Written by Kyle Hunt | BEXSci.
Fact checked by Andrew Lenau, ISSA CPT & Sports Nutritionist
FACT CHECKED
We may earn a commission on purchases made through links on this page at no cost to you. Learn More
Testosterone Replacement Therapy (TRT) has gained significant attention in recent years as a solution for the adverse effects of low testosterone. With promises of renewed energy, improved mood, and a reinvigorated zest for life, TRT has emerged as a popular option to address the challenges of aging.
However, amidst the growing interest, concerns about its safety have surfaced. Supplementing with testosterone has a bad reputation in society. The stigma around it is causing many to question whether TRT is a viable and safe long-term option.
In this article, we explore science and anecdotal expertise on the safety and benefits of TRT. We will delve into the fundamental aspects of testosterone, its crucial role in the body, and why hormone therapy might be the right path toward a healthier, more vibrant life.
Table of Contents:
- What Is Testosterone?
- What Is TRT?
- When To Start TRT
- What To Expect On TRT
- Is TRT Safe?
- How Much TRT Is Safe?
- Who Shouldn't Start TRT
- FAQs
What Is Testosterone?
First, let's start with a quick breakdown of testosterone. Testosterone is a hormone found in both men and women but is more commonly known as the male hormone. It's responsible for male traits like facial hair, deep voice, and muscle growth. It also helps maintain bone strength and energy levels.
As people age, their testosterone levels naturally decrease, causing problems like low sex drive, fatigue, and reduced muscle mass. When someone has significantly low testosterone levels, it's called male hypogonadism.
What Is TRT?
Testosterone Replacement Therapy (TRT) has recently become a popular medical treatment to help people with low testosterone. The therapy involves supplementing with extra testosterone to bring their levels back up to normal. TRT can be administered through injections, gels, patches, or pellets.
TRT is best used under the guidance of a qualified healthcare professional. With the proper guidance, it has shown to be generally safe and effective. That said, it is only suitable for some. As with most drugs, there are potential side effects to consider.
When To Start TRT
Determining when to start testosterone treatment is tricky. Many symptoms of low T could be caused by poor lifestyle choices and not low testosterone.
For starters, TRT is primarily intended for men, but women can take it too. And because t-levels diminish with age, it's most commonly used by older folks. Some research suggests TRT should be recommended for men over 651.
However, initiating testosterone therapy should not be based solely on age. Younger adults can suffer from low testosterone too. It comes down to symptoms. If you are experiencing fatigue, low libido, reduced physical performance, etc., the next step is to have a blood test. The blood work will confirm low testosterone is causing the symptoms and not something else.
Beyond restoring health, some bodybuilders and athletes utilize testosterone therapy to boost muscle development and performance. You can learn more about this in our article: The Ultimate Guide To Using TRT For Bodybuilding.
The benefit of working with a TRT clinic is receiving a prescription for pharmaceutical-grade testosterone. The drug obtained from a pharmacy is of better quality than most illicit testosterone. Keep in mind a reputable hormone replacement therapy clinic will not prescribe you testosterone unless you need it.
As beneficial as TRT can be for some people, it's not for everyone, specifically those with prostate or breast cancer, severe sleep apnea, or untreated heart issues.
What To Expect On TRT
When starting testosterone therapy, it's important to understand what to expect and how it may impact you. In the next couple of sections, we will explore the effects of TRT.
While responses to TRT can vary among individuals, expected outcomes include increased energy, improved mood, enhanced libido, and gains in muscle mass. And, you can see some real-life outcomes using TRT in our article: TRT Before And After: What To Expect & Real-Life Outcomes.
We will get into some of the potential side effects, too.
TRT Benefits
Above all, research on TRT shows it increases testosterone back to physiologic levels. So, it does what it is supposed to on the hormone front. However, does that make a difference in improving symptoms caused by low T?
Research shows it does. TRT improves libido, erectile dysfunction, overall sexual function, and mood. It also increases energy and bone mineral density, decreases body fat, and increases muscle mass2.
