The beginning steps of testosterone replacement therapy (TRT) can be slow and require acclimating to the early increases in mood and energy, but as long as you don’t need to adjust your administration method or dosage, this initial phrase starts to level out after a few months. Major physical benefits, such as muscle growth, cardiovascular health protection, and reduced inflammation, become noticeable with long-term use.
Starting TRT: The First Steps
Hormones play a critical role in growth, development, and regulate numerous health processes. The overproduction, absence, or deficiency of hormones leads to hormonal imbalance which can result in a range of health complications.
Testosterone, a sex steroidal hormone, produced primarily in the testes is a critical health regulator in those assigned male at birth (AMAB). Those who suffer from lowered testosterone levels are at risk of muscle loss, low libido, and developing chronic heart conditions.
If you believe you’re experiencing testosterone deficiency, you may be curious as to your treatment options. Testosterone replacement therapy (TRT) has been clinically used as a treatment for low testosterone for roughly 70 years.1
Having an idea of what to expect from testosterone can help you weigh the potential of moving forward with TRT.
Initial Doses and Administration Methods
Treating testosterone deficiency through TRT involves replacing the hormone with a synthetic bioidentical version of testosterone. This addresses low testosterone by increasing serum testosterone levels and the way it can be administered varies. Current and common forms of testosterone are categorized by either topical or injected administration methods. Oral supplements are not an FDA-approved form of administration as they have been shown to rapidly metabolize, leading to testosterone fluctuations and liver complications.
If you’re considering TRT, there are multiple well-studied options, including topical gels, patches, implants and injections. Initial dosage will depend heavily on your physiological deficiency and administration method. For example, most gels are initially prescribed at ~50 mg daily, while injections can range from a dose of 100-750 mg per month.
Monitoring and Adjustments
It’s incredibly important to closely monitor your health, especially immediately after any new medical treatment in order to prevent unwanted effects. The effects of TRT, like many hormonal treatments, drastically depend on the dosage. Regularly scheduled labs to check serum testosterone levels along with documenting any adverse side effects can help your healthcare provider decide if you would benefit from a TRT dosage adjustment.
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Book TRTShort-Term Effects of Starting TRT
TRT will consist of some common early effects from short term use of testosterone. These effects include benefits and side effects that are expected to occur within the initial time frame of starting TRT. An understanding of what to anticipate in the first few weeks and months can help you prepare and better monitor your results.
First Week of TRT
Physical Changes and Sensations
In individuals assigned female at birth (AFAB) as well as those AMAB, testosterone plays a key role in regulating energy and mood. Low testosterone can interfere with sleep, increase fatigue and disrupt the production of happy hormones. Thus, one of the first effects you can expect are increased energy levels, allowing you to do things you enjoy and engage in activity that may have been previously difficult. Moreover, in your first week you may experience improvements in your emotional state, finding yourself in a better mood.
Common Side Effects
Each type of TRT has its own potential side effects related to the method of administration, including injection or implant site pain, itching, or skin irritation when using topical gels and patches. Additionally, there are common early side effects associated with the general use of testosterone to look out for, such as an increase in acne and mood swings.
First Month on TRT
The first month of TRT will be an extension of the first week with similar symptoms and added effects resulting from more time on testosterone.
Physical and Emotional Adjustments
After more time using TRT, you can expect further changes in both emotions and energy. A noticeable and often highly desired change is increased libido. Decreased sex drive can be a disturbance for many people and is often a main indicator of testosterone deficiency.
Additionally, those experiencing low levels of testosterone can experience increased body fat, decreased lean mass, and decreased muscle mass. Research has linked prolonged TRT usage to physical changes, including more optimal body composition from increased muscle mass.
Monitoring Progress
The first month after starting TRT can be overwhelming. Along with expected emotional and physical changes, you may be experiencing unwanted results you were not prepared for. These adverse effects could be due to factors like drug interactions as well as too little or too much testosterone.
Testosterone treatment requires consistent and open communication with a healthcare provider. Follow-up appointments and blood tests are important checkpoints for progress monitoring. This allows for you and your doctor to properly and timely respond to any impacts from starting TRT.
Long-Term Expectations
Sustained Energy and Mood Improvements
Long term use of testosterone (6 months and beyond) is when many effects of TRT should begin to balance out. Mood and testosterone levels should no longer be fluctuating. Consistent energy levels, improved mood and increased libido can all positively impact quality of life. A better emotional and energy state can reduce stress levels, aid in improved sleep, and provide a healthier mental environment.
It is important to hold realistic expectations and remember testosterone is not a fix-all. However, long term TRT effects can have sustained benefits that greatly impact your overall well-being.
