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What Is Testosterone Replacement Therapy? (TRT Benefits)

Connor Sellers
Published by Connor Sellers
Fact checked by Donald Christman, BHSc FACT CHECKED
Last updated: September 24, 2022

Adult men with low testosterone levels report signs of chronic fatigue, decreased sexual desire, and weight gain, prompting them to undergo testosterone replacement therapy (TRT).

However, some of my fitness clients who used prescription testosterone gel and injections reported cardiovascular problems and worsening of their heart disease symptoms, leading me to conduct research and investigation.

This article will explain what testosterone replacement therapy is, why it is used, the risks it entails and whether it is a safe solution to increase your testosterone level.

Let's begin.

Quick Summary

  • Testosterone replacement therapy, alternatively called androgen replacement therapy, is a hormone treatment that exogenously supplements or replaces testosterone.
  • TRT is primarily used to treat low bioavailable testosterone levels associated with muscle loss, sexual dysfunction, and poor health.
  • TRT can be a safe and effective testosterone treatment option with proper medical advice and supervision.

Importance of Testosterone Treatment

doctor using a syringe

Testosterone treatment is aimed at enhancing muscle growth, sex life, and overall well-being by restoring low testosterone to normal levels.

Unlike anabolic steroids, which contain testosterone in high doses for rapid muscle building, testosterone prescription medication aims to normalize hormone levels in men diagnosed with low serum testosterone levels or male hypogonadism [1].

Testosterone treatments are critical for addressing low T symptoms, which include:

  • Low sex drive
  • Increased body fat
  • Loss of muscular strength
  • Mental disorders
  • Persistent exhaustion

When testosterone deficiency is left untreated, free testosterone levels can get too low, leading to depression and severe conditions like low bone density and heart disease risk [2] [3].

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Benefits Of Testosterone Therapy

Testosterone therapy can provide many potential benefits to men with symptoms of low testosterone, including:

  • Increased bone mineral density
  • Increased lean muscle mass
  • Improved insulin sensitivity
  • Increased energy and sex drive
  • Improved erectile function

Research suggests testosterone therapy may help preserve bone strength by stimulating bone turnover, repair, and regeneration [4].

Also, treatment with testosterone was shown to increase lean body mass and total body strength significantly. However, several studies reported varying magnitude depending on which testosterone preparation was used, such as injections, gels, or pills [5].

Recent studies revealed that hormone therapy might also improve men's mild erectile dysfunction (ED). Furthermore, a study of men who took prescription testosterone showed positive results, including increased social energy and sexual interest [6] [7].

Lastly, testosterone therapy improves insulin sensitivity, prevents diabetes mellitus and cardiovascular disease, and suppresses the inflammation marker serum hsCRP, lowering chronic inflammation [8].

Risks Of Testosterone Replacement Therapy

man with oxygen and another in chest pain

The common side effects of testosterone therapy are rash, itching, and irritation.

Furthermore, the FDA Drug Safety Communication mandated a warning on all testosterone products stating that there is evidence of increased dangers of heart attack and stroke following testosterone therapy prescription in men [9] [10].

"Because of the marketing, men have been flooded with information about the potential benefit of fixing low testosterone, but not with the potential costs. Men should be much more mindful of the possible long-term complications."

- Dr. Carl Pallais, Endocrinologist, Assistant Professor of Medicine at Harvard Medical School

According to experts, the risks of long-term testosterone therapy are shown to aggravate a few specific health conditions, including:

Benign Prostatic Hyperplasia (BPH)

Some studies have demonstrated that testosterone supplementation increases prostate size by 12 percent, but recent evidence indicates that increased prostate size is not associated with worsening BPH [11].

Furthermore, older men on testosterone therapy may have increased total prostate volume, but this increase is comparable to prostatic hypertrophy that occurs with time regardless of T levels [12].

Prostate Cancer

man with his hands on his pants

Earlier studies have established that testosterone therapy increases men's risk of prostate cancer, prompting some physicians to exercise caution when prescribing testosterone to male patients at higher risk.

However, recent studies reveal that prostate cancer cells need testosterone to grow, which is why prostate cancer hormone therapy aimed at inhibiting testosterone production slows cancer growth [13] [14].

Breast Cancer

The effects of long-term testosterone exposure have been shown to raise estrogen levels in men, increasing their risk of developing breast cancer [15] [16].

However, while having a high T level is associated with an increased risk of breast cancer, research also suggests it can sometimes act as a preventive factor against cancer progression [17] [18].

Red Blood Cells

Polycythemia, or an elevation in red blood cell mass as determined by increased hemoglobin and hematocrit levels in the laboratory, is the most commonly encountered negative effect of testosterone therapy [19].

According to one study, testosterone administration increases hemoglobin and hematocrit by 7 percent and 10 percent, respectively, by stimulating the hormone erythropoietin, which promotes red blood cell production [20].

Obstructive Sleep Apnea (OSA)

man with sleep apnea

Obstructive sleep apnea is considered a relative contraindication to TRT because it is believed to aggravate sleep apnea in general [21].

Research suggests that TRT may exacerbate sleep apnea through various physiological mechanisms, including changes in airway motor control and altered responses to low tissue oxygen levels [22].

Is Testosterone Therapy Safe And Effective In Increasing Testosterone Levels?

Testosterone therapy may be safe and effective in increasing testosterone levels when hypogonadism is correctly diagnosed and medically evaluated. Also, the hormone therapy must be closely monitored and supervised by your doctor.

However, men should also be aware of severe long-term risks such as an increased risk of heart attack and stroke, breast and prostate cancer, BPH, polycythemia, and worsening obstructive sleep apnea.

The bottom line is that you should seek competent medical advice and consider other natural options to improve T levels, including a healthy diet, regular exercise, and supplementation with testosterone boosters.


References

  1. https://www.medicinenet.com/is_trt_a_steroid/article.htm
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376477/
  3. ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512682/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036835/
  5. https://pubmed.ncbi.nlm.nih.gov/29542875/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649360/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6765788/
  8. https://pubmed.ncbi.nlm.nih.gov/20092788/
  9. https://www.webmd.com/heart-disease/news/20190723/testosterone-therapy-may-threaten-the-heart
  10. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-cautions-about-using-testosterone-products-low-testosterone-due
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/
  12. https://www.urotoday.com/recent-abstracts/men-s-health/bph-benign-prostatic-enlargement/90013-testosterone-replacement-therapy-and-luts-bph-what-is-the-evidence-beyond-the-abstract.html
  13. https://www.cancernetwork.com/view/testosterone-replacement-linked-lower-rates-aggressive-prostate-cancer
  14. https://www.mayoclinic.org/tests-procedures/
  15. https://pubmed.ncbi.nlm.nih.gov/24928451/
  16. https://www.breastcancer.org/research-news/men-w-high-estrogen-could-have-high-risk
  17. https://pubmed.ncbi.nlm.nih.gov/22394304/
  18. https://pubmed.ncbi.nlm.nih.gov/26160683/
  19. https://pubmed.ncbi.nlm.nih.gov/27784544/
  20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022090/
  21. https://www.liebertpub.com/doi/10.1089/andro.2020.0001[
  22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305865/

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