Who Is Masculinizing Hormone Therapy For
This therapy allows some gender-nonconforming people who are designated female at birth to feel more comfortable in their bodies. For many transgender men and nonbinary DFAB people, masculinizing hormone therapy changes the way they look and sound to better match their understanding of their gender or gender identity.
Masculinizing hormone therapy is just one option for treating gender dysphoria. Gender dysphoria is the medical term for the emotional distress that happens when societys expectations of your gender dont match your gender identity. Hormone therapy may allow you to feel more at ease living as your authentic self.
Side Effects Requiring Immediate Medical Attention
Along with its needed effects, testosterone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking testosterone:
Less common
- inability to have or keep an erection
- increased in sexual ability, desire, drive, or performance
- increased interest in sexual intercourse
- loss in sexual ability, desire, drive, or performance
- more erections than usual or erections that last a long time
- swelling of the breasts or breast soreness in both females and males
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Testosterone Therapy Side Effects
Men are turning to testosterone replacement therapy to increase energy levels, muscle mass and sex drive. But manufacturers warn that these drugs can cause unwanted changes, both mild and severe. The most commonly reported side effects include acne, enlargement of male breasts and prostate disorders. In rare cases, TRT has been associated with serious medical problems and even death.
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Who Is Testosterone Replacement Therapy For And How Does It Work

Doctors prescribe TRT to males with hypogonadism. To receive a definitive diagnosis, blood tests must show that a person has low testosterone levels, which the American Urological Association notes as being below 300 nanograms per deciliter . The individual must also have other symptoms, such as fatigue, breast growth, and sexual dysfunction.
However, doctors do not usually recommend TRT as the first course of action for low testosterone levels, even for males who show such symptoms.
If other conditions or medications cause testosterone levels to drop, doctors usually treat the underlying condition before recommending TRT.
According to a 2019 study, TRT can improve sexual function, including:
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Risk Of Cardiovascular Morbidity And Mortality
Reduced serum T levels have been associated with an increased risk of the development of CVD, including ischemic heart disease and stroke, yet whether TD is directly linked to the pathogenesis of CVD, a marker of pre-existing CVD, or concomitant manifestation of another underlying disease remains unclear . Low endogenous T levels correlate with an increased risk of adverse CVD events, and endothelial dysfunction and increased atherosclerosis are means by which male hypogonadism may contribute to an increased risk of death . The potential that TD may be involved in the pathogenesis of CVD would create a notion that TRT would result in improved cardiovascular outcomes, yet no current evidence exists to support this claim.
To date, the literature has been conflicting, suggesting TRT has either no beneficial effect on reduction of cardiovascular morbidity or mortality, or even a detrimental effect. Two meta-analyses found no differences in cardiovascular events between TRT and placebo groups , while a more recent meta-analysis found that TRT increased the risk of cardiovascular events, although the data seemed to vary by source of research trial funding. The authors concluded that overall, and particularly in trials not funded by the pharmaceutical industry, exogenous T increased the risk of cardiovascular-related events . It should be noted that trials that were not supported directly by the pharmaceutical industry commonly used T doses of 100150 mg in older and frail men.
What Are The Side Effects Of Testosterone Replacement Therapy
Anti-Aging & Regenerative Associates
Home » FAQs » What Are the Side Effects of Testosterone Replacement Therapy?
Testosterone replacement therapy is used to boost testosterone levels in men. As with any medical treatment, it is essential to weigh the risks, benefits, and side effects if you are considering treatment.
TRTs side effects can include increased production of red blood cells, acne, sleep disturbances, prostate enlargement, and reduced sperm production, among other possible side effects. However, scientific evidence indicates that TRT is considered safe in most men.
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Effects Of Testosterone On Body Habitus
TRT is associated with external, physical changes in the men. Exogenous testosterone is known to cause an imbalance in the hypothalamic-pituitary axis. As such, testosterone can be converted to estrogen by aromatization. Excess estrogens may lead to gynecomastia and/or breast pain, both of which may be seen in 10-25% of men on TRT. The ratio of estradiol to androgens is the key factor in the development of gynecomastia rather than absolute increases in androgens themselves. Clinicians must be aware of non-iatrogenic causes of gynecomastia and therefore the appropriate work-up should be sought out to rule out other pathology, especially if there is any breast tenderness or unilateral gynecomastia. Only a few case-reports describe a relationship between male breast cancer and TRT.
In addition, excess estrogens may cause an increase in visceral obesity. With vigilant monitoring of serum estrogen levels, TRT has been shown to promote weight loss. Well-known to many prescribers of TRT is a risk of water retention and/or edema. The etiology of this association remains unclear to date. The degree of retention is generally mild. As mentioned above, men on TRT with a history of CHF should follow closely.