Physical Health Benefits
The physical health effects can also be greatly increased and sustained throughout long term testosterone use. Increased bone density, muscle mass and lean mass are all benefits linked to restoring testosterone levels. Long term TRT can have positive effects beyond body composition. Studies have seen reduced bodily inflammation in those AMAB after long term TRT. Research has recognized several chronic and severe conditions linked to low levels of testosterone.
Testosterone deficiency is linked to cardiovascular diseases and risk factors for premature death such as stroke and coronary artery disease. On top of this, individuals AMAB with low testosterone levels are at a higher risk for metabolic syndrome and type 2 diabetes, which have serious implications on cardiovascular health.
Considering the largely negative effects associated with testosterone deficiency, it is not difficult to see how having hormonal balance connects to physical health.
Restoring testosterone has extensive physical health benefits that are vital to improving overall well-being and quality of life especially in those AMAB.
Managing Long-Term Side Effects
Consistently using testosterone over a long period of time also comes with side effects that are important considerations before starting treatment. Not only is this key before starting a long term health plan, you can ensure you have developed a well informed TRT management plan.
Regular Health Monitoring
Whether or not you experience significant or noticeable side effects, it is important to have regularly scheduled health check-ups.2 A comprehensive health plan includes consistent and transparent communication with a trusted health care provider and this is even more essential when taking hormonal treatment.
In order to have successful and appropriate treatment, long term TRT should be accompanied by health monitoring. Physicals and lab tests are important metrics that you and your doctor need in case of adjustments and to ensure that your health needs are being met.
Addressing Potential Issues
Managing the long term side effects of TRT requires addressing the potential issues that extended testosterone use can cause. Elevated testosterone is associated with thickening of muscle cells, and cardiac muscle is no exception, which can make it difficult for the heart to pump blood efficiently. Studies show that cardiac hypertrophy can result from higher levels of testosterone.
Additionally, research has found that increased testosterone is also linked to reduced testes’ size, and lowered semen efficacy in those AMAB. Further research needs to be done to better understand the effects of continued TRT, especially in those with preexisting conditions like sleep apnea, erythrocytosis, and prostate cancer. Individuals desiring to preserve fertility or who may be concerned with acute complications due to elevated testosterone levels or should investigate alternatives to TRT.
Conclusion
Experiencing the negative effects of low testosterone levels can severely impact your quality of life. In order to take the next step in restoring your testosterone levels with testosterone replacement therapy it’s important to understand what the treatment path may look like. Once you determine which method of testosterone administration you prefer, you’ll likely enter a monitoring and adjustment period to ensure you’re on the right track.
Early effects of testosterone treatment can include improved mood and increased energy and libido. Testosterone increase is also associated with better body composition through increased muscle mass and lean mass along with decreased body fat. Long term TRT use can sustain these results and greatly increase physical benefits like improved cardiovascular health and reduced inflammation.
These benefits are not without cons, however, and the potential side effects of both short term and long term TRT should be considered as it is not a suitable option for everyone. Moreover, like all hormonal treatment, testosterone use requires a comprehensive management plan with regular physical check ups to monitor your progress. Introducing long term medical care into your lifestyle is not always easy. It’s important to have a personal and professional network that can support you through this journey. No medical treatment plan has identical results for everyone, but knowing what to anticipate can help you feel confident in knowing your health options.
FAQs About TRT Therapy
How Quickly Do You See Results from TRT?
While the specifics of your TRT results timeline will depend on many factors, you can experience your first changes in your mood and energy as early as the first week. Physical changes are usually noticeable in the span of several months, and long term testosterone treatment will result in sustained differences.
What Are the Realistic Expectations of TRT?
No medical treatment is perfect, and setting realistic goals is an important part of being on testosterone. You may need to adjust your initial dose, administration method, or supplement your health plan with additional therapies for your desired results. Moreover, TRT can hold short and long term side effects that should be properly contemplated prior to using TRT.
What to Expect When Starting TRT?
Initial use of testosterone will come with a lot of changes. You may experience improved mood and energy as well as increased libido. Starting TRT will likely have an adjustment period, and you’ll need to be in close communication with your doctor, especially early in your treatment.
What Does It Feel Like to Be on TRT?
TRT can be a very positive experience, considering the many benefits associated with restoring testosterone. However, like most hormonal treatments, TRT can cause symptoms like disrupted sleep, and acne, and will require a management plan. Many people on TRT feel improved mental health, more energetic, and are relieved to no longer deal with the difficulties of testosterone deficiency.
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