Testosterone Replacement Therapy (TRT), is a treatment doctors use to help men whose bodies aren’t making enough testosterone on their own.
This hormone affects so much more than people realize. It influences muscle tone, bone strength, energy levels, mood, sex drive, and even motivation. When testosterone drops too low, a condition known as hypogonadism, it can take a real toll on how you feel and function day to day.
In the sections ahead, we’ll talk about what TRT actually involves, how it works, the upsides and possible downsides, and what the process is like if you decide to give it a try.
We’ll also touch on natural methods and lifestyle changes that might help raise testosterone, so you can get a clear sense of which path makes the most sense for you.
At Curativ, you’ll find expert care and the best wellness services to guide you through every step. With the right plan, regular check-ins, and healthy habits, you can feel like yourself again.
What is Testosterone Replacement Therapy (TRT)?
Testosterone Replacement Therapy is basically a way to give your body the testosterone it’s no longer making on its own. The goal is to bring hormone levels back into a healthy range, and there are a few different ways to do it (each with its own quirks).
How does TRT work?
Some men get injections, either into a muscle or just under the skin. These can be done weekly or every few weeks, depending on the formula, but they sometimes cause hormone levels to spike and dip between doses.
Others prefer gels or creams that you rub on every day, which keep things steadier but come with a small risk of rubbing off on someone else if you’re not careful.
There are also skin patches, which you swap out daily. They’re simple but can irritate the skin. For a more hands-off option, doctors can implant tiny pellets under the skin (usually in the hip or buttock) that slowly release testosterone for months at a time, though it does mean a quick in-office procedure.
Finally, there are oral tablets, but these are less common because they can be tough on the liver and don’t always absorb consistently.
The “best” method really depends on your lifestyle and comfort level. Some guys like the set-it-and-forget-it approach of pellets, while others don’t mind daily gels or the routine of scheduled injections.
Who Is TRT For?
Testosterone Replacement Therapy (TRT) is intended for men whose natural testosterone levels have dropped below what the body needs to function and feel well. The aim isn’t to create unnaturally high levels—it’s to restore balance and relieve the effects of a true deficiency.
You might be a good candidate if:
- Lab work confirms low testosterone (generally below 300 ng/dL) on more than one early-morning test.
- You have noticeable symptoms such as low sex drive, constant fatigue, mood changes, reduced muscle mass, or difficulty concentrating.
- There’s an identifiable cause like age-related decline, an injury to the testicles, pituitary problems, or medical conditions that interfere with hormone production.
If you suspect low testosterone, the first move is a full hormone evaluation and bloodwork with a qualified specialist to see whether TRT is appropriate.
What Counts as Low Testosterone (Hypogonadism)?
“Normal” testosterone levels can shift a bit depending on your age, the lab, and how the test is done, but most adult men fall somewhere between about 300 and 1,000 ng/dL.
When levels consistently stay below the low end of that range—and you’re experiencing symptoms—it’s often diagnosed as low testosterone (also called hypogonadism).
Typical signs include:
- Lower sex drive or trouble with erections
- Ongoing fatigue or low energy
- Mood changes or depression
- Loss of muscle or strength
- More body fat, especially around the belly
- Thinner bones and higher risk of fractures
- Trouble focusing or a “foggy” mind
Causes of Low Testosterone
Low testosterone can stem from many factors, such as:
- Getting older: Levels naturally decline, usually starting in your 30s.
- Health problems: Obesity, type 2 diabetes, metabolic syndrome, chronic illnesses, or issues with the pituitary or hypothalamus.
- Injury or infection: Damage to the testicles, certain infections, or treatments like radiation and chemotherapy.
- Genetics: Conditions like Klinefelter’s syndrome or other inherited disorders.
- Lifestyle habits: Poor sleep, high stress, heavy drinking, some medications, or too little exercise.
How Low Testosterone It’s Diagnosed?
- Blood tests: Typically two early-morning testosterone tests on different days, when hormone levels peak. Doctors may also check free testosterone.
- History and physical exam: A review of symptoms plus an exam that looks for physical signs, such as changes in testicular size.
- Extra tests if needed: Hormones like LH, FSH, prolactin, and SHBG, and sometimes imaging of the pituitary gland to rule out deeper issues.