Here is what one Reddit user had to say about what to expect on TRT:
"I'm 40. Had repeated low t tests and tons of the typical symptoms - the depression was the worst. Been on just about 7 weeks. Feel WAAAY better in nearly every way: libido, improved gym strength/endurance/recovery, much less irritable with the kids and wife, better mood all around and much less depressed, just to name a few. No sides yet." (source)
Let's break down the benefits further:
- Increased Energy: One of the initial benefits of TRT is increased energy levels. Individuals often report feeling more energized and less tired, which can lead to improved productivity and a better quality of life.
- Improved Mood: TRT can positively impact mood and emotional well-being. It may help reduce irritability, sadness, and mood swings associated with low testosterone levels. It's common for people to notice increased confidence as well.
- Enhanced Libido: TRT can improve sexual desire and libido, as well as erectile dysfunction, addressing one of the common symptoms of low t in men.
- Muscle Mass and Strength: TRT may promote increased muscle mass and improved muscular strength. This effect is especially notable in individuals who lift weights.
- Fat Loss: TRT can lead to changes in body composition, such as reducing body fat. If you combine TRT with a sound diet, you can expect drastic changes to your physique.
- Bone Density: Testosterone plays a role in maintaining bone density. TRT can help slow down bone loss and reduce the risk of breaks, particularly in older individuals with low testosterone levels.
To further dig into the pros of TRT, head to our article on the 8 Best TRT Benefits!
TRT Side Effects
You might experience some initial side effects when you start testosterone therapy but don't worry. They are usually temporary. Plus, not everyone will have these effects.
Some initial side effects include swelling or bloating, mood changes like irritability or sensitivity, and skin sensitivity or tingling. TRT can also impact your sleep, making falling or staying asleep challenging, and some report obstructive sleep apnea. While TRT aims to improve sexual function, some men may have temporary changes in libido or erectile function.
Occasionally, you might notice mildly swollen or tender breasts, but that usually goes away too. Another thing you might see is feeling hungrier than usual. As long as you eat a healthy diet, this is not a problem.
Mild acne is another side effect. One Reddit user had this experience:
"One downside for me is chest acne. I've been taking it for nine months, and it suddenly started. Being very proactive with it now. Just so you know, I've never had chest acne before this. Only downside for me." (source)
Remember to talk openly with your healthcare provider during your treatment, so they can address any concerns and ensure that TRT is working safely and effectively for you. Regular check-ins and blood tests are essential to ensure that TRT provides the necessary benefits.
Serious Risks And Long-Term TRT Side Effects
Like any drug, TRT can have risks and long-term side effects that you should be aware of. These potential risks include an increased chance of cardiovascular disease like heart attacks and strokes, especially in older men or those with existing heart conditions.
TRT can also cause the prostate gland to grow, leading to urinary problems in some men. Blood clots are another potential risk, which can be dangerous if they travel to organs like the lungs.
Long-term use of TRT may affect natural testosterone production and reduce sperm count and fertility in men. Some forms of TRT, like oral testosterone, may pose a risk of liver toxicity.
Additionally, TRT can increase the amount of red blood cells, thickening the blood and potentially contributing to cardiovascular risks. One way to prevent this from becoming an issue is by regularly donating blood.
Mood changes, sleep apnea, and other side effects are also possible with TRT. However, not everyone will experience these effects, and the severity may vary among individuals.
Of course, this all sounds bad. But, living with low T also has health concerns beyond its associated symptoms. Research shows the health risks associated with untreated hypogonadism include an increased risk of all-cause mortality, coronary artery disease, and stroke3.
Working closely with a TRT clinic mitigates most of the adverse side effects. A clinic will monitor your progress, adjust the treatment plan, and address problems to ensure TRT's safe and appropriate use. To help you find a safe, experienced clinician to guide you through the process, we've compiled a list of the 8 Best Online TRT Clinics.
Is TRT Safe?
If you meet the criteria for needing TRT, in general, it is safe. But, working with an experienced practitioner plays a crucial role in its safety. In fact, hands down, the safest way to start testosterone therapy is by working with a clinic. Getting TRT from a doctor typically involves several steps to ensure safe and effective treatment.
