Understand The Potential Risks And Consider Alternatives Before Boosting Your Hormones Indefinitely
Millions of American men use a prescription testosterone injection or gel as forms of testosterone replacement therapy to restore normal levels of the manly hormone. The ongoing pharmaceutical marketing blitz promises that low T treatment can make men feel more alert, energetic, mentally sharp, and sexually functional. However, legitimate safety concerns linger. For example, some older men on testosterone replacement therapy could face higher cardiac risks.
“Because of the marketing, men have been flooded with information about the potential benefit of fixing low testosterone, but not with the potential costs,” says Dr. Carl Pallais, an endocrinologist and assistant professor of medicine at Harvard Medical School. “Men should be much more mindful of the possible long-term complications.”
Signs of low testosteroneDeclining muscle and bone mass Increased body fat |
Weeks After Beginning Treatment For Low T
Improved erectile function begins around this time and continues to improve over the next several months. Mental alertness and improved memory are also apparent during this time with continued improvement expected.
A slight decrease in triglycerides and total cholesterol begin, while an increase in full erections and sexual performance are noticeable.
Are There Any Risks To Starting Testosterone Therapy
Like any kind of therapy or medical treatment, testosterone therapy does have some potential side effects. However, the many positive benefits you will get from testosterone therapy far outweigh any potential risks. In fact, prior fears of increased risk of prostate cancer, stroke & heart disease which date back to the 1940s have been shown to be unfounded by meta-analysis studies ,some of which were funded by the National Institute of Health 2018.
When you take into consideration the many positive before and after results you can expect to see from testosterone therapy, not starting because of a fear of side-effects, is not a poor choice of action. If you have been diagnosed with low testosterone, and do not begin testosterone replacement therapy, your testosterone will only continue to decline, and your symptoms to worsen.
On the other hand, if you work with your doctor to achieve the many positive and lasting benefits of testosterone therapy, you will have made a good decision!
What you can expect from testosterone therapy is:
- Increased strength
- Increased ability to burn fat and build muscle
- Healthier skin and bones
If you need testosterone therapy, and you do not take it, all you can expect is a life filled with more weakness and depression.
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Testosterone Therapy: Months Four And Five
As you enter month four of being on testosterone replacement and complete month five, you will hardly recognize the person you were when you started your program. In months four and five, you will see the most significant before and after results of your T-therapy. When you like in the mirror, you will see a trimmer, slimmer, more youthful version of yourself. After five months of testosterone therapy, you will have significantly more energy, your muscles and bones will be stronger, your body fat will be considerably reduced, and your sex life will probably be the best it has been in years!
Effect Of Testosterone: Your Energy Levels Can Soar

“It’s very common for men to come in with low T and one of their primary symptoms is fatigue,” says Dr. Morgentaler. “And when we treat them, a lot of men will say that their energy has improved.” Many men also report an improvement in the “brain fog” that can come along with low testosterone, adds Dr. Tamler.
While researchers aren’t exactly sure how exactly testosterone plays a role in energy yet, Dr. Morgentaler says one of the thoughts is that it has an effect on your mitochondria, which produce energy within cells. This case isnt closed on this yet, but the theory is that “testosterone turns them on so they’re more productive in terms of creating the energy that the cells need.”
Dr. Tamler also notes that it may be tied back to androgen receptors as well. “If they don’t get sufficient input, that can cause fatigue,” he says. So bringing testosterone levels back up can help reverse this.
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How Should This Medicine Be Used
Testosterone cypionate, testosterone enanthate , and testosterone undecanoate injection come as a solution to be injected into a muscle and as a pellet to be injected under the skin by a doctor or nurse in an office setting or clinic. Testosterone enanthate injection comes as a solution to be injected subcutaneously once a week by yourself or a caregiver.
Testosterone injection may control your symptoms but will not cure your condition. Your doctor may adjust your dose of testosterone depending on the amount of testosterone in your blood during your treatment and your reaction to the medication.
Always look at your testosterone enanthate solution before you inject it. It should be clear to light yellow in color and free of visible particles. Do not use it if it is cloudy, contains visible particles, or if the expiration date on the package has passed.