Can I Undergo Masculinizing Hormone Therapy Without Help From A Healthcare Provider
Taking testosterone without a healthcare providers guidance is dangerous. It can be tempting to bypass an appointment with a healthcare professional to get started on testosterone quickly. This is especially the case if you have friends who are undergoing therapy, who share their prescribed testosterone and dosage recommendations with you. But everyone is different. Getting the dosage wrong can pose long-term risks to your health. Taking testosterone without a prescription isnt safe.
See your provider to ensure youre getting treatment thats safe and optimized to help you achieve your unique treatment goals.
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Lowered Sperm Count/ Infertility & Testicle Shrinkage
If you boost testosterone exogenously , it can potentially stunt the production of the hormones that are responsible for sperm production.
The stunting of these hormones production can also lead to testicular atrophy/ testicle shrinkage.
If you are planning to start have children, this is something that needs to be considered before starting a TRT course & needs to be discussed with your doctor.
Again a good clinic will look at all the different types of treatment available to you & adapt the treatment accordingly.
Will Trt Affect My Fertility
Yes, but this can be offset with the use of HCG.
Testosterone which is administered from outside of the body affects your natural production of both testosterone and sperm. This leads to reduced fertility.
The testosterone and oestrogen levels in the blood are detected by the pituitary gland which results in a negative feedback loop leading to a reduction in LH and FSH .
Together these two hormones stimulate the production of testosterone and sperm in the testicles. If they are reduced, the production of sperm and therefore fertility drops dramatically.
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Comparison With Previous Reviews
Our review added several new studies of substantially larger sample size to prior systematic reviews and reflects the current state of the available evidence. Our results are consistent with previous reviews to a great extent in terms of the inability to find a statistically significant effect of testosterone treatment on patient-important adverse outcomes, such as death, cardiovascular events, the incidence of prostate cancer, or worsening of lower urinary tract symptoms. Despite the increase in the number of studies and sample size since previous reviews, these risk estimates for these outcomes continue to be imprecise.
Diabetes And Low Testosterone

A link between diabetes and low testosterone is well established. Men with diabetes are more likely to have low testosterone. And men with low testosterone are more likely to later develop diabetes. Testosterone helps the body’s tissues take up more blood sugar in response to insulin. Men with low testosterone more often have insulin resistance: they need to produce more insulin to keep blood sugar normal.
As many as half of men with diabetes have low testosterone, when randomly tested. Scientists aren’t sure whether diabetes causes low testosterone, or the other way around.
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Blood Clots With Testosterone Replacement Therapy
The 3rd TRT side effect can include the risk of blood clots. Testosterone can synergistically work with a lipid called thromboxane, and may increase mens blood vessel constriction. What can happen is the blood slows thus making, in therapy more blood clots to occur. This Deep vein thrombosis can happen to clots that form in major arteries or veins, particularly with the legs. The clots formed, if they break away from the veins can travel freely within the body. If they end up in the lungs to create a pulmonary embolism, and within the brain, can cause a stroke.
A patient could prevent this a couple different ways. Every year about 900,000 Americans die of thrombosis, some of those as a TRT side effect. In many cases a blood thinner would be prescribed but there are more issues with taking those types of pharmaceuticals that we will cover later.
To help protect against these TRT side effects a patient could start vigorous exercise and get the blood circulating, that boost can reduce your risk by 22%. Also sitting too long can put you at risk so get up every half an hour and pace around. Increase your intake of Vitamin K, which has shown to be very beneficial by breaking down arterial plaque and increasing the flexibility of arteries.
At the Mas Clinic we are dedicated to optimal mens health. Sign up today to get on our TRT waitlist and avoid TRT side effects.
What Should You Do About Troubling Side Effects
TRT does come with several possible side effects, and its important that you undergo the relevant testing with your doctor prior to starting treatment. Those with cancer, heart disease, or sleep apnea are at much higher risk of dangerous side effects and should tread cautiously. While the potential side effects of TRT pose significant risks to your health, others are milder and more manageable. However, thats not to say that you should ignore side effects if they are bothering you. If you have any concerns about possible side effects, this is something you should discuss with your doctor. They may be able to assist with solutions or management of these, without needing to stop your TRT.
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How Much Time Does Testosterone Replacement Therapy Take To Start Working
Both scientific studies and our clinical experiences have shown that testosterone therapy delivers a balance of short- and long-term effects. While it can take up to several months to completely resolve all of your low-T symptoms, you can see improvements much sooner than that.
Many men start to experience benefits of TRT within just a few weeks of starting treatment, fully achieving their wellness goals within four to six months.
At Focal Point, we work hard at optimizing your testosterone to ensure you are getting maximum benefit from the therapy. This is where Focal Point has become the leader in testosterone therapy. After your initial consultation and treatment plan, we schedule a follow up blood draw in 6-8 weeks to look at how the body is responding to the therapy. We look for key indicators like Free Testosterone, DHEA, Vitamin D and SHBG to understand how the body is utilizing the testosterone. This is where the magic happens and our patients start to feel the full benefits of testosterone therapy.
Once our guests are optimized with testosterone, we have the ability to introduce peptide therapy. This is like supercharging the therapy as we start to work with other hormones such as growth hormone using CJC/IPAMORELIN and others to enhance the testosterone therapy.
How To Deal With Common Dht Side Effects
1. Smaller, more frequent doses may lead to less spikes in testosterone and therefore DHT which means less of these side effects.
2. Finasteride can be used in men to prevent DHT conversion in the scalp this can cause side effects of its own in men and should be used with caution and consideration.
3. Minoxidil may help to prevent hair loss and grow back some lost hair. DHT blocking shampoos may also help.
4. Ensuring the testosterone dose is not too high will reduce the side effects further.
5. Washing the back and shoulders regularly will reduce build-up of sebum and reduce acne.
Contact us for more information on medications to control DHT related side effects.
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Subgroup Analysis And Sensitivity Analysis
We performed subgroup analyses to explore possible causes of heterogeneity and to detect subgroup-treatment interactions. These analyses are presented in the table in the Appendix . The route of testosterone administration and dose partially explained the heterogeneity of results. Intramuscular route and high dose were associated with greater increases in red cell indices , PSA, and systolic and diastolic blood pressure. Higher doses were associated also with more increase in LDL and total cholesterol. Baseline testosterone status affected the response of hemoglobin and hematocrit patients with low baseline had more increase of both indices. The population characteristics affected the effect size for several outcomes, suggesting an obvious source of heterogeneity however, these effects were paradoxical and difficult to interpret in a summary meta-analysis of a study-level aggregate data, as is the case in this analysis. We used Peto odds ratio and the treatment arm method for continuity correction in sensitivity analyses, which are the recommended approaches to deal with studies with low event rates the use of these methods did not change study conclusions. The exclusion of studies in which the loss of follow-up significantly differed between the intervention and control groups did not change the conclusions of this report.
Subtle Symptoms Of Low Testosterone
The symptoms of low testosterone are sometimes obvious, but they also can be subtle. Testosterone levels decline naturally in men as they age over decades. But certain conditions can also lead to an abnormally low level. Symptoms of low testosterone include:
- Low sense of well-being
If men have symptoms of low testosterone and tests show they have an abnormally low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended. It has also not been approved for treating men with low levels because of aging.
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The Risk/benefit Ratio Of Trt
As with any medical intervention, the benefits of Low T therapy must be weighed against the potential risk of adverse reactions or side effects. Just as Paracelsus indicates, whether testosterone replacement creates a poisonous or beneficial environment is largely dependent upon how the medication is delivered and dosed.
Those who abuse testosterone and other androgens may experience significant and even life threatening side effects. Somewhat similarly, if treatment of Low T is mismanaged or not carefully monitored, patients will experience a higher rate and increased severity of adverse reactions or possibly a complete lack of meaningful results.
For the most part, this discussion will deal with side effects associated with TRT in general, but some attention will be given to particular differences in the variety of methods utilized for treatment of Low T.
What Other Treatments Are Available To Treat Low Testosterone

In addition to TRT, other anti-aging and regenerative therapies are available at our clinic to keep you feeling great inside and out. Our treatment options for symptoms associated with low testosterone levels include:
- IV infusion therapy
- Physician supervised weight loss plans
- Confidence boosting aesthetic procedures
- Hair restoration therapy
We adopt a total approach to health when treating our patients. This means we consider the whole person rather than just focusing on specific symptoms. We devise a health plan tailored to your particular needs, which could include multiple treatments to combat symptoms physically, emotionally, and mentally. For example, to treat low testosterone, we may recommend TRT be used in combination with a tailored weight loss plan.
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How To Avoid Side Effects
While many of these side effects seem scary and are mentioned in nearly every article you read about the risks of testosterone Replacement Therapy, if you read the actual studies you find that most of them found that TRT may actually help those who have the underlying conditions already when they begin the therapy.
If you are concerned about the potential side effects of Testosterone Replacement Therapy, that should give you all the more reason to ensure that you go through an assessment with a medical professional. They will take baseline readings and go through your health record to know before prescribing treatment if you would be a good candidate for the therapy or not. They should monitor your levels periodically throughout the treatment, in order to check that there arent any potential negative health issues developing as a result.
If you are concerned about prostate issues, there are many different supplements like these available that can help reduce enlargement which may be a good idea to take for any male over 40 years old, whether you are taking Testosterone Replacement Therapy or not.
The tips to avoid the potential side effects of Testosterone Replacement Therapy are essentially the same health tips that any man should follow as they get older: consult a health professional regularly, eat as healthy as you can, exercise, and ensure that you are getting all of the essential vitamins and nutrients that your body needs.