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Medically Reviewed by Dr. George Touliatos
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.
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).
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.
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.
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?
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.
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.
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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.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
The Total Testosterone Level You Entered Is Incorrect. Figure Must be in nmol/L you can use our converter here.
Your testosterone levels appear to be in the normal range.
You must be over 38, have had your ovaries removed or have suffered with premature menopause to warrant further hormone tests.
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.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
You appear to have higher than normal testosterone levels, please contact us for further investigation.
You appear to have normal testosterone levels. Contact us if you have any concerns.
Mike 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.
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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.
