Testosterone Replacement Therapy 101: What it Is & How to Administer It

Testosterone deficiency can come with many challenges: symptoms of fatigue, deteriorating mental health, and a lowered sex drive. In fact, many patients with low T struggle to cope with pesky symptoms and seek testosterone replacement therapy (TRT).

But what does that mean?

When your testosterone levels reach below the standard “normal range” of 300 nanograms per deciliter (ng/dL), the American Urology Association (AUA) considers this to fall within the low-T range. 

Whether or not you are a good candidate for testosterone replacement therapy will depend on:

(1) How low your levels are exactly 

(2) Whether you are experiencing any symptoms

(3) How severe these symptoms are.

Your healthcare provider will take these and other factors into account before making a suggestion. If you wind up starting TRT, therapy can help you get your levels back up and make you feel like your old self again.

How Quickly Does Testosterone Replacement Therapy Work?

Depending on the type of testosterone replacement therapy you’re taking and the severity of your low T, you will begin observing symptoms diminish at different rates. The various routes of administration may lead to enhancements within varying time spans.

While TRT is fairly effective, it is not an overnight solution to hypogonadism. Taking testosterone regularly, however, can yield consistent results. 

A lot of the contributing factors depend on you individually and the exact medical circumstances that surround your health. With testosterone injections, for example, it also depends on your symptoms. You might feel your libido and energy levels rise within just a few weeks, while muscle-related improvements may appear many months later.

The Most Common Types of Testosterone Replacement Therapy

There are many different ways to administer testosterone, so options for testosterone replacement therapy are versatile. From oral testosterone to subcutaneous injections to intranasal gels and pellets that go under your skin — countless options are now available to patients.

Below we will discuss some of the most common types of hormone therapy for men.

(1) Oral

Oral testosterone replacement therapy comes in the form of a capsule or soft gel that’s typically administered twice daily. While dosing may differ, based on your actual testosterone levels, oral testosterone makes for a convenient way to take testosterone daily and consistently.

While much easier to administer, recent research has shown that oral testosterone can be as advantageous as other methods used to treat male hypogonadism with much potential for becoming the preferred treatment for many patients.

(2) Topical

Topical testosterone replacement therapy is very diverse and includes gels, creams, and patches — which are typically applied once daily. The topical use leads to the gradual absorption of testosterone, which can yield more stability when it comes to your testosterone levels.

The tricky part about creams and gels is that they can easily be transferred over to another person through skin-to-skin contact. You also want to make sure you wash your hands carefully as they can irritate your eyes.

Usually, manufacturers recommend waiting at least six hours for complete absorption after applying topical creams or gels.

On the other hand, patches can stay on your skin for a full 24 hours and are replaced with a new patch after. However, using a patch regularly can cause redness and skin irritations over time. 

(3) Subcutaneous

Testosterone injections are some of the most common forms of testosterone replacement therapy whereby testosterone cypionate is typically administered subcutaneously (under the skin). 

While the idea of injections can seem daunting, you or your spouse can learn to administer the shots on your own. Alternatively, you can visit your doctor to receive testosterone shots — usually every few weeks. 

Testosterone injections are options for both short-term and long-term treatment, and while injection site reactions are possible, they are rare.

How Effective is Hormone Therapy for Men?

Hormone therapy for men is generally considered an effective means of restoring your natural testosterone levels. A fair amount of men report noticing an improvement in symptoms when initiating testosterone replacement therapy.

For many, symptoms of low energy and low sex drive quickly resolve on TRT. In addition, TRT can help with other symptoms, like increasing your muscle mass and bone density. 

Overall, the effects of testosterone replacement therapy can have positive outcomes for patients with low T and can improve their quality of life. If administered to the appropriate patients and monitored consistently, testosterone replacement therapy can provide enhanced energy levels, libido, and more.

Are There Any Side Effects to TRT?

As with any drug, testosterone replacement therapy can have side effects, some of which depend on your personal medical history and your age. Some common side effects include acne, breast enlargement, and swelling in your ankles - albeit, only a small percentage of men actually experience these side effects. 

Using testosterone long-term, on the other hand, can lead to a higher risk of developing certain medical conditions — however, this pattern was only observed in older men and has been correlated with age.

Other side effects may depend on the route of administration you’re using:

  1. Topical testosterone, such as gels, may cause redness.
  2. Skin pellets may cause swelling and bruising.
  3. Subcutaneous injections can leave patients with an injection site reaction.

Generally, hormone therapy for men with low serum testosterone has benefits that outweigh TRT risk factors. Nonetheless, you should always consult with a qualified medical professional. Your doctor will evaluate you and let you know whether you are a good candidate for testosterone replacement therapy.

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