The older we get, the slower our bodies produce the hormones needed to maintain our bodily functions and vitality. Those deficiencies are even worse for some due to age or specific conditions. Since low hormone levels can have undesirable side effects, many men start to wonder if they need Testosterone Replacement Therapy (also known as TRT).
Having low testosterone levels (also known as “Low T” or hypogonadism) is a very common issue for men and even some women. Replacement therapy can be beneficial, but it’s essential to understand both the advantages and the potential risks.
Before talking to your healthcare provider about TRT, it helps to understand what it is, what symptoms point to low testosterone, how we diagnose it, and what to expect from treatment.
What Does Testosterone Do?
For men assigned male at birth (AMAB), testosterone is a crucial hormone during development and highly important in many aspects of lifelong health.
In the womb, the higher presence of testosterone causes the development of the penis and testes. During puberty, it aids in the growth of facial and body hair and deepens the voice.
Throughout a man’s life, it continues to be a vital hormone for producing red blood cells and sperm, promotes muscle development and strength, and supports healthy bone mass and fat distribution. It can also affect energy levels, mood, libido, and even quality of sleep.
For women, testosterone is also essential, but in much smaller amounts. In some instances, TRT may help women improve their mood, energy, and libido, especially after menopause. However, it’s generally considered only for those with an evident deficiency, as excess testosterone can lead to other issues. Estrogen replacement therapy is far more common for women.
Signs You Might Need Testosterone Replacement Therapy
Everybody experiences a dip in hormone levels as they get older. It’s simple biology. For some, lower levels don’t affect them enough to require TRT.
For others, the effects of Low T are not just noticeable but can present several frustrating and even life-changing issues.
While Testosterone Replacement Therapy may not be needed or recommended for everyone, some common signs that it is worth exploring include:
- Persistent fatigue
- Erectile dysfunction or low libido
- Decreased sperm count and fertility issues
- Mood changes, like depression or irritability
- Trouble with memory or focus
- Hair loss, specifically body hair
- Loss of muscle and physical weakness
- Increased body fat
- Reduced bone density
- Male breast tissue development (gynecomastia)
While many of these symptoms naturally develop with aging, they may require testosterone therapy if they occur more severely or at a younger age. Some men are more prone to significant symptoms if they are obese, diabetic, consume large quantities of alcohol, have sleep apnea, or have certain genetic or acquired conditions.
Regardless of your age or health, discussing any of the above symptoms with your healthcare provider is always a good idea. Early treatment can slow or reverse them before they get worse.
How We Diagnose Low T
Before beginning TRT, we have to make sure it is the right treatment for you. Fortunately, it is very simple to diagnose.
After discussing your symptoms, we will do a blood test to check your testosterone levels. For the most accurate results, it’s best to schedule an appointment earlier in the day when your levels are naturally higher. If your testosterone levels are lower than average, we may recommend replacement therapy based on other aspects of your health.
However, if they are within normal ranges, we can discuss other aspects of your health and lifestyle. Sometimes, factors like stress, poor sleep, or certain medications can contribute to symptoms that mimic Low T. A thorough assessment helps us find the proper treatment for your needs.
Potential Side Effects of Testosterone Replacement Therapy
For most people, the benefits of Testosterone Replacement Therapy often outweigh any risks. However, like any medical treatment, it can come with side effects. These may include:
- Acne or oily skin
- Fluid retention, which can lead to issues like ankle swelling
- Increased red blood cell count, which can raise the risk of blood clots
- Worsening of sleep apnea and other issues
- Decreased sperm count
- Enlarged prostate leading to urinary difficulties
- Male breast tissue swelling and tenderness
These side effects may be minor or temporary, but reporting them to your healthcare provider is always important.
Although more research is needed for long-term effects, previous studies suggested a possible connection between TRT and cardiovascular problems, but that has not been replicated with broader and more recent research.
However, it is not recommended for those with a history of cancer, especially prostate and male breast cancer, or those with a high risk of stroke or heart attack.
Throughout Testosterone Replacement Therapy, we monitor the symptoms you experienced with Low T, your testosterone levels during therapy, and the development and progress of potential side effects. If needed, we may adjust the dosage until you start to feel like you again.
What to Expect When Starting Testosterone Replacement Therapy
If TRT is right for you, it can come in several forms, including injections, gels, patches, or tablets. Injections are often the most affordable and convenient option, especially for patients without insurance.
In the first few weeks, you may notice gradual changes — improved mood, increased libido, better sleep, or more energy. Significant effects, like increased muscle strength, may take several months to become noticeable. Regular follow-up appointments are vital to check your progress and adjust the dosage if needed.
We’re here to support you through each step, answer questions, and make sure you feel empowered about your health. Testosterone Replacement Therapy can be a life-changing treatment when used responsibly, and our goal is to help you live life to the fullest.
