Low testosterone levels — sometimes called “low T” — occur when the testes do not produce enough of the primary male sex hormone, testosterone. Total testosterone levels generally decline as men get older, declining each year after 30 years of age, so many older men have low testosterone levels. In fact, nearly 4 to 5 million men in the United States have been diagnosed with low testosterone.
Low levels of testosterone can have an effect on a man’s mental and physical health and well-being. Fortunately, there is a solution. Testosterone replacement therapy (TRT) can help restore testosterone levels to a normal, healthy range.
Read on to learn more about TRT, and the importance of monitoring your health while you are on this life-changing therapy.
What Are the Symptoms of Low Testosterone?
The American Urology Association defines low blood testosterone as less than 300 nanograms per deciliter (ng/dL). Testosterone deficiency — or low testosterone — can cause a number of symptoms in men, including:
- Decreased body hair
- Erectile dysfunction
- Hot flashes
- Increased body fat
- Low sex drive
- Reduced muscle mass
- Sleep apnea
In addition to these symptoms, low testosterone levels can cause health problems and lead to certain diseases, including diabetes, metabolic syndrome, obesity, and heart disease. Treating low testosterone with testosterone replacement therapy is imperative to restore your health, wellbeing, and vitality.
What Is Testosterone Replacement Therapy?
Testosterone replacement therapy (TRT) — or androgen replacement therapy — is a form of hormone therapy that doctors give to men who have testosterone deficiency. It is often prescribed to reduce the effects of male hypogonadism, which results from the testes producing insufficient amounts of testosterone.
Testosterone replacement therapy helps to restore the levels of testosterone in the blood, reversing symptoms. There are different delivery methods for TRT, with injections being the most common.
TRT can be administered in the following ways:
- Injectable. The most common form of TRT, short-acting injections are typically given every 1-2 weeks. These short-acting injections are administered subcutaneously (under the skin). For long-acting treatment, injections may be given every 2-10 weeks. These are typically administered intramuscularly in the glutes. The dosage and frequency of TRT injections depend on the severity of the deficiency and your overall health.
- Topical. Testosterone gels and creams can be applied directly to the skin on a daily basis. Absorption through the skin can help increase testosterone levels.
- Transdermal patches. Patches are also available and can be applied to the skin and stay in place for a full 24 hours until the patch is replaced with another the following day. Transdermal patches run the risk of causing adverse skin reactions, such as rash or irritation.
- Oral. Oral testosterone via capsules or tablets is less common, as it is expensive and long-term use may lead to liver damage. Only those who cannot use other delivery methods of TRT should take testosterone orally.
- Intranasal. This delivery method involves applying a testosterone gel inside the nose approximately 3 to 4 times a day (every 6-8 hours).
Millions of men in America have been prescribed testosterone replacement therapy to restore their testosterone levels within a healthy, normal range. Men who use TRT may notice improvements in their energy levels, sexual function, mood, cognitive function, and overall health and wellbeing.
How Does Testosterone Replacement Therapy Monitoring Work?
Before you begin TRT, your doctor will evaluate your baseline health through a physical examination and bloodwork. This allows your healthcare provider to establish your current testosterone levels and overall health before starting TRT. This initial data will be used to track how your body responds to TRT and monitor your health while on the therapy.
Most doctors will want to see you once every three months once you begin therapy.
This generally involves bloodwork to determine how well the TRT is working for you so your doctor can make adjustments to your dosage and delivery methods if needed.
Monitoring when you begin TRT may involve:
- Assessment before TRT begins. This will involve the doctor asking about your symptoms, checking your blood pressure, doing a physical examination, and ordering blood tests.
- Lab work. Complete blood count, testosterone levels, and prostate-specific antigen (PSA) tests will be conducted at least on a quarterly basis.
- Annual check-ups. This will involve a trip to the doctor for a physical exam, a full blood panel, discussing your symptoms, any side effects you’re experiencing from TRT, and any health concerns you have.
Your monitoring schedule may look a little different, depending on your situation and health status. If you’re at higher risk for certain health conditions, for example, you may require more frequent monitoring to detect any potential risks early on.
At Elite HRT, our providers will work with you to determine a monitoring schedule that is convenient for you and tailored to your specific needs.
What Is Monitored While on TRT?
While you’re on testosterone replacement therapy, you will be monitored to ensure the TRT is working as it should and you are in good health.
While your doctor may order additional tests, you can expect the following to be monitored:
- Blood pressure
- Side effects from TRT
- Symptoms of low testosterone
- Testosterone levels
- Hematocrit or red blood cell counts to monitor stroke risk
- White blood cell counts
- Prostate-specific antigen or PSA levels, which can contribute to prostate cancer
Your doctor may order additional tests, depending on your health. If you are diagnosed with a health condition that is not related to TRT while on the therapy, be sure to talk to your provider. They may need to adjust your dose, depending on your diagnosis and how it may interact with testosterone therapy.
How Do I Prepare For Blood Work?
When you’re on TRT, you will be monitored by a healthcare professional to ensure you are on the correct dosage and are not experiencing any adverse side effects from the therapy.
You’ll likely need blood work on a quarterly basis in order to track your progress and so your doctor can address any health concerns early before they progress.
You can expect the following for your routine blood work:
- Consistent timing. In order to consistently monitor your testosterone levels, your healthcare provider will want to take blood at the same time of day each time you go. This is typically morning between 8-11 am. Drink plenty of fluids to make your blood draw go more smoothly.
- Fasting before blood draws. Your provider may ask you to fast before your blood draw. This means you will need to stop eating after midnight and then only have water in the morning of your lab work. If you take medications in the morning, check with your doctor to ask if you should take them or wait until your blood has been drawn.
What Is Dosage Optimization?
Your testosterone replacement treatments will be closely monitored by a healthcare professional. This is to ensure you stay healthy on treatment but also to ensure you are on the correct dosage.
Regular blood work can help your doctor determine the best dosage for you to help you maintain healthy testosterone levels. Your doctor can increase or decrease your dose to help you feel your best and get your levels within a normal range.
Is TRT Safe?
If you have low testosterone levels, TRT is generally safe. However, it’s important to understand that it may cause side effects.
TRT side effects may include:
- Benign prostatic hyperplasia (enlarged prostate gland)
- Chest pain
- Deep vein thrombosis
- Difficulty breathing
- Low HDL (“good”) cholesterol levels
- Sleep apnea
- Swelling in hands and/or legs
Talk with your doctor if you are experiencing side effects as a result of TRT. They may adjust your dosage if needed to avoid high testosterone levels.
TRT is approved only for men who have been diagnosed with low testosterone levels. It should only be used under the guidance and supervision of a medical professional. TRT should not be used by men without hypogonadism, such as athletes or those looking to boost muscle mass or energy levels.
If you have low total or free testosterone levels, TRT can be a life-changing treatment that can help you gain back your vitality and let you live life the way you want to.
Testosterone replacement therapy is an excellent therapeutic treatment for men who have low testosterone levels. TRT can help restore your testosterone levels to a healthy range, which can improve your energy levels, increase your sex drive, help you gain muscle mass and lose fat, and help you have a more balanced mood.
Our experienced healthcare professionals here at Elite HRT are here to help you restore your strength, energy, and health.
Contact us today to get started on your customized TRT program. We’ll follow up to ask you about your symptoms and get your assessment started to determine if TRT is right for you.
What Is Low Testosterone? | Urology Care Foundation
Update for Men on Testosterone Replacement Therapy (TRT) | Urology Care Foundation
Screening and Monitoring in Men Prescribed Testosterone Therapy in the U.S., 2001–2010 |NCBI