TRT is one of the most talked-about treatments for men today. It’s often seen as the answer to low libido, fatigue, and mood swings. But how much do you really know about it? This article walks you through the benefits and risks of TRT so you can make an informed decision.
Overview of Testosterone Replacement Therapy
Testosterone Replacement Therapy (TRT), alternatively called as androgen replacement therapy, is a medical treatment that increases testosterone levels in men suffering from insufficient testosterone. This condition is called hypogonadism, where the body is no longer producing enough testosterone on its own. It may stem from issues in the testicles or problems in the brain regions responsible for directing hormones.
Testosterone naturally declines with age. From around 30 years old, men typically experience a 1% drop in testosterone each year. While that sounds small, it builds up over time. Low testosterone, or “low T,” can also occur earlier due to injury, illness, or other underlying issues. Signs and symptoms of low T include:
- Reduced sex drive
- Erectile dysfunction
- Fatigue or low energy
- Depression or mood swings
- Poor concentration or memory
- Loss of muscle mass
- Increased body fat
- Excessive hair loss
- Low semen volume
- Infertility
A diagnosis of hypogonadism is made when a man’s blood testosterone level falls below 250 to 300 ng/dL (depending on the country and its reference range). Low testosterone can cause all sorts of male sexual dysfunction. It affects libido, erection quality, and semen production. Even if the cause is partly psychological or vascular, addressing low T is a key step in restoring sexual health.
Types of Testosterone Replacement Therapy
There’s no one-size-fits-all approach to testosterone replacement. Here are the modes of TRT that you can try:
Topical Testosterone
Topical testosterone can be either a gel or a skin patch that’s used daily. Gels are absorbed through clean skin. It’s usually applied on the upper arms, shoulders, or thighs. Patches stick to various parts of the body and are rotated to avoid skin irritation. These options are convenient but may transfer testosterone to others through close skin contact.
Testosterone Injections
Testosterone injections are given either into a muscle or under the skin. They can be short-acting (every 1 to 2 weeks) or long-acting (every 10 weeks). This method is affordable and delivers strong results but may cause hormone level spikes or dips between doses. Some prefer doing the injections at home while others go to a clinic.
Testosterone Implants
Implants are tiny pellets that doctors insert under your skin. They release testosterone slowly over 3 to 6 months and require a minor outpatient procedure. Many choose implants for their consistency and convenience. However, the insertion site may feel sore or bruised after the procedure.
Buccal Testosterone
This type is a small and sticky tablet placed on your upper gum twice a day. It releases testosterone steadily into your bloodstream through the oral tissues. Buccal tablets are needle-free and discreet. However, they can cause gum irritation or headaches. It’s best to switch sides with each use to reduce discomfort.
Intranasal Testosterone
This form is a gel you apply inside each nostril three times daily. It’s absorbed quickly and avoids skin contact risks. Some find it useful for maintaining stable levels throughout the day. Side effects may include nasal irritation, headaches, or nosebleeds.
Testosterone Pills
These are swallowed with water. Oral testosterone is often consumed twice a day with meals. Newer pills avoid liver strain by absorbing through the lymphatic system, not the liver. They’re convenient but can be costly and are less commonly prescribed. Some users report higher blood pressure so monitoring is key.
Advantages of Testosterone Replacement Therapy
We know that TRT is used to treat low testosterone. But what other benefits does it offer to your overall health? Here’s how TRT makes a real difference for men who need it:
- Stronger Erections – low testosterone can inhibit blood flow to your penis which can trigger erectile dysfunction. In response to this, TRT improves circulation and sexual response. This helps men not only regain confidence in the bed but also have real satisfaction when having physical intimacy.
- Improved Sperm Count – in certain cases, medically managed TRT can support sperm production by regulating hormonal signals. This can be especially important for men who are trying to conceive.
- Enhanced Energy Levels – testosterone plays a major role in the metabolism of energy and the creation of red blood cells. With TRT, men often feel less fatigued and more motivated to engage in daily activities including physical intimacy.
- Increased Bone Density & Muscle Mass – Testosterone helps maintain strong bones and supports lean muscle growth. TRT can prevent accidental fractures (due to weakened bones) while making it easier to stay active and sexually fit.
- Raised Insulin Sensitivity – low testosterone is linked to insulin resistance and metabolic issues. TRT can help regulate blood sugar which helps reduce inflammation that may affect sexual function. Since diabetes can trigger erectile dysfunction, TRT may support erectile function for diabetic men.
