TRT in the UK

The Pros and Cons of TRT

The Pros and Cons of TRT

By Mike Kocsis | 7 minutes read | Last updated: November 30, 2023
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  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    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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    Understanding Low T

    Testosterone is considered the primary sex hormone in 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.

    Testosterone concentration varies from man to man. It even fluctuates in a single man throughout his life. The normal serum testosterone level falls between 300 to 1,000 nanograms per deciliter (ng/dL). If your testosterone level is below 300 ng/dL, you may have low testosterone.


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


    Experiencing 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. Fatigue, hot flashes, or changes in energy levels may be indicative of several underlying issues. 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. It is mostly conducted early in the morning as men have a higher testosterone level during this time period. Your doctor may ask you to have this test several times, as testosterone levels can fluctuate for multiple reasons. Click here to find our more about testosterone blood tests 

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    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, it can also be caused by other conditions such as:

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


    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. There are a few treatment options available for low t but Testosterone Replacement Therapy is the most commonly known and practiced treatment.


    TRT for Low T

    Testosterone replacement therapy, abbreviated as TRT, is a hormone therapy given to men who are unable to produce testosterone in normal amounts due to a certain medical condition. 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 methods of TRT based on how the hormone is administered in the body. Your doctor will discuss the effects of each and then help you select the one that best suits your lifestyle and needs. Some key TRT methods include:


    Topical gel:

    As the name indicates, it is the gel form of testosterone that is applied directly to the skin, from where the hormone gets absorbed into the bloodstream. 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 exposed to gel.


    It is the standard form of TRT in which the hormone is administered just under the skin with a tiny needle. The injection is usually given once a week, but you should follow your doctor’s instructions.

    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.

    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.


    Testosterone capsules (testosterone undecanoate) are also available. They are more convenient compared to other forms of TRT described above. However, they may cause 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 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 cold or nasal congestion.


    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.


    Pros of TRT

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

    Improve sexual function

    TRT raises levels of serum testosterone which is required to increase a man’s sex drive as well as performance. 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.

    Increase muscle mass and bone density

    Men with low T notice a significant bone density and muscle mass reduction. TRT may help them recover their bone and muscle health. In a 2019 study of 25 men with hypogonadism, researchers noticed a modest improvement in participants’ bone density.

    Reverse 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 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.

    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.


    TRT is an FDA-approved procedure meaning its safety and efficacy have been tested and proved 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

    Like any other medical procedure, TRT also has its cons. Some men report skin reactions or acne, breast enlargement, and worsening of sleep apnea after starting TRT. However, these side effects are not common.

    In addition to this, TRT may also cause some long-term health effects. For instance, some studies show that TRT may reduce prostate health in men. In a meta-review of 19 studies, researchers concluded that TRT could increase the risk of prostate events in older men.

    Similarly, studies also show an increased risk of 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.

    Many sources suggest TRT affects your fertility but nowadays there is treatment you can take in conjunction with TRT that stops it from affecting sperm count (TRT with hCG)


    How to Avoid Cons?

    TRT 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 treatment in a way that avoids potential side effects.


    Ask your doctor

    Is there any other way to increase testosterone?

    If your low T is due to stress, lack of sleep and similar issues, improving your lifestyle may boost your testosterone levels 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.

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    Summing It Up

    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 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 above.


    References/Bibliography/Scientific Studies/Further Reading 

    Basaria, S. and Dobs, A.S., 1999. Risks versus benefits of testosterone therapy in elderly men. Drugs & aging15(2), pp.131-142.

    Bassil, N., Alkaade, S. and Morley, J.E., 2009. The benefits and risks of testosterone replacement therapy: a review. Therapeutics and clinical risk management5, p.427.

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    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. You can read more about our Editorial Process by clicking here.

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    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.

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    Last update: November 30th, 2023
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