Pros and Cons of TRT: 9 Benefits and 7 Downsides of TRT

Home > Testosterone > Pros and Cons of TRT: 9 Benefits and 7 Downsides of TRT

Testosterone replacement therapy (TRT) has gained a lot of popularity over the last two decades. However, some men are still unaware of its benefits and risks, and so can’t decide whether to seek treatment or not.

If that sounds like you, you have come to the right place! In this article, we will talk about the pros and possible side effects of TRT so you can find out if you are a suitable candidate for this treatment or not.

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Pros of TRT: 9 Benefits of TRT you should know

There are many reasons why you should go for testosterone therapy. Enlisted below are some key advantages of this medical procedure.

Improves sexual function

TRT raises levels of serum testosterone, which is required to increase a man’s sex drive, erectile function, and overall sexual function.

A recent study shows that men with low T notice an improvement in their libido, sexual satisfaction, and symptoms of erectile dysfunction after getting TRT.

Improves bone mineral density

Men with low T notice a significant bone density reduction. TRT may help them recover their bone mineral density, improving overall bone health and reducing the risk of fractures even in older adults.

In a 2019 study of 25 men with hypogonadism, researchers noticed a modest improvement in participants’ bone density.

Increases muscle mass

Muscle mass naturally declines with age. Low T also causes muscle loss. You can reverse this issue through testosterone supplementation.

TRT is linked to improved muscle mass in both younger and older men.

Reverses symptoms of hypogonadism

TRT is traditionally used to reduce the symptoms of hypogonadism, a condition in which your testes fail to produce and maintain healthy testosterone levels. It has two types – primary and secondary male hypogonadism.

In primary hypogonadism, the testes don’t produce testosterone even after getting signals from the brain. In contrast, in secondary hypogonadism, the testes don’t receive any signal from the brain to produce testosterone.

If you have any of these conditions, TRT can help you reduce its symptoms, such as loss of bone mass, low bone density, decreased facial hair growth, and erectile dysfunction.

Boosts energy levels

Another worth mentioning benefit of testosterone therapy is its positive impact on your energy levels. Testosterone can help you feel more energetic and active.

A 2022 study conducted on men with late-onset hypogonadism concludes that “TRT for >1 year was associated with significantly lower fatigue scores.”

Improves mood and concentration

Low T can cause irritability, anxiety, depression, mood swings and even brain fog. All these side effects can disturb your life, especially social and professional lives.

The good news is that studies show TRT can help tackle mood related issues and depressive symptoms associated with hypogonadism.

Better quality of life

With healthy testosterone levels, you can feel better mentally, physically and emotionally.

TRT restores your testosterone levels which positively influence energy, fatigue, emotional stability, cognitive sharpness and more. All these benefits collectively translate into improved daily functioning and an overall higher quality of life.

Several options for taking testosterone

You can take testosterone in different ways, for instance, through gels, patches, or injections.

You can select any of these methods based on what you find more convenient and what suits your budget. Each method has its own pros and cons. You can discuss them with your doctor and select the one that best suits you.

FDA-approved

TRT is an FDA-approved procedure, meaning its safety and efficacy have been tested and proven by experts. The FDA cautions that TRT should be used for men whose testosterone levels are low because of a medical condition, not old age.

Cons of TRT: 7 Downsides of TRT you need to be aware of

Infertility and testicular shrinkage

Many sources suggest TRT affects fertility by bypassing the brain-testes signalling system.

Testes stop making internal testosterone and sperm because they are no longer being told to. Over time, they may also shrink (testicular atrophy).

However, nowadays there is a treatment you can take in conjunction with TRT that stops it from affecting sperm count (TRT with hCG).

Cardiovascular health

Data also shows an increased risk of heart disease or cardiovascular diseases, but results have been mixed on this topic.

Some studies indicate TRT may increase cardiovascular disease risk, particularly in the first two years of the treatment, while others show that it may offer cardiovascular benefits.