- Stable mood – hormonal imbalances can lead to irritability, low self-esteem, and even anxiety which contribute to erectile dysfunction. TRT helps regulate mood and reduce emotional lows. This often leads to better communication and intimacy with partners.
Side Effects of Testosterone Replacement Therapy
Like any medical treatment, TRT comes with potential risks. If you notice any of the side effects below, talk to your doctor immediately. Note that many of these happen in men with preexisting conditions that don’t align well with TRT or in men who start treatment without actually having low testosterone:
- Smaller testicles – testosterone therapy can reduce the body’s own testosterone production leading to testicular shrinkage. This is a common side effect when external hormones override natural function.
- Prostate enlargement – TRT can stimulate the prostate gland causing it to grow. This may lead to difficulty urinating or a weaker stream.
- Breast enlargement – excess testosterone may be converted to ‘female’ hormones. This causes the breast tissue to swell. This can be distressing and may also affect body image and sexual confidence.
- Lower sperm count – TRT can disrupt the hormonal signals that control sperm production which can, in turn, result in infertility. This is especially important for men who plan to have children in the future.
- Priapism – this painful and dangerous sexual condition happens when you stay erect for too long (lasting beyond four hours). While rare, if you suspect you’re having priapism, you should get urgent or emergency medical care to prevent long-term damage.
- Baldness or excessive hair – testosterone may trigger hair loss on the scalp or increase body hair growth (depending on your genetic sensitivity to hormones). This doesn’t directly affect sexual function but can impact confidence.
- Acne – hormonal changes from TRT can stimulate oil glands. Oily skin or face can trigger acne flare-ups. This is more likely in men already prone to oily skin.
- Swollen ankles – TRT can cause fluid retention (especially in the lower legs and ankles). If unaddressed, this might lead to discomfort or affect mobility.
- Urinary abnormalities – an enlarged prostate or hormonal changes may cause more frequent urination, urgency, or difficulty emptying the bladder. This can interrupt sleep and reduce overall quality of life.
- Skin rashes or itching – these occur in men using topical testosterone gels or creams. It can often be managed by switching application sites or the mode of TRT you’re using.
- Increase in blood clots – TRT can raise red blood cell count. This increases the risk of deep vein thrombosis or pulmonary embolism. These are serious complications that require urgent care.
- Cardiovascular issues – for men without low testosterone, TRT may raise blood pressure and strain the heart. This increases your risk of experiencing heart attacks and strokes (especially in those with underlying heart problems). Cardiovascular diseases are the most common physiological contributor to erectile dysfunction.
- Worsening of sleep apnoea – testosterone can affect breathing regulation during sleep. Men with this condition may find their symptoms become more severe.
- Worsening of prostate cancer – TRT can stimulate the growth of prostate cancer cells. This is why screening is critical before starting treatment.
- Mood swings – testosterone affects brain chemistry and mood regulation. It may increase irritability, anxiety, or sudden emotional changes. This can lead to strained relationships that affect sexual connection.
This means a man shouldn’t be on TRT if he has prostate/breast cancer, benign prostatic hyperplasia (enlarged prostate), cardiovascular diseases, sleep apnea, blood clot issues, elevated red blood cells, and plans to have biological children (no prior fertility issues).
TRT vs Anabolic Steroids
Anabolic steroids are manmade chemicals that imitate natural testosterone. Men often take it in unhealthy doses to build muscle and boost performance. Unlike TRT, which uses carefully regulated amounts to restore natural hormone levels in men with hypogonadism, anabolic steroids flood the body with too much synthetic testosterone. These excessive doses are linked to serious health risks like aggression, liver damage, heart issues, and mood disorders. Meanwhile, TRT is medically supervised and generally safe for men without conditions like prostate cancer or heart failure. Still, long-term studies on TRT have mixed results which is why it’s important to assess your personal risks before starting treatment.
Conclusion
TRT isn’t a magic fix. However, it can be life changing for men struggling with low T. So, if you’re feeling constantly tired, losing muscle, or just not feeling like yourself anymore, it might be time to get checked. Our clinic has helped thousands of men like you regain their sex drive and confidence. Book an appointment with us to get access to our multidisciplinary treatment for a full rehabilitation of your sexual health!
