How Testosterone Replacement Therapy Really Works

Testosterone Replacement Therapy

When you think of testosterone replacement therapy, you probably think of men well into their 50s and 60s who get testosterone prescriptions from their doctors to keep their hormone levels in check.

However, younger men commonly participate in this therapy in order to prevent a host of problems associated with having too little testosterone.

Here, you’ll learn more about hormone replacement for men, including inherent testosterone replacement therapy risks.

The Effects of Low Testosterone

When there is not enough testosterone in your body, whether due to age or the suppression of your body’s ability to produce it, you may experience some or all of the following:

  • Fatigue
  • Irritability
  • Decreased sex drive
  • Occasional impotence
  • Increased body fat
  • Gynecomastia
  • Testicular atrophy (hypogonadism)

Testosterone, one of the most abundant hormones in the male body, plays a vital role in regulating health and wellbeing.

When there is not enough, it can cause a bevy of symptoms and make you feel less than healthy. The good news is that testosterone replacement therapy helps to keep these effects at bay, and it is often quite simple to implement it into your daily routine.

Natural Lack of Testosterone vs. Testosterone Suppression

Testosterone Replacement TherapyAs men age, their bodies slowly start producing less and less testosterone.

Although this is a natural process and one that most men will experience at some point in their lives, there is no reason to just “live with it”.

Testosterone replacement therapy helps to make up for the hormone that their bodies no longer produce, thus combatting all of the effects listed above.

On average, men’s testosterone production begins to naturally decline starting at around age 30, and this decline grows with each passing year. It is estimated that some 75% of men over the age of 30 could benefit from testosterone replacement therapy, but only 3% to 4% of men actively seek treatment.

In bodybuilders who use anabolic steroids or high amounts of testosterone to build muscle, things are different. These individuals fill their testosterone receptors with exogenous testosterone and testosterone-like chemicals, thereby shutting down their bodies’ ability and need to produce the hormone naturally.

Then, when they stop using the steroid, they have no testosterone at all. This is why they must implement post-cycle therapy to ward off significant symptoms like gynecomastia and hypogonadism. Both of these conditions can cause the same symptoms as naturally low testosterone, but the symptoms can be much more severe and come on quite suddenly.

When Do You Need Testosterone Replacement Therapy?

If you are in your mid to late 30s and you have noticed changes in your energy, moods, sex drive and performance in the bedroom, low testosterone may be to blame. Your physician can run tests to determine your levels, and he or she can also prescribe testosterone supplements to help you get things back to normal once again.

You may use a pill, gel, or cream each day, or you may be asked to return to your doctor’s office once or twice per week for an injection. In some cases, you may be able to administer prescribed testosterone injections at home.

Bear in mind that “normal” testosterone levels will vary by age. In the medical world, anything from 280ng/dL to 1100ng/dL is considered normal. When you see your doctor, he or she will take several things into consideration when it comes to determining your eligibility for testosterone replacement therapy.

The first, of course, is your symptoms. If you are exhibiting classic signs of low testosterone – very little sex drive, erectile dysfunction, unexplained weight gain, and chronic fatigue are the most common – then this plays heavily into your doctor’s decision. Next, he or she will use lab tests to see where you are on the scale.

If your testosterone is below 280ng/dL, or if your testosterone is somewhere in the middle of the normal range, but you are still experiencing symptoms, your doctor may prescribe exogenous testosterone.

Specific Advice for Bodybuilders

Things are a bit different for bodybuilders and athletes who choose to use anabolic steroids or exogenous testosterone for performance enhancement. In this case, their bodies stop producing testosterone altogether.

Testosterone replacement therapy becomes a necessity, and that is why most steroid cycles contain some type of injectable testosterone. However, post-cycle therapy is the most important consideration. This helps men begin to produce normal amounts of testosterone once again.

This PCT process involves using a SERM, which creates the hormones that stimulate your testicles to produce testosterone. The therapy lasts four to six weeks, on average.

Testosterone Replacement Therapy Side Effects

As with anything, there is a risk for side effects when it comes to testosterone replacement therapy. Too much testosterone can lead to estrogenic side effects; your body converts excess testosterone into estrogen, which can cause the development of breast tissue, mood swings, and even worsening fatigue.

That’s why it is so very important to follow your doctor’s recommendations for dosing, which vary from person to person and from drug to drug. Different forms of testosterone require more frequent dosing, and in most cases, doctors will start their patients on a high dose to build up the concentration, then back down to a “maintenance” dose over time.

The average dosing schedule for testosterone undecanoate, one of the most popular forms used in testosterone replacement therapy, can be found in the table below.

TimeframeDoseExpected Results
Week 1
Instant boost in testosterone concentration
Week 4
Booster; further raises testosterone concentration
Week 14 (and every 10 weeks thereafter)
Maintenance – maintains testosterone concentration

Though waiting 10 weeks between doses may sound extreme, in many cases, this is what works best. Infrequent high doses provide just enough of a Testosterone booster to keep symptoms at bay, and for many men, it is simply more convenient.

In some cases, though, men may receive Testosterone pills, creams, patches, or gels they will need to use daily, and there are even subdermal pellets that can be injected under the skin to provide slow-release testosterone over the course of several weeks.

Testosterone Replacement Therapy Cost

Testosterone TherapyFinally, many men avoid seeing testosterone replacement therapy because they are afraid of the cost.

For the most part, and in most countries, your health insurance will cover the cost of your treatment (minus your copay) if your doctor determines that the treatment is medically necessary.

In other words, your lab results must show that you have low testosterone levels.

If you seek testosterone replacement therapy during a steroid cycle and purchase it online or off the street instead of from a pharmacy, the cost will vary based on the form of testosterone you buy and your location.

Testosterone replacement therapy is simple enough, and it is something that all men should consider at some point in their lives. Not only does it help counteract irritability, fatigue, and issues in the bedroom, but it also helps you feel like your younger self once again.