Testosterone replacement therapy (TRT) helps men with low testosterone levels (low T) feel like themselves again.
For many men, the symptoms of low T—including low sex drive, chronic fatigue, brain fog, and erectile dysfunction—are devastating. Low T is usually defined as having total testosterone below 300 ng/dL, but many men experience symptoms well above this level.
This is because men lose about 1% to 2% of their testosterone every year, often beginning in their 30s, possibly earlier: this is known as andropause and is an unavoidable consequence of aging.
If you and your healthcare provider have decided that TRT is the right choice for you, it's essential to understand what to expect as you begin your treatment journey.
The Benefits of TRT
Testosterone plays a crucial role in many aspects of male health, including muscle growth and strength, fat distribution, libido (sex drive), and mood.
When your testosterone levels are low, you may experience symptoms such as decreased sex drive, erectile dysfunction, fatigue, depression, reduced muscle mass, and increased body fat.
By restoring your testosterone levels to a healthy range, TRT can help alleviate these symptoms and improve your overall quality of life.
Within the first few months of starting treatment, many men report:
- Increased energy levels
- Enhanced sexual function
- Increased muscle mass and strength, particularly when combined with a regular exercise routine and a balanced diet
- Improved concentration and cognitive performance
- Reduced mood swings, depression, and anxiety
TRT can actually have a major impact on muscle mass and strength. Testosterone is a key anabolic hormone that stimulates protein synthesis and promotes muscle growth.
When your testosterone levels are optimized through TRT, you may find that you are able to build muscle more efficiently and recover more quickly from workouts. This can be especially beneficial for older men who may have experienced age-related muscle loss or decreased strength.
TRT vs. Illegal Steroids | Why TRT Is Incredibly Safe
It’s important to note that TRT is not in any way similar to illegal anabolic steroids. The amount of testosterone found in illegal steroids is often 10 times greater (sometimes much more) than what you’ll find in a normal dose of TRT and is combined with other dangerous substances.
Additionally, the bioidentical testosterone you receive from a clinic is created in a compounding pharmacy—in the US, these pharmacies operate under strict regulations and are required to maintain extremely high levels of sterility among other strong safety measures. Illegal anabolic steroids are under no such restrictions.
To put it simply, TRT has many decades of research behind it, has been approved by the FDA since the 1950s, and continues to be the gold standard for improving men’s hormonal health.
Not only is it safe, but it may even enhance your health—some studies have found that TRT may protect your heart from cardiovascular events.
Injections vs. Pellets: Understanding Your Options
There are several delivery methods available for TRT, including injections, gels, patches, and pellets. Two of the most common options are injections and pellets, each with its own advantages and disadvantages.
TRT Injections
Testosterone injections are typically administered intramuscularly on a weekly or bi-weekly basis. This method allows for greater flexibility in dosing and the ability to quickly adjust your treatment plan if needed.
Injections can be self-administered at home, which may be convenient for some men. However, injections can sometimes be painful, and some patients are not able to tolerate the sight of blood or needles.
TRT Pellets
TRT pellets are small, rice-sized implants that are inserted under the skin, usually in the hip or buttock area. Pellets provide a steady release of testosterone over several months, typically lasting between 3–6 months.
Testosterone levels tend to be more stable on pellets, and the method is much more convenient, only requiring you to go to the clinic a few times each year. Pellets also eliminate the need for self-injection and the associated pain and potential for error.
However, pellets require a minor surgical procedure for insertion and removal, which may not be suitable for all men.
The procedure is typically performed in a healthcare provider's office under local anesthesia and takes only a few minutes. Pellets are inserted through a small incision, which is then closed with surgical adhesive or stitches.
One drawback is that dosage adjustments with pellets are less flexible compared to injections, as the pellets continuously release a set amount of testosterone over an extended period.
If your testosterone levels are not optimally balanced, your healthcare provider may need to remove the pellets and insert new ones with an adjusted dosage.
Ultimately, the choice between injections and pellets will depend on your individual preferences, lifestyle, and medical history.
Your healthcare provider will work with you to determine the most appropriate delivery method for your needs, taking into account factors such as your age, overall health, and treatment goals.
Fertility Considerations
If you are considering starting a family or are concerned about your fertility, it's essential to discuss this with your healthcare provider before beginning TRT.
Testosterone replacement can decrease sperm production, which may impact your ability to conceive naturally. This effect is generally reversible once TRT is discontinued, but it may take several months for sperm production to return to normal levels.
In some cases, your provider may recommend alternative treatments or suggest freezing your sperm before starting TRT to preserve your fertility options.
They may also recommend a consultation with a reproductive endocrinologist or fertility specialist to discuss your options and develop a plan that balances your TRT treatment with your family planning goals.
It's important to note that while TRT can affect sperm production, it does not serve as a reliable form of male contraception—not all men lose their fertility, and the fertility loss is not predictable.
If you are sexually active and wish to avoid pregnancy, it's essential to use alternative forms of birth control, such as condoms or your partner's contraceptive method.
Committing to Your Treatment Plan
TRT is typically a long-term commitment. Once you begin treatment, stopping therapy may lead to a return of your low testosterone symptoms.
It's crucial to work closely with your healthcare provider to establish a treatment plan that works for you and to commit to regular follow-up appointments and monitoring.
During your follow-up appointments, your provider will assess your response to treatment, monitor for potential side effects, and adjust your dosage as needed. They may also recommend additional tests or screenings.
In addition to your TRT treatment, your provider may also recommend lifestyle changes to support your overall health and well-being. These may include regular exercise, a balanced diet, stress management techniques, and adequate sleep.
Incorporating these healthy habits into your daily routine can help optimize the benefits of your TRT treatment and improve your overall quality of life.
Is Testosterone Replacement Therapy Right for You?
If you're experiencing the symptoms of low testosterone and believe TRT may be right for you, the first step is to talk to a healthcare provider.
Learn more about testosterone replacement therapy here or schedule an appointment with a specialist today to discuss your options.