without its risks.

In particular, men who are considering TRT should be aware of the following:

There are possible links between testosterone replacement therapy and an increased risk of certain types of cancer, including prostate^[13], lung, and bladder cancer.
There are possible links between testosterone replacement therapy and an increased risk of blood clots, as per the study^[14].
You may experience adverse effects such as increased acne, increased body hair and/or growth, enlarged sex organs, and irritability.
If you take TRT, you should avoid using testosterone creams or gels. These should only be applied by a physician.

How To Take Testosterone Replacement Therapy?

There are a few different ways^[15] to take testosterone replacement therapy. You can either take it by mouth or inject it into the body.

The most common way to take testosterone replacement therapy is by mouth. Other ways to take Testosterone Replacement Therapy are-

Injected Into The Body– To inject testosterone replacement therapy into the body, you’ll need a doctor to give you an injection. This will usually happen in the arm or leg and will last for around two hours.
Topical Application– Topical application refers to applying testosterone replacement therapy directly to the skin, rather than through swallowing or sublingual administration. This is often more comfortable for people who are unable to undergo an injection and allows for faster absorption of the treatment across the skin.

Bottom Line

Testosterone replacement therapy is a safe and effective treatment for low levels of this hormone.

However, not everyone needs TRT and those who do should be aware of the possible risks and side effects.

Before beginning treatment, you should be evaluated by a doctor and discuss your specific symptoms and risk factors.

The following information is specific to testosterone replacement therapy, but it should be used as a guide to help you decide if you need it.

If you are eligible for the treatment, it is important to take it according to the instructions provided and to seek medical help if there are any side effects.

References/Sources

Working4Health prefers using primary and verified references. We have strict sourcing guidelines and our primary references include peer-reviewed research, academic, and medical institution studies.

Christina Carnegie. Diagnosis of Hypogonadism: Clinical Assessments and Laboratory Tests. Rev Urol. 2004; 6(Suppl 6): S3–S8.
Omeed Sizar; Janice Schwartz. Hypogonadism Last Update: June 27, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532933/
Gary Wittert. The relationship between sleep disorders and testosterone in men. Review Asian J Androl. 2014 Mar-Apr;16(2):262-5. doi: 10.4103/1008-682X.122586. Available from https://pubmed.ncbi.nlm.nih.gov/24435056/
Adel Gassab Mohammed, Abbas Ali Mansour, and Jawad Hassan Ahmed Effect of exogenous glucocorticoids on male hypogonadism Biomed Rep. 2020 Sep; 13(3): 12.Published online 2020 Jun 26. doi: 10.3892/br.2020.1319
David J Handelsman Androgen Physiology, Pharmacology, Use and Misuse Last Update: October 5, 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279000/
Benjamin J. Delgado; Wilfredo Lopez-Ojeda. Estrogen Last Update: June 28, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/
Hiroshi Kumagai, Asako Zempo-Miyaki, Toru Yoshikawa, et al. Increased physical activity has a greater effect than reduced energy intake on lifestyle modification-induced increases in testosterone J Clin Biochem Nutr. 2016 Jan; 58(1): 84–89.Published online 2015 Nov 27. doi: 10.3164/jcbn.15-48
Nazem Bassil, Saad Alkaade, and John E Morley. The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. 2009; 5: 427–448. Published online 2009 Jun 22. doi: 10.2147/tcrm.s3025
Travis Goodale, Archana Sadhu, Steven Petak, et al. Testosterone and the Heart Methodist Debakey Cardiovasc J. 2017 Apr-Jun; 13(2): 68–72.doi: 10.14797/mdcj-13-2-68
Understanding How Testosterone Affects Men September 23, 2013 Available from: https://www.nih.gov/news-events/nih-research-matters/understanding-how-testosterone-affects-men
Polackwich AS, Tadros NN, Ostrowski KA, et al. Benefits and Consequences of Testosterone Replacement Therapy: A Review Eur Endocrinol. 2013 Mar; 9(1): 59–64.Published online 2013 Mar 15. doi: 10.17925/EE.2013.09.01.59
Ana Marcella Rivas, Zachary Mulkey, Joaquin Lado-Abeal. Diagnosing and managing low serum testosterone. Proc (Bayl Univ Med Cent). 2014 Oct; 27(4): 321–324. doi: 10.1080/08998280.2014.11929145
Ranjith Ramasamy, Erik S. Fisher, and Peter N. Schlegel Testosterone replacement and prostate cancer Indian J Urol. 2012 Apr-Jun; 28(2): 123–128.doi: 10.4103/0970-1591.98449
Rob F. Walker, Neil A. Zakai, Richard F. MacLehose, et al. Association of Testosterone Therapy With Risk of Venous Thromboembolism Among Men With and Without Hypogonadism JAMA Intern Med. 2020 Feb; 180(2): 190–197.Published online 2019 Nov 11. doi: 10.1001/jamainternmed.2019.5135
Hyun Jun Park, Sun Tae Ahn, and Du Geon Moon Evolution of Guidelines for Testosterone Replacement Therapy J Clin Med. 2019 Mar; 8(3): 410.Published online 2019 Mar 25. doi: 10.3390/jcm8030410

About the Author
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Michael Stuart

Michael has been in the male wellness industry for 25+ years. Before joining Working For Health as a full-time male wellness journalist, he contributed to multiple online portals in the male wellness field. Before that, he has been an assistant to several sexologists.