You can inject testosterone enanthate injection in the left or right side of your abdomen except your navel and the area 2 inches around it. Do not inject into an area where the skin is tender, bruised, red, or hard or where you have scars, tattoos, or stretch marks.
Your healthcare provider will show you how to use testosterone enanthate injection . Be sure that you understand these directions, and ask your healthcare provider if you have any questions.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
What To Expect During The Treatment Period
It usually will take three to six months for testosterone injections to really work with men. Some may see improvements sooner than others, but for most men the process is gradual. The only concern is that if an individual stops treatment because they do not feel like it is working, then it wont work. Much like other chronic conditions, if therapy is stopped, then the problem will return.
With a well-structured testosterone injection program provided by a doctor, men can expect to see noticeable results. To get a quick glimpse into the weekly journey of this treatment type, you can watch the video below:
For a more detailed explanation, read below!
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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.
Are There Any Side Effects
Any changes in hormone levels within the body will inevitably produce side effects. Hormones control and regulate almost every bodily function, therefore side effects of this kind of treatment are largely unavoidable. Most can be managed, however.
Heart disease is probably the largest and most concerning of the side effects. Additional testosterone being introduced into the body puts pressure on the heart, so you should take care to exercise good heart health if you are considering this kind of treatment. Those with existing heart conditions may be at higher risk of this side effect. TRT can also raise your risk of diabetes, as too much testosterone can affect the bodys ability to create and process insulin.
Other possible side effects include acne, fluid retention, risk of prostate abnormalities, including cancer, shrinking of testicles, increased urination, risk of blood clots and stroke, worsening of sleep apnea symptoms, and increased aggression and mood swings.
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Things You Didnt Expect On Trt
It would be remiss not to disclose some of the things you will experience on TRT that most males arent expecting. Exogenous testosterone is a drug and it can produce some side effects, much like any other drug.
When you start taking exogenous testosterone, your body will decrease its natural production of testosterone. This is due to the negative feedback loop your pituitary gland works through to regulate your production of testosterone.
In healthy individuals, the pituitary will produce luteinizing hormone and signal the testes to produce testosterone to keep levels in adequate range. The pituitary negative feedback loop is much like a shutdown mechanism of your bodys internal testosterone-producing pathway, since youre getting all the testosterone you require through an exogenous source.
Naturally, your body doesnt need to produce testosterone since its essentially being fed with the hormone.
As a side effect of this, your testicles can shrink in size since less LH is being produced . You may also experience a reduction in sperm counts, which can be an issue if youre trying to have children.
Fat And Muscle Changes
Men generally have less body fat than women. This is partly related to testosterone, which regulates fat distribution and muscle maintenance in your body. With low T, youll likely notice an increase in body fat, especially around your midsection.
Your hormones also help regulate muscle growth. So, with low T, you may feel like youre losing muscle size or strength. However, this only occurs if your low T is prolonged and severe.
Testosterone shots can help regulate fat distribution, but you shouldnt expect significant weight changes from hormone therapy alone. As for muscle maintenance, testosterone therapy has been found to help increase muscle mass, but not strength.
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How Can I Expect The Best Results Of Testosterone Injections
Expecting to get the best results from your testosterone therapy, has a lot to do with who you choose as your prescriber of testosterone injections. Our doctors and clinicians have decades of experience in providing men with low testosterone, customized hormone replacement therapy programs to help them achieve their personal best at any age.
While many patients will start to see some improvements in the very first few days after starting testosterone replacement, testosterone injections are designed to have cumulative effects over the course of your therapy.
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Testosterone Therapy: Month 1 To 2
In the first month of testosterone therapy and into month two, in addition to the improvements in your sex life, you can expect to see the following:
- Reduced anxiety, aggression, and improved sociability
- Reduced systemic inflammation
- Reduced insulin resistance and some weight loss
- Improved lipid profile decrease in triglycerides, increased good cholesterol, and decreased bad cholesterol
- An overall feeling of improved health and wellness
How To Find Out If You Have