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TRT - Testosterone Replacement Therapy

Testosterone replacement therapy (TRT), is a hormone replacement therapy often prescribed to counter the effects of male hypogonadism, or low testosterone production.

TRT can help men with low testosterone regain sexual function, support overall health and energy levels, as well as mood and mental function.

How Low Testosterone is Treated

When the body no longer produces sufficient amounts of testosterone, replacement therapy is an option.

The testosterone replacement is achieved by absorption through the skin (transdermal or topical) or direct injection (subcutaneous) into the muscle mass or under the skin.

Hormone delivery options include:

  • Skin patch (transdermal): A skin patch is similar to a nicotine patch. It’s worn on the arm or upper body, and is changed every day. The patch continually distributes testosterone in a controlled release through the day.
  • Mouth patch (transdermal): This “patch” is actually more of a tablet. It sticks to the upper gums near the incisor. The tablet slowly dissolves and must be replaced during the course of the day. Testosterone is delivered continuously to gum tissue.
  • Gels (topical): There are several brands of gels that may have different application methods. Testosterone is absorbed directly through the skin by applying the clear gel on your skin once a day, either the body or in the nose. Gels can also be applied using a pump that that dispenses testosterone in the amount prescribed by your doctor.
  • Injections and implants (Subcutaneous): Testosterone can also be injected directly into the muscles, or implanted as pellets under the skin. The pellets slowly dissolve releasing the hormone into the bloodstream.

The delivery method will be selected by the physician and patient.

Low-T Therapy Risks & Benefits

There are both benefits and risks associated with treating low testosterone. The figure below provides information on TRT’s impact on various health conditions that could be impacted by your course of treatment.

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Benefits of Low-T Therapy

The ideal outcome from TRT is to regain sexual function, energy and clarity of mind. Some men experience a strong change. Others get limited benefits.

Many men report improvement in energy level, sex drive, and quality of erections. Testosterone also increases bone density, muscle mass, and insulin sensitivity in some men.

Men also often report an improvement in mood from testosterone replacement. They may be able to focus better, and see improvements in memory and cognitive skills.

Testosterone Therapy Risks

Testosterone therapy can raise a man’s risk for blood clots and stroke. Uncommon side effects include sleep apnea, acne, and breast enlargement. All such side effects go away if treatment is stopped.

Men who use a testosterone gel should wash their hands thoroughly after applying a dose and make sure that no one else touches the spots where they medicate. If a woman or child comes into contact with testosterone gels, it can cause side effects in them – although this is a very rare occurrence.

To continue to benefit, a man with low testosterone must remain on it, and this poses some risk because the very long-term impacts are not fully known. Research over the past few decades has shown little evidence of a link between testosterone replacement therapy and prostate cancer. However, the question has not been entirely laid to rest.

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Frequently Asked Questions About Testosterone Replacement Therapy

How soon will I start to feel the effects?

Typically, men can start to feel a boost in mood, sexual function and energy levels within a month of treatment. Regaining muscle mass and strength may take longer, depending on your commitment to exercise.

Are there reasons why I shouldn’t try TRT?

We don’t recommend TRT for people with the following conditions:

  • Benign prostatic hypertrophy
  • Sleep apnea
  • Congestive heart disease
  • Prostate cancer or elevated prostate specific antigen
  • Severe urinary conditions
  • Studies have shown that testosterone replacement can worsen these conditions.
  • TRT can only benefit those who have low testosterone.
Are there any side effects from TRT?

There is insufficient research to fully understand the long-term effects of TRT. Low level side effects can include rash or itching where a gel or patch is applied. There are some concerns related to heart attack and stroke.

Though not empirically proven, there is concern that TRT might stimulate the growth of prostate cancer cells.

Medical providers agree that monitoring patients is an essential element of a responsible treatment plan.

Can I get TRT to help with weight lifting?

No. TRT is a clinical treatment for a medical condition. Individuals receiving TRT should not be taking any steroids or other muscle enhancers. Please make sure Dr. Steinberg is aware of all your prescription medications and over the counter supplements.

Is this male menopause?

Testosterone is classified as an androgen hormone. Declining testosterone levels are sometimes referred to an andropause. Like menopause in women, when men move past middle age, there are undeniable changes in their bodies and minds.

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