Many men start to feel tired, lethargic, and lose interest in sex as they age. Some people think, "Oh... this is just normal as we get older." But that doesn't always have to be the case. Sometimes, these symptoms can be caused by a decrease in the male hormone testosterone in your body. Testosterone Replacement Therapy, or TRT for short, is a treatment for such a condition. So today, let's talk about everything in simple terms.
What is TRT? Who really needs it?
Simply put, TRT is a method of restoring testosterone levels in a man who has low testosterone levels due to some medical reason by administering exogenously produced testosterone hormone.
But here's something very important. This treatment is only approved for people with a medically diagnosed condition, called hypogonadism . This condition can be caused by a problem with one of the following organs involved in testosterone production:
- Testicles
- Pituitary gland
- Hypothalamus
For example, chemotherapy or radiation therapy for cancer can damage these organs. Or the problem can occur due to a genetic condition.
Most importantly, TRT is not approved for use as testosterone levels naturally decline with age. It is also not recommended for use for things like bodybuilding. It can be dangerous.
Also, some people are not suitable for this treatment at all. For example, TRT is not recommended for people with conditions such as prostate cancer or heart failure.
What happens before treatment begins?
Before you start TRT, your doctor will first make sure that you really have low testosterone levels and what is causing it. They will also check to see if this treatment is safe for you. This will include asking about your complete medical history, doing a physical exam, and possibly doing some blood tests, such as:
- Two morning testosterone tests: Confirm the diagnosis.
- Hemoglobin and hematocrit levels.
- Liver function tests.
- Luteinizing hormone test.
- PSA (prostate-specific antigen) test: Learn about prostate health.
- Prolactin hormone test.
Your doctor will consider all of this and decide whether TRT treatment is right for you or not.
What are TRT treatments? How does it work?
During TRT treatment, you are given synthetic testosterone, which can significantly improve your symptoms, such as low sex drive and erectile dysfunction.
But remember, TRT doesn't cure the underlying cause of low testosterone. What's really happening is that the hormones you're taking stop your testicles from producing testosterone naturally. That means you'll need to keep taking the medication to keep your hormone levels in check. If you stop treatment, it will take some time for your body to start producing testosterone again.
There are several ways to deliver TRT treatment. Together, you and your doctor can choose the method that works best for you.
| Treatment method | How to use and what to know |
|---|---|
| Skin gels | Apply to clean, dry skin every day. Most importantly: Do not let the gel come into contact with anyone else's skin (especially women or children) while it is still wet. |
| Intramuscular injections | It is injected into a muscle once a week or two weeks. Some long-acting vaccines can be injected every 10 weeks, but this must be done at a medical center. |
| Subcutaneous injections | An injection injected under the skin once a week. |
| Patches | You have to apply it to your skin every day. You have to change the place you apply it to to avoid skin allergies. |
| Pellets | Every 3-6 months, a doctor inserts several small pills under the skin. These release hormones at a steady rate over a long period of time. |
| Nasal gel | You should apply the gel to both nostrils three times a day. |
| Oral pills | A pill to be taken twice a day. |
After you start treatment, your doctor will check you regularly. You may need to have blood tests again to check for things like testosterone levels and changes in your blood.
What are the benefits and possible side effects of TRT?
TRT treatment can provide you with several benefits. However, like all medications, it carries a risk of side effects.
Benefits
- Improved sexual function and desire.
- Increase in lean body mass.
- Increased bone mineral density.
- Improved mood and energy levels.
- Feeling good about life overall.
Side Effects
- Acne or oily skin.
- Ankle swelling due to water retention in the body.
- Difficulty urinating due to prostate stimulation.
- Enlarged or painful breasts (Gynecomastia) .
- Worsening of sleep apnea .
- Small size of the testicles.
- Decreased sperm count and resulting infertility .
- Increased PSA levels in blood tests.
- Blood thickening due to an increase in the number of red blood cells.
This is why it is essential to undergo this treatment under the supervision of a doctor.
How long does it take to see results? Can this be stopped?
It may take a few weeks to notice changes in your body and mind after starting TRT. This varies from person to person. If your symptoms don't improve after about 3 to 6 months, your doctor may recommend stopping the treatment. This is because low testosterone may not be the cause of your problem.
Yes, you can stop TRT at any time. If you can't tolerate the side effects, if you don't get results, or if you develop another condition that makes it dangerous for you, you can stop treatment. But after you stop, your hormone levels will go back to their previous low levels.
Who is TRT not good for?
TRT treatment can be dangerous for people with certain health conditions. TRT is not recommended if you have any of the following conditions:
- Untreated heart failure.
- Untreated obstructive sleep apnea.
- If you have had a heart attack or stroke within the last 6 months.
- If you have prostate cancer or male breast cancer.
- If you are hoping to have children in the future. TRT is not suitable for those hoping to have children, as it can reduce sperm count and cause infertility.
Take-Home Message
- TRT is not a magic anti-aging or body-beautifying drug. It is a treatment for a specific medical condition, such as hypogonadism .
- Only your doctor can decide whether or not to start this treatment. He or she will perform all the necessary tests to make that decision.
- TRT has both benefits and risks of side effects, so it is essential to undergo this treatment under the constant supervision of a doctor.
- This is usually a long-term treatment. If you stop, your hormone levels will return to normal.
- If you think you have symptoms of low testosterone, don't be shy about it and talk to a doctor. That's the best thing you can do.
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