Prostate health

There was an initial concern that testosterone therapy could cause prostate cancer or worsen symptoms of benign prostatic hyperplasia (BPH). However, many of the latest studies show no such connection between TRT and prostate health.

A 2023 trial involving 5246 hypogonadal men with low initial prostate cancer risk found no difference in prostate cancer diagnosis between TRT users and placebo after 3 years of follow-up.

However, screening (PSA checks and digital rectal examinations) before and during TRT is still essential. And TRT in adult men with a history of prostate cancer should be approached cautiously, if at all.

Gynecomastia and skin issues

Like any other medical procedure, testosterone therapy also has its cons.

Some men report skin reactions or acne, breast enlargement, and worsening sleep apnea after starting TRT. However, these side effects are not common and they can be managed with dose adjustment or changes in the delivery method.

Blood clot risk

TRT patients may have a high risk of red blood cell clots, specifically venous thromboembolism (VTE). However, studies show mixed results in this regard.

To ensure the safety of the testosterone supplementation, TRT providers regularly test red blood cell levels. If these levels exceed the normal range, they may hold or adjust your medication.

Hair loss

TRT may contribute to hair loss, especially if you are genetically at a higher risk of male pattern hair loss (androgenetic alopecia).

Long-term treatment

TRT is a long-term commitment that requires strict compliance and careful management to avoid complications. Stopping it can bring your testosterone levels back to your initial levels, making unpleasant low testosterone side effects return.

Understanding low testosterone

Testosterone is considered the primary sex hormone in healthy men as it helps them develop secondary sexual characteristics. It is produced and secreted by the testes when they receive signals from the pituitary gland.

The normal testosterone level falls between 300 to 1,000 nanograms per deciliter (ng/dL). If your testosterone is below 300 ng/dL, you may have low testosterone.

What are low T symptoms?

Low testosterone produces different symptoms in different individuals. A lot of men report the following symptoms:

• Bone mass loss
• Muscle mass loss
• Low libido
• Erectile dysfunction
• Hot flashes
• Fatigue
• Difficulty concentrating
• Memory problems
• Lack of energy
• Irritability
• Depression
• Anxiety
• Low self-esteem
• Increased body fat

Experiencing these symptoms can be unsettling, and while they may align with various conditions, it’s crucial to recognize that they are not exclusive to one specific cause.

How to diagnose low T?

Fatigue, hot flashes, or changes in energy levels may be indicative of several underlying health problems. Therefore, should you ever find yourself grappling with such symptoms, it is highly advisable to seek the expertise of a medical professional.

Your doctor will run a few tests. If they suspect you’re testosterone-deficient, they may include a testosterone blood test.

Testosterone blood tests measure the total testosterone concentration in your blood serum. Your doctor may ask you to have this test several times, as testosterone levels can fluctuate for multiple reasons.

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What are the causes of Low T?

Low testosterone can be brought on by a number of factors. While it is normal for men to have low T due to old age (also called age-related low testosterone), it can also be caused by other conditions, such as:

• Testicular cancer
• Male breast cancer
• Injury to the testicles
• Brain injury
• Pituitary gland disease
• Radiation cancer treatment
• Genetic conditions like Klinefelter’s syndrome
• Obesity
• Stress
• Alcohol or drug abuse
• Hypogonadism

Identifying the main cause of low T is the first step in fixing the problem. Once the issue is diagnosed, your doctor will design a treatment plan accordingly.

TRT for low T or hypogonadism

Testosterone replacement therapy is a hormone therapy given to men with age-related low testosterone or those who are simply unable to produce testosterone in normal amounts.

Over the last few years, TRT has been used by millions of men to increase testosterone serum levels and reduce low T symptoms.

There are different types of TRT based on how the hormone is administered in the body. Some key TRT methods include:

Testosterone topical gel

As the name indicates, it is the gel form of testosterone that is applied directly to the skin. It is one of the most convenient TRT forms.

