For men with low blood testosterone levels and symptoms most likely caused by a low level, the benefits of hormone replacement therapy usually outweigh potential risks. For men who clearly have testosterone deficiency, there is no apparent increased risk of heart attack or stroke or greater chance of developing a new prostate cancer from testosterone replacement therapy. Hall scheduled an appointment with a specialist, and in 2024 started testosterone replacement therapy (TRT)—receiving regular small doses of the hormone that’s almost synonymous with male health. Hormone replacement therapy (HRT) is often the first-line treatment for low testosterone levels in women.
These methods include transdermal patches and gels, oral capsules, intranasal testosterone, long-acting intramuscular injections, subcutaneous injections, and testosterone implants. Since 2000, many options are available to deliver testosterone to correct testosterone deficiency. Men with testosterone deficiency should be replaced with testosterone unless there are contraindications or near-term fertility is desired. These agents have no effect in patients with complete deficiency of LH and FSH or those with primary testicular failure causing testosterone deficiency. LH stimulates testosterone production by the Leydig cells in the testis and together with FSH stimulates spermatogenesis. Partial estrogen antagonists (e.g., clomiphene) and selective estrogen receptor modulators (SERMs, e.g., tamoxifen) bind to the estrogen receptors and decrease the effects of estrogens on target tissues.
However, the wisdom and effectiveness of testosterone treatment to improve sexual function or cognitive function among postmenopausal women is unclear. Testosterone may stimulate the prostate gland and prostate cancer to grow. The most common example is probably prostate cancer. As surprising as it may be, women can also be bothered by symptoms of testosterone deficiency. Also, as men get older, their livers make more sex hormone binding globulin (SHBG), which binds to testosterone circulating in the bloodstream. In fact, as men age, testosterone levels drop very gradually, about 1% to 2% each year — unlike the relatively rapid drop in estrogen that causes menopause.
We also discuss how to adjust the dose of testosterone replacement depending on the method used for testosterone replacement, goals of testosterone replacement, and patient preferences. Older observational studies suggested that long term testosterone use could increase their risk of cardiovascular disease. Doctors also watch out for high red blood cell counts, which could increase the risk of clotting. Men can often feel a big difference when they stop therapy because their body's testosterone production has not yet recovered. On treatment, the body stops making testosterone. Men get started on testosterone replacement and they feel better, but then it's hard to come off of it. Testosterone replacement therapy may be an option for you.
Find out more about natural ways to boost testosterone here. If any individual takes medications they believe lowers testosterone, they should consider discussing this with their doctor. However, a 2021 study suggests that TRT may improve total cholesterol levels.
Although this new information is somewhat reassuring, men and their doctors should still weigh these issues before committing to long term testosterone therapy. A relatively small number of men experience immediate side effects of testosterone supplementation, such as acne, disturbed breathing while sleeping (worsening sleep apnea), breast swelling or tenderness, or swelling in the ankles. If a man's testosterone is below the normal range, it's best to repeat it once more to be sure before starting testosterone therapy - often staying on it indefinitely. General fatigue and malaise has so many other causes, and when most men get a blood test, the result is a normal testosterone level. Together, you and your healthcare provider will weigh the risks and benefits of TRT to see if it could help. If symptoms of low testosterone are interfering with your quality of life, know that you don’t have to just grin and bear it. Research has also studied the increased risk of venous thromboembolism, and the results are mixed.
These positive results have led to a drastic increase in the use of testosterone replacement for men with symptomatic hypogonadism, though long-term data is lacking on the safety. Testosterone replacement therapy (TRT) is a widely used treatment for men with symptomatic hypogonadism. Checking testosterone levels is as easy as having a blood test. Some men and women experience immediate side effects of testosterone treatment, such as acne, disturbed breathing while sleeping, breast swelling or tenderness, or swelling in the ankles. However, many men with normal testosterone levels have similar symptoms, so a direct connection between testosterone levels and symptoms is not always clear.

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