Here's a general outline of what you might expect:
- Research: The first step is research to find the best TRT clinic for you. To help you, we have a detailed article called Where To Buy Testosterone Online that will help you learn more about the process.
- Initial Consultation: Schedule an initial consultation once you find the clinic you want to work with. During this visit, you will discuss your symptoms, medical history, and any concerns you might have related to low testosterone levels.
- Blood Test: To determine if you have low t levels, the clinic will conduct blood tests to measure your hormone levels accurately. These tests will help confirm if you are a suitable candidate for TRT.
- Diagnosis and Treatment Plan: After reviewing your medical history and test results, the healthcare provider will diagnose whether you have low testosterone and discuss TRT's potential benefits and risks. They will create a personalized treatment plan tailored to your specific needs.
- Prescription: If TRT is deemed appropriate for you, the clinic will provide you with a prescription for testosterone medication. Depending on the healthcare provider's recommendation, the drug may be injections, gels, patches, or pellets.
- Follow-up Appointments: Regular follow-up appointments will be scheduled to monitor your progress on TRT. These appointments are essential to assess how well the treatment is working for you, adjust the dosage if necessary, and address any concerns or side effects that may arise. Throughout your TRT journey, the clinic's healthcare team will be there to answer questions and provide support whenever needed.
If you need help deciding what TRT clinic to work with, I recommend Fountain TRT, a premium TRT clinic that was started to ensure patients suffering from low T get the care and attention they deserve. It was co-founded by Dr. Doron Stember, who specializes in treating patients with low T, so you know you'll be in good hands.
We help men boost their testosterone up to a healthy, normal level using testosterone therapy. With our online doctor’s visits, treatment is a breeze. Start your personalized evaluation...
If you're ready to start your TRT journey, begin by filling out Fountain's online TRT evaluation, which includes a testosterone test, followed by a 1-on-1 video call with a Fountain provider to discuss your results.
How Much TRT Is Safe?
The correct dosage of testosterone treatment varies for each person. Your healthcare professional will determine your initial dose based on age, hormone levels, and medical history.
However, it usually takes some time to get the dosages dialed in. You might have to undergo trial and error to get the best results. That said, the longer you are on the drug, the more data you and your doctor have to get it right.
TRT aims to achieve optimal testosterone levels to improve symptoms without causing harm. For safety, typically, you want to start with the lowest effective dose. From there, the healthcare provider closely monitors the response and adjusts as needed.
The dosage depends on the specific form of testosterone replacement products used. As mentioned, it's given through injections, gels, patches, or pellets.
- Injections: Typically, injections are given once every seven to fourteen days. Depending on the individual's needs, the dosage can range from 50 to 200 mg per injection4.
- Gels and Patches: Dosages for topical gels or patches may vary, but they usually provide a more consistent release of testosterone over time. The specific dosage will depend on the concentration of the gel or patch.
- Pellets: Pellets are small, subcutaneous implants that gradually release testosterone over several months. Dosages are based on the number and strength of the pellets implanted.
It's crucial to follow your healthcare provider's recommendations and not self-adjust TRT dosages, as it can be risky. In general, a clinic will keep the dosage of TRT within the range that maintains testosterone levels in the mid to upper-normal range for the individual's age and sex.
This is another reason why regular follow-ups and open communication with the provider are essential to ensure both results and safety.
Who Shouldn't Start TRT
Any male with comorbidity that makes testosterone use or TRT an increased risk should know the dangers. The big one is prostate cancer. If you have prostate cancer, TRT can make it worse. There is also a possibility that it can increase your risk of prostate cancer. The same goes for benign prostatic hyperplasia, polycythemia, and sleep apnea5.
Additionally, it doesn't make sense for people with normal testosterone levels. Starting TRT when testosterone levels are already within the normal range is unnecessary and could lead to potential side effects and health risks.
Along the same lines, TRT is generally not recommended for younger men whose bodies are still developing and have sufficient natural testosterone production.
People with severe heart, liver, or kidney problems may also not be suitable candidates for TRT due to the associated risks.
Women of childbearing age should not undergo TRT as it can disrupt their natural hormone balance and lead to potential fertility issues. Similarly, men who plan to have children and maintain fertility should explore alternative options, as one of the risks of testosterone use is decreased sperm production.
FAQs
Here are a few answers to popular questions surrounding the safety of TRT.
Does insurance cover TRT?
The coverage of testosterone therapy by insurance varies depending on the insurance plan and the specific medical necessity. However, most insurance plans cover TRT if prescribed for medically confirmed low testosterone levels and deemed necessary by the healthcare provider. Learn more about this in our article: How Much Does TRT Cost?
Is TRT steroids?
TRT involves the administration of testosterone, which is a natural hormone produced in the body. While testosterone is classified as an androgen steroid hormone, TRT is not the same as using anabolic steroids for performance enhancement or bodybuilding purposes. TRT is a medically supervised treatment for individuals with testosterone deficiency and related symptoms.
Does TRT help with weight loss?
Testosterone therapy significantly impacts body composition, including losing fat and building muscle. However, its effect on body weight may vary among individuals. For one, it depends on your starting body composition. If you have fat to lose, testosterone will help with weight loss. On the other hand, if you are skinny, it will help you pack on muscle and gain weight. Secondly, your diet plays a huge role as well. We talk about this in more detail in our article: Does Testosterone Help You Lose Weight?
Does TRT raise blood pressure?
In some cases, TRT may cause a slight increase in blood pressure. However, the effect on high blood pressure is usually minimal and not a concern for most individuals. Healthcare providers closely monitor blood pressure during testosterone therapy to ensure safety.
At what age is TRT recommended?
TRT is generally recommended for individuals with medically confirmed testosterone deficiency, regardless of age. However, it is more common for older individuals to experience symptoms of low testosterone. Testosterone therapy for younger individuals is typically only prescribed if they have specific medical conditions leading to low testosterone.
Is it safe to take TRT for life?
Long-term testosterone therapy is necessary for most users. The safety of extended TRT use depends on individual factors, including health, medical history, and dosage management. Regular monitoring and follow-up blood work are essential for TRT's continued safety and efficacy.
Limiting Testosterone Therapy Risks
The safety of Testosterone Replacement Therapy is critical for those exploring this treatment option. And with the amount of mixed information available, knowing who to trust can be challenging.
While TRT can benefit those with low testosterone, it is a drug. Like most drugs, there could be complications if used irresponsibly. However, when used as intended, TRT can be a valuable tool in restoring hormonal balance and enhancing overall well-being and quality of life.
The key to a safe and positive TRT experience is ensuring the right people are in your corner. To help you on your TRT journey, we've done the research for you. Now all that's left is for you to decide which of these 8 Best Online TRT Clinics is the perfect fit for you!
We help men boost their testosterone up to a healthy, normal level using testosterone therapy. With our online doctor’s visits, treatment is a breeze. Start your personalized evaluation...
References:
- Shin, Y. S., & Park, J. K. (2019). The Optimal Indication for Testosterone Replacement Therapy in Late-Onset Hypogonadism. Journal of Clinical Medicine. https://doi.org/10.3390/jcm8020209
- Grech, A., Breck, J., & Heidelbaugh, J. (2014). Adverse effects of testosterone replacement therapy: An update on the evidence and controversy. Therapeutic Advances in Drug Safety. https://doi.org/10.1177/2042098614548680
- Jia, H., Sullivan, C. T., McCoy, S. C., Yarrow, J. F., Morrow, M., & Borst, S. E. (2015). Review of health risks of low testosterone and testosterone administration. World Journal of Clinical Cases : WJCC. https://doi.org/10.12998/wjcc.v3.i4.338
- Osterberg, E. C., Bernie, A. M., & Ramasamy, R. (2014). Risks of testosterone replacement therapy in men. Indian Journal of Urology : IJU : Journal of the Urological Society of India. https://doi.org/10.4103/0970-1591.124197
- Barbonetti, A., & Francavilla, S. (2020). Testosterone replacement therapy. Andrology. https://doi.org/10.1111/andr.12774
Kyle Hunt
Author