4 minute read

The pros and cons of TRT: 5 benefits and 5 drawbacks

By Joe Young | Medically reviewed by Dr Nimlan Shanmugathas

Testosterone Replacement Therapy (TRT) is a widely recognised and extensively researched treatment for low testosterone levels. Medical experts and numerous clinical studies have documented the benefits, as well as the potential risks. 

Let’s take a look at the benefits and drawbacks. 

The benefits of TRT

1. Revitalised energy levels

One of the most notable benefits of TRT is bringing back your zest for life. In a year-long study, men receiving TRT experienced a marked reduction in fatigue compared to those who did not receive the therapy.

2. Enhanced libido and sexual performance

Low testosterone levels are often associated with decreased sex drive and erectile dysfunction (ED). TRT can improve both issues in men with low testosterone levels, especially those with mild symptoms. For severe ED, additional treatments like sildenafil or tadalafil, or psychological therapy might be needed.

3. Improved muscle mass and bone density

Testosterone plays a critical role in maintaining muscle mass and bone density. Men with low testosterone are at a higher risk of osteoporosis and muscle loss. Studies found that TRT significantly increases and maintains both bone mineral density and muscle mass, even in older patients.

4. Cardiovascular health

TRT has potential benefits for cardiovascular health. A study of over 6,300 patients showed that TRT had a mild protective effect on the heart, reducing the risk of heart attacks. However, it's important to approach this benefit with caution. Its effects can vary depending on individual health conditions. Careful monitoring and consultation with a healthcare provider are crucial for older men and those with pre-existing heart issues.

5. Better mood and outlook

 Low testosterone can lead to irritability, anxiety, and depression. TRT has been linked to improved mood, with participants reporting better emotional wellbeing and reduced depressive symptoms. There's no conclusive evidence that taking testosterone leads to aggression.

The drawbacks of TRT

1. Impact on fertility

For men looking to start a family, TRT should be carefully considered. While TRT can improve sexual health, it can negatively impact fertility by significantly lowering sperm counts. In most cases, this effect is reversible once treatment is stopped.

2. Prostate health concerns

Despite a growing number of studies demonstrating no increase in prostate cancer incidence among men on TRT, it's crucial to assess the prostate before starting. Once the therapy begins, regular monitoring for prostate issues is important. An early increase in PSA levels after starting T Therapy might reveal a hidden prostate cancer that wasn't detected at the start. 

3. Increased risk of blood clots

TRT can increase the number of red blood cells, thickening the blood and raising the risk of blood clots. This can lead to serious conditions like deep vein thrombosis or pulmonary embolism. Regular blood monitoring is advised to mitigate this risk.

4. Testicular shrinkage and skin conditions

When external testosterone is introduced into the body, natural testosterone production can decrease in the testicles, leading to shrinkage. Additionally, TRT can cause skin issues like acne due to increased oil production in the sebaceous glands.

5. Long-term commitment

TRT is typically a long-term, if not lifelong, treatment. Once you start, your body may reduce or cease its natural testosterone production, making it challenging to stop therapy without experiencing low testosterone symptoms again.

The numan take

TRT can significantly enhance your quality of life. However, it’s crucial to approach it with a thorough understanding of the advantages and potential risks. Since TRT often represents a lifelong commitment, consulting with a medical professional to discuss all available treatment options is essential. By carefully weighing the pros and cons, you can make an informed decision that best supports your health.