However, the user should be cautious while using the gel. He should not go near fire or rub any other skin surface with the surface having gel.

Testosterone injection

Injections are the standard form of TRT in which the hormone is administered just under the skin with a tiny needle. Generally, these injections are given once a week. Follow your doctor’s instructions for best results.

Testosterone transdermal patch

Patches containing testosterone are applied directly to the skin at least once a day.

Doctors often advise patients to select a different area for the patch application each day. Compared to other forms of TRT, patches can cause skin irritation and redness.

Testosterone buckle patch

It is a tablet-shaped pouch placed between the gum and the upper lip. You can drink liquids and chew gum while the patch is in its place. A buckle patch may cause gum irritation and lip swelling.

Oral testosterone

Testosterone capsules (testosterone undecanoate) are also available. They are more convenient compared to other forms of TRT described above.

However, they may cause liver toxicity and high blood pressure, due to which the FDA has approved oral testosterone only for men who have low T due to a medical condition.

Nasal testosterone gel

Natesto is an FDA-approved nasal gel that is applied inside the nose, from where it gets absorbed rapidly. It is used 2 to 3 times per day.

You may need to take testosterone in a different way if you have a cold or nasal congestion.

Testosterone pellet

It is a pill-like structure that is implanted under the skin through a minor procedure. A single pellet can last from three to six months. Since it involves skin breakage, it may result in skin infection and scarring.

How to avoid TRT cons?

Testosterone treatment comes with its unique pros and cons. If you are experiencing low T symptoms, you should discuss your situation with your doctor to find a suitable solution. They can help you understand TRT better and determine whether you are a suitable candidate for it or not.

If TRT is the right treatment for you, a professional hormone health specialist will guide you throughout your testosterone deficiency treatment in a way that avoids potential side effects.

Work with us today to get a customized TRT treatment plan that suits your health condition and goals just right.

FAQs about TRT pros and cons

Is there any other way to increase testosterone?

If your low testosterone levels are due to stress, lack of sleep or any other similar issues, improving your lifestyle may help boost them naturally. But if the cause is a medical condition like hypogonadism, TRT is the most effective solution.

How long will TRT take to show its effects?

Your doctor will most likely confirm improvement in your testosterone levels within 6 months.

For how long will I have to take TRT?

TRT is a lifelong procedure. The moment you stop taking testosterone, your testosterone levels will drop again.

Summary

TRT can offer significant benefits, from increased energy levels and muscle mass to improved mood and cognitive function. However, it’s crucial to weigh these advantages against potential drawbacks, such as the risk of side effects and the need for ongoing monitoring.

Deciding on TRT should be a thoughtful, informed process, ideally undertaken in consultation with healthcare professionals who can tailor the treatment to individual needs.

As with any medical intervention, an understanding of the potential benefits and potential risks better equips you to make an informed choice about your health.

Ultimately, the journey towards hormonal balance requires a comprehensive approach, where the pros and cons of TRT are carefully considered in the context of overall well-being.

If you’re thinking about starting TRT, don’t hesitate to get in contact with our very own specialist doctors by clicking the button below.

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References

Zhang, W., Cui, Z., Shen, D., Gao, L. and Li, Q., 2025. Testosterone levels positively linked to muscle mass but not strength in adult males aged 20–59 years: a cross-sectional study. Frontiers in Physiology, 16, p.1512268.

Bhasin, S., Travison, T.G., Pencina, K.M., O’Leary, M., Cunningham, G.R., Lincoff, A.M., Nissen, S.E., Lucia, M.S., Preston, M.A., Khera, M. and Khan, N., 2023. Prostate safety events during testosterone replacement therapy in men with hypogonadism: a randomized clinical trial. JAMA Network Open, 6(12), pp.e2348692-e2348692.

de Almeida Ferreira, M. and Mendonça, J.A., 2022. Long-term testosterone replacement therapy reduces fatigue in men with hypogonadism. Drugs in context, 11, pp.2021-8.

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