Benefits of TRT
When properly prescribed and monitored, TRT can deliver significant benefits:
Physical improvements
- Increased lean muscle mass, decreased fat mass
- Improved bone mineral density, reducing risk of fractures
- Enhanced strength, better physical stamina
Sexual health
- Improved libido and sexual desire
- Better erectile function
- More frequent spontaneous erections
Psychological and cognitive effects
- Increased sense of well-being, confidence, mood elevation
- Reduced depression and irritability in many men
- Better mental clarity, reduced “brain fog”
Metabolic and other health markers
- Increased insulin sensitivity in some men
- Improved lipid profiles (though results vary)
- Potential improvements in fat distribution, reducing visceral fat
- Possibly enhanced cardiovascular health in select populations—but this is an area of active research and debate
What to Expect During TRT?
Before you start
The first step is a thorough check-up. Your doctor will order blood tests to see where your testosterone levels stand and to look at related markers like LH, FSH, prolactin, PSA, liver enzymes, hematocrit, and cholesterol.
They’ll also go over your medical history—things like heart health, prostate concerns, and family risks—and talk through what you’re hoping to get out of treatment, whether that’s more energy, a better mood, improved sexual health, or maintaining fertility.
Getting started
If you decide to move forward, choose a treatment method that fits your lifestyle, budget, and health profile.
Doses usually start on the low side and are adjusted gradually. Improvements tend to come in stages: many men notice a lift in energy and mood first, followed by changes in sexual function and, over several weeks or months, shifts in muscle mass or body composition.
Monitoring and fine-tuning
TRT isn’t a set-it-and-forget-it therapy. Your doctor will recheck testosterone levels after the first few weeks or months to make sure you’re in the right range and tweak the dose or delivery method if needed.
They’ll also keep an eye on things like hematocrit, PSA, liver and kidney function, and cholesterol. Any side effects can be managed by adjusting the dose or switching to a different form of treatment.
Over time, you’ll revisit your goals together, sometimes lowering the dose once you’re feeling good, or even tapering off if the drawbacks outweigh the benefits.
Can You Quit Testosterone Therapy Once You’ve Started?
Yes, you can stop TRT but it’s not as simple as just quitting overnight. When you’re on testosterone therapy, your body often reduces or shuts down its own natural testosterone production because it senses there’s already enough in your system.
If you stop suddenly, you may feel a sharp drop in hormone levels before your body starts making testosterone again, which can bring back (or even worsen) symptoms like fatigue, low mood, or loss of libido.
How quickly your natural production recovers varies from person to person. Some men bounce back in a few weeks or months, while others may need medical support—such as medications to help kick-start the body’s own testosterone.
If you’re thinking about stopping TRT, don’t go it alone. Work with a hormone specialist who can guide you through a safe taper or transition plan, monitor your hormone levels, and help manage any withdrawal effects.
At Curativ, experienced providers can help you decide whether it’s the right time to pause or stop therapy and create a step-by-step plan to protect your health while your body readjusts.
Is TRT Safe?
Testosterone Replacement Therapy can be safe when it’s done the right way—with careful testing, a personalized plan, and regular check-ins with a qualified doctor.
The treatment itself isn’t dangerous, but problems can arise if it’s started without proper evaluation or if hormone levels aren’t monitored along the way.
Even with proper care, TRT isn’t completely risk-free. It can increase red blood cell counts, affect fertility, enlarge the prostate, and in some men may carry heart-related risks. That’s why ongoing monitoring and honest communication with your doctor are so important.
Risks and Side Effects of TRT
Like any hormone therapy, testosterone replacement comes with potential downsides. Starting treatment means weighing the possible benefits against these risks.
Common, Short-Term Side Effects
Some effects can show up soon after beginning therapy:
- Acne or oily skin
- Skin irritation from gels or patches
- Mild fluid retention (swelling in ankles or feet)
- Mood changes or irritability
- Breast tenderness or slight enlargement
- Sleep problems, including worsening of sleep apnea in some men
When TRT May Not Be Safe
Doctors typically avoid TRT in men with:
- Active prostate cancer or very high risk of developing it
- Already high hematocrit or polycythemia
- Uncontrolled heart failure or severe cardiovascular disease
- Untreated sleep apnea
- Plans for near-term fertility, since TRT can suppress sperm production
The Bottom Line
Low testosterone can drain your energy, mood, and overall drive—but it doesn’t have to stay that way. Testosterone Replacement Therapy has helped many men regain strength, confidence, and a sense of well-being. That said, it’s not something to jump into without careful thought. Heart health, fertility, and prostate concerns all need to be part of the conversation.
If you’re curious about TRT, start with proper testing and an honest talk with a knowledgeable doctor.