The Truth About Testosterone Replacement Therapy: Who Needs It and Why

One out of every four men over the age of 30 has low testosterone, and most don’t even know it. The prevalence of low testosterone is even higher in men over the age of 50. The symptoms are often mild initially. You may experience a decrease in energy, a lower sex drive, mood changes, loss of muscle mass, or difficulty concentrating, among other things. 

Most men will write these symptoms off as stress or the normal effects of aging. However, there is a chance that a drop in testosterone could be the cause. Some symptoms are normal with aging, but low testosterone can have a significant impact on the quality of life. Testosterone is not just a sex hormone but is considered an important master hormone (similar to thyroid hormone). A deficiency can put you at increased risk for metabolic diseases.

So, how do you know when it’s time to take action? This article highlights the signs to look for and when to consider testosterone replacement therapy.

Signs of Low Testosterone

Low testosterone, also known as Low T, can affect multiple areas of a man’s health. Common signs include:

1. Low Sex Drive

The most common and noticeable symptom of low testosterone is a low sex drive. Occasional dips in libido are normal, but if you notice a persistent decline that impacts your relationships or self-esteem, it could be a sign of low T, especially when accompanied by other symptoms like fatigue or erectile dysfunction.

2. Fatigue

Testosterone plays a vital role in boosting energy naturally. When levels are low, the body’s capacity to remain alert and recover from daily activities diminishes. Unlike the typical fatigue from overworking or stress, this type of exhaustion often persists, even after a full night’s sleep. If you have persistent low energy despite adequate rest, you can discuss with your primary care physician to determine if checking your testosterone may be indicated.

3. Depression or Mood Swings 

Testosterone affects neurotransmitters like dopamine and serotonin, which play a part in mood regulation. When it’s low, emotional well-being may be negatively affected. If you suddenly become more emotional, withdrawn, or experience mood swings, it may be a sign of low T.

4. Loss of Muscle Mass

Testosterone is an essential hormone for building and retaining muscle. Low levels can cause a reduction in muscle mass, even if you’re active. In severe cases of low testosterone, you may even experience generalized muscle weakness. You might find it challenging to gain muscle at the gym or lose strength more easily over time. If you feel like you’re putting in the effort but your workouts are less effective, it could be a result of low testosterone.

5. Increased Body Fat

Hormonal imbalance can change the way your body stores fat and make it difficult to lose weight. A lack of testosterone is a common cause of gynecomastia, or enlarged breast tissue due to a drop in testosterone relative to estrogen. If you find that you’re gaining more fat around your midsection or suddenly developing excess breast tissue, you may have low testosterone.

6. Erectile Dysfunction

Erectile dysfunction (ED) can result from low testosterone levels. This is because low T can impact the strength and frequency of erections. Men with low testosterone levels also experience a reduced number of spontaneous erections, including morning wood.

7. Osteoporosis

Chronic low testosterone can also increase your risk for osteoporosis. Testosterone plays an important role in maintaining bone formation and mineralization. If you have osteopenia or osteoporosis before the age of 65 on bone density testing, checking your testosterone level may be helpful to rule out a possible contribution from this hormonal imbalance.

What Is Testosterone Replacement Therapy (TRT)?

If lifestyle modifications, sleep, and clean eating are not improving the symptoms associated with low testosterone levels, it’s advisable to consider a medical approach to find relief. Fortunately, there’s a medical treatment that could help you regain your natural hormonal balance. It’s known as testosterone replacement therapy (TRT). 

TRT comes in many forms, including injections, gels, patches, pellets, or oral formulations. This treatment can improve your mood, libido, and energy. It can also help you build or maintain muscle mass. However, it’s not suitable for everyone. Therefore, it is essential to consult a reputable medical professional before initiating any treatment plan. 

When to Consider Testosterone Replacement Therapy

You may want to consider TRT if:

1. Blood Tests Show Your Total Testosterone Is Consistently Below 300 ng/dl

Your testosterone levels can vary throughout the day. But if the level of your testosterone is consistently low, your doctor may diagnose you with clinical hypogonadism, especially if your levels are below 300 nanograms per deciliter (ng/dl). Frequently, your physician may also check your free testosterone level (If < 6pg/ml, this is also considered a low level). 

To be sure, your doctor will likely order morning blood tests, since testosterone is typically highest in the morning. Two separate low T results are usually needed to make the diagnosis. If lab results confirm that your testosterone levels are low and you are having related symptoms, a doctor may prescribe TRT. If you are started on TRT, your doctor may consider monitoring your blood count and testosterone level regularly to ensure adequate response to therapy and to monitor safety.

2. You’ve Had Symptoms of Low Testosterone for Several Months

Everyone experiences occasional performance dips. But when symptoms such as brain fog and muscle loss persist for months or years, it’s a sign that your hormones are probably out of balance. 

Chronic symptoms over an extended period are a sure sign you are suffering from a hormonal imbalance, not just a fleeting symptom. Don’t wait until things get worse, as early intervention can often halt the downward spiral and help you feel normal again.

3. Symptoms Are Impacting Your Quality of Life

If symptoms related to low testosterone start impacting your daily life, it’s often a clear sign that you need medical intervention. You may start to avoid social interactions or relationships, feel uninterested in work, or lose motivation in hobbies you previously enjoyed. 

Although some symptoms may seem mild initially, they can gradually accumulate, affecting your mental health, physical strength, and overall emotional well-being. At this point, it’s important to discuss TRT with your healthcare provider.

4. Lifestyle Changes Haven’t Helped

Most physicians will suggest you improve your sleep, change your diet, and take part in exercise. You will also be taught how to manage stress. But if you’ve already made these lifestyle improvements and still feel off, low T might be the underlying cause. 

TRT is not a substitute for healthy living, but can be an effective complement if your body’s not producing enough testosterone naturally. If you’ve done the work but have not noticed significant improvements, it’s reasonable to discuss treatment options that can help restore balance.

Final Thoughts on Testosterone Replacement Therapy 

Testosterone replacement therapy is not for everyone, but if you’re a good candidate, TRT can be the key to finding relief and regaining confidence. If you have a healthy lifestyle but start noticing symptoms of low T,  talk with your doctor about it to see if testosterone therapy is the right option for you.