How Does Testosterone Replacement Therapy Work?

Testosterone replacement therapy (TRT) has become more and more mainstream, as healthcare professionals recognize how common low testosterone is and have begun testing for it more regularly. 

But what exactly is TRT and how does it work to help people feel better? If you suspect that you might have low testosterone, or you have already been diagnosed with it and want to learn more about the treatment for it, read on. 

What is testosterone?

Testosterone is a hormone that both women and men's bodies produce, and it plays a role in all kinds of functions in the body like muscle mass, bone health, mood regulation, libido, and more.  Testosterone levels can vary widely, with levels being naturally higher in people assigned male at birth versus those assigned female at birth. 

Testosterone being at a normal level is particularly important in men, as it helps to regulate things like body and facial hair growth, fat distribution, and sperm production. 

Who is testosterone replacement therapy used for?

Low testosterone (aka. low T or male hypogonadism) is the most common reason for TRT to be used. People with low testosterone can have a variety of symptoms, including:

• Fatigue (chronically feeling tired)

• Low libido or sexual dysfunction

• Depression

• Mood swings

• Difficulty concentrating

• Increased body fat, particularly around the belly

• Losing muscle mass

What causes low testosterone?

While testosterone levels naturally get lower as people age, there can be other causes like testicular injury, chemotherapy, other hormonal disorders, medications, lifestyle, alcohol, stress, genetic disorders, sleep apnea, HIV/AIDS, and other chronic health conditions. 

How does testosterone replacement therapy work?

TRT refers to supplementing your body’s naturally produced testosterone with testosterone from an outside source. This can come in many forms, including:

• Injections: Testosterone can be injected into your muscle on a weekly or biweekly basis. 

• Gels or creams: Topical testosterone is applied to your skin, and is absorbed through to the bloodstream. 

• Patches: Testosterone patches are stuck onto the skin and deliver a steady dose of testosterone through absorption into the bloodstream. 

• Pellets: Testosterone-containing implants are surgically implanted under the skin, and release testosterone over several months. 

• Oral: Though less commonly used due to the potential for serious side effects, there are orally ingested or absorbed forms of testosterone. 

It is important to discuss the various forms of testosterone treatments and which would be the best for your particular situation with your prescriber. There are risks and benefits associated with each type of treatment. 

What are the benefits and risks of TRT?

There are risks and benefits to any medical treatment, and TRT is no exception. Since TRT is becoming more widely used, new data is coming out every day about the potential benefits and risks associated with TRT. 

Benefits of TRT

If you’ve been having symptoms caused by low testosterone, then TRT can help with:

• Boosting energy levels

• Improving concentration

• Improving mood

• Raising bone dentist

• Increasing muscle mass

• Improving libido and sexual function

Studies have shown that if low testosterone is the primary cause of these issues, then TRT will make significant improvements to the symptoms you have been experiencing. But it’s important to keep in mind that this improvement is seen in people with low testosterone levels as shown on their testing, not those with normal testosterone levels experiencing the same symptoms. 

Risks of TRT

As with any medication, TRT has some side effects and risks associated with it. This can include:

• Oily skin

• Acne

• Increased risk of blood clots and high red blood cell levels

• Prostate enlargement or cancer

• Worsening of sleep apnea

• Worsening of high cholesterol levels

• Liver disease, especially with high-doses or some oral forms

• Increased risk of male breast cancer

• Gynecomastia (breast enlargement in men)

• Infertility

These are just some of the side effects to be aware of, so be sure to ask your prescriber about all of the potential risks involved with TRT before you start.  

Who should avoid TRT?

Anyone with untreated testicular, prostate or breast cancer should avoid TRT. Also, people with a high red blood cell count, heart failure, untreated sleep apnea, or people who want to remain fertile (have children) should avoid TRT. 

If you consume more than eight drinks per week, smoke, or use street drugs or supplements, discuss these habits with your doctor before starting TRT. These substances can interfere with treatment or cause unwanted side effects or interactions.

What to expect from TRT treatment

TRT is not an instant fix or treatment. It can take weeks to months to know if TRT will work for you, and regular checkups can help you see if your levels are moving in the right direction. 

Lifestyle changes can be a great help to get your levels back on track as well, exercising regularly, sleeping well, and cutting back on alcohol are just some of the ways that you can help yourself feel better. 

While testosterone replacement therapy can be life-altering for those with low testosterone levels, results can vary between individuals. Talk to your healthcare provider so that they can help guide you through the best treatment options.