TRT in the UK

4 Reasons Why TRT Didn’t Work For You

4 Reasons Why TRT Didn’t Work For You

By Mike Kocsis | 3 minutes read | Last updated: January 23, 2023 |
  • Categories:
  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    More and more men diagnosed with low testosterone are turning their attention toward Testosterone Replacement Therapy (TRT). Often, after having done research, they decide to start looking for a doctor to treat them. After completing a course of TRT, some patients are left disappointed that their low testosterone symptoms didn’t seem to disappear. Most of the time it’s not the treatment that’s the problem. There’s no one-size-fits-all when it comes to TRT – your doctor should tweak your TRT treatment according to your specific medical needs.

    That’s why it’s so important that you choose a clinic that offers bespoke TRT like Balance My Hormones to get the best results. The following are 5 most common reasons why TRT doesn’t work.

    Take Hormone Quiz


    #1 Estrogen Management

    Contrary to popular belief, both men and women have estrogen. The difference is that men have lower levels of the hormone compared to women. Testosterone replacement therapy raises estrogen levels via the aromatisation process (i.e. the conversion of testosterone to estrogen). Estrogen performs a number of important functions in male health, including modulating libido and cognition. However, too much estrogen can result in side effects such as gynecomastia and bloatedness. That’s why it’s important that you work with an experienced TRT doctor who knows how to manage estrogen effectively. This can be done either through adjusting your testosterone protocol (i.e. lowering the dose) or through the use of aromatase inhibitors (AIs).


    #2 Prolactin Management

    In females, prolactin is the hormone responsible for the production of milk.  The role of prolactin in men, however, is not fully understood. What we do know is that elevated levels of prolactin can interfere with your sex drive. It can also result in poor erections and difficulty maintaining an erection. Most men can expect their prolactin levels to rise after initiating testosterone replacement therapy. This is normal when testosterone is introduced. However, this should subside after a few months. If prolactin levels fail to drop after a few months of initiating treatment, it’s likely due to elevated estrogen levels.


    #3 Unrealistic Expectations

    This issue is purely mental as opposed to physical. Sometimes, men have unrealistic expectations of TRT. They expect it to work miracles and to solve all their problems. What most fail to realise is that testosterone replacement therapy takes time to work. It can take several weeks, even months in some cases before you start to feel its effects. Therefore, anyone starting TRT should have the expectation that it could take months before you start to ‘feel yourself’ again.


    #4 Hair loss Medication

    Finasteride is the most popular hair loss prevention medication. It works by inhibiting the type II 5alpha reductase enzyme. This prevents the conversion of testosterone into dihydrotestosterone (DHT). Reducing the amount of DHT has been shown in clinical trials to slow down the progression of male pattern baldness but the issue is usually too much DHT in the scalp area. However, DHT plays an important role in libido, mood and sexual function so if you lower your serum DHT levels, you run the risk of adverse side effects. It begs the question, is it that testosterone replacement therapy doesn’t work for you, or is your hair loss medication contributing to hormonal imbalance?

    hair loss men

    Book Free Consultation

    Final Thoughts

    For most men, testosterone replacement therapy will work very well.  Although in some instances it doesn’t work and the patient doesn’t feel as well as they’d hoped. There’s usually a valid reason why testosterone therapy doesn’t work. This is typically due to an easily identifiable issue (e.g. high prolactin) that can be easily managed by an experienced TRT doctor.

    But if testosterone doesn’t work straight away for you, don’t give up hope. Consider investigating one of the above reasons, and it’s likely you’ll find the solution.




    Was this article helpful?

    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject.

    We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.

    Quick Low Testosterone Test

    If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal.

    Check your testosterone

    Tick all that apply:

    I have the following symptoms:

    Testosterone conversion tool
    Order testosterone blood tests

    Low Testosterone Levels

    You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.

    Take our ADAMS low testosterone questionnaire.

    Please Retry

    The Total Testosterone Level You Entered Is Incorrect. Figure Must be in nmol/L you can use our converter here.

    Take our ADAMS low testosterone questionnaire.

    Normal Testosterone Levels

    Your testosterone levels appear to be in the normal range.

    Take our ADAMS low testosterone questionnaire.


    You must be over 38, have had your ovaries removed or have suffered with premature menopause to warrant further hormone tests.

    Take our ADAMS low testosterone questionnaire.

    Further investigation needed

    Please contact us to discuss your hormones, we need your total testosterone levels to validate your hormone deficiency. You can order a blood test here.

    Take our ADAMS low testosterone questionnaire.

    Low Testosterone Levels

    You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.

    Take our ADAMS low testosterone questionnaire.

    High Testosterone Levels

    You appear to have higher than normal testosterone levels, please contact us for further investigation.

    Take our ADAMS low testosterone questionnaire.

    Normal Testosterone Levels

    You appear to have normal testosterone levels. Contact us if you have any concerns.

    Take our ADAMS low testosterone questionnaire.

    About the Author: Mike Kocsis

    Mike KocsisMike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

    Learn More About Us

    Last update: January 23rd, 2023
    Male Pattern Hair Loss and Hormones
    Male Pattern Hair Loss and Hormones
    24 November, 2023, by Mike Kocsis

    Men lose 50 to 100 hairs every day. Your hair falls out, and new hairs take their place as their growth cycle begins.  However, sometimes you start losing more hair than you grow. As a result, thin hair patches appear on your head. Data show more than 85% of men lose hair at some time […]

    Read Article
    Primary Hypogonadism: Symptoms, Causes, and Treatments
    Primary Hypogonadism: Symptoms, Causes, and Treatments
    13 November, 2023, by Mike Kocsis

    Male hypogonadism is a condition in which your body fails to produce sufficient male sex hormone, testosterone, which plays many crucial roles in the body. It can affect men of any age; however, it is more prevalent in middle to old aged men. Data shows that 35% of men older than 45 years have primary […]

    Read Article
    The Relationship between Low Testosterone and the Immune System
    The Relationship between Low Testosterone and the Immune System
    27 October, 2023, by Mike Kocsis

    Testosterone, also referred to as the ‘king of hormones’ for men, plays a crucial role in driving libido, regulating mood, and maintaining bone density. But did you know testosterone’s influence extends far beyond these well-known roles? Recent studies have unveiled an interesting relationship between testosterone levels and the immune system. Keep reading the article to […]

    Read Article

    Get In Touch

    File(s) size limit is 20MB.

    Book a FREE consultation
    With Balance My Hormones.

    Get Started Today
    Evidence based
    research backed
    hormone optimization

    Balance My Hormones helps customers restore their hormones to optimal levels through bespoke TRT and HRT treatment plans. We use modern American treatment methods and have over 25 years of experience in hormonal health which is backed up by our very own GPhC pharmacy.