Testosterone Replacement Therapy (TRT)

If you have signs and symptoms of low testosterone that bother you, there are many choices for raising the levels. Not everyone chooses treatment. Testosterone replacement therapy (TRT) can be given using:

  • Skin gel
  • Shots
  • Long-acting pellets
  • Patches
  • Pills

The most common type is skin gel, which is used by about 70 out of 100 patients. The gel is rubbed onto your shoulders or upper arms after a shower. About 17 out of 100 patients use shots and 10 out of 100 use patches. About 3 out 100 patients use testosterone in other forms, such as patches or pellets placed in the body. At this time, pills are not approved for use in the U.S.
You should not take testosterone for non-medical reasons, such as body building, preventing aging changes or performance enhancement. Men should not take TRT if they have normal testosterone levels or if their testosterone levels have not been tested. If you have normal testosterone levels, using TRT will not help your health problems. Also, if you are trying to father a child, you should not be on TRT. TRT can decrease your sperm count and fertility.

Before you take TRT, a doctor who is skilled in diagnosing low-T should examine you carefully. Your doctor should not prescribe TRT without taking an in-depth health history and giving you a physical exam and blood tests. Many of the symptoms for low-T can be the result of other health problems. Other causes of symptoms need to be ruled out before testosterone is prescribed.

Before you start TRT, your doctor should talk to you about possible side effects. Side effects can include:

  • Acne (pimples)
  • Breast swelling or soreness
  • A high red blood cell count
  • Swelling of the feet or ankles
  • Smaller testicles
  • Infertility

If your doctor prescribes TRT, you should have regular check-ups. Your doctor should follow up with blood tests for testosterone level, PSA and hematocrit. (PSA is a test for prostate issues including prostate cancer. Hematocrit tests your red blood cell count.) Based on your health history, your doctor may want to follow up with other tests.

Discuss the benefits and risks of taking testosterone replacement therapy with your doctor. You should not be taking TRT if you do not have low levels of testosterone. You should understand the possible benefits, side effects and risks before you start taking TRT. You should also know that today's science does not offer final answers about whether taking TRT will increase your risk of prostate cancer or heart disease.