Is Testosterone Replacement Therapy Safe?
Introduction
Testosterone replacement therapy (TRT) is a medical intervention that raises and stabilizes hormone levels for men with low testosterone. The first hormonal treatments were developed and administered in the 1930s.
The nature and presentation of hormone loss differ from man to man due to the variation in their baseline testosterone levels. Thanks to a deeper medical understanding of the nature and role of testosterone and scientific advancements, there are now numerous effective and reliable forms of TRT.
As awareness of and access to the treatment improves, many men have broached questions about the treatment’s risks. The surging demand for TRT has also led to some sensationalist news coverage and misassumptions.
This article explains the treatment, what makes someone a good or bad candidate for it, and its potential side effects. Understanding the benefits and risks of TRT will help you have a productive conversation with your doctor and make the best decision for your health.
What is Testosterone Replacement Therapy?
Males require adequate levels of testosterone for proper health and function. The hormone influences sexual desire and performance, body composition, energy levels, mood, and overall wellness. When levels dip below the normal range, usually 300 ng/dL, men often begin experiencing symptoms of hormone loss.
Unfortunately, many individuals dismiss their symptoms as inevitable signs of aging. While gradual hormone decline is typical, TRT is appropriate once symptoms of testosterone loss manifest, regardless of age.
Low testosterone can lead to many physical and emotional symptoms whose severity depends on the extent of hormone loss. After confirming hypogonadism, or low testosterone, with blood tests and a straightforward discussion of the symptoms, the doctor will explain your treatment options.
TRT methods include injections into the gluteal muscle, topical creams, skin patches, and implantable pellets. The optimal treatment depends on the nature of your symptoms and the level of testosterone. These factors influence the dosage and frequency of TRT.
Many of the methods rapidly raise levels, leading to early symptom improvement. As your body adjusts to the increased hormones, the doctor will fine-tune the dosing to stabilize levels.
Who Should Do Testosterone Replacement Therapy?
Most men with low testosterone levels and at least one symptom will benefit from TRT. Monitoring yourself for signs is essential because gradual hormone loss leads to subtle changes that are easy to dismiss when viewed day-to-day.
Men who experience any of the following symptoms should consult a doctor to determine if they experience low testosterone:
Erectile dysfunction
Diminished or absent sex drive
Fatigue or an overall malaise
Loss of muscle mass
Increase in belly fat
Thinning or shedding hair on the head, face, or body
Mood changes, including anxious or depressed feelings
Irritability
Mental fogginess, including forgetfulness and trouble concentrating
Who Shouldn’t Do Testosterone Replacement Therapy?
Men without low testosterone or those with low testosterone who do not present symptoms should not receive TRT. The treatment does not benefit those with healthy levels or without symptoms.
Individuals with a history of prostate cancer should not have TRT. Those with other cancers should consult their oncologist. TRT may exacerbate heart, kidney, and liver disease.
It is essential to be forthcoming and comprehensive about your medical history during your TRT consultation. Your frankness ensures the doctor can rule out potential complications from TRT.
Most Common Side Effects of Testosterone Replacement Therapy
Every medical treatment carries the chance of side effects. Their occurrence and extent vary from person to person based on the form of TRT, individual biochemistry, and pre-existing health conditions. The most common side effect is oilier than normal skin and acne outbreaks. Some men experience swelling in the hands or legs due to fluid retention.
Shrunken testicles and lowered sperm count are also possible. It’s best to discuss the chances of developing these side effects with your doctor if you’re planning to father children while taking TRT.
Are There Any Serious Risks With Taking TRT?
TRT is generally safe and effective when prescribed and monitored by a qualified doctor. Risks significantly rise if you attempt to self-treat using testosterone purchased online or get the therapy from a gym or non-medical clinic.
While there are some anecdotal reports of increased risk of heart attack and stroke due to TRT, there is no medical consensus on the extent of the risks. Most of the available data is limited to studies of older men, a population with a higher risk of these events.
Alternatives to Testosterone Replacement Therapy
The primary alternative to TRT is modifying your lifestyle. Poor overall health depresses hormone levels. Losing weight, building muscle, quitting smoking, and reducing or stopping alcohol use can naturally raise testosterone levels.
Some studies show a diet high in lean proteins, nuts, and healthy fats enhances testosterone levels. Doctors recommend avoiding processed and sugary foods. Lifestyle modifications can also compound the positive effects of TRT.
Supplements including zinc, saw palmetto, ginger, and ashwagandha may help raise testosterone levels, though much of the evidence for their effectiveness is anecdotal.
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May 24, 2023
Written By
Jake Peter
Fact-checked By
Dr. Avidon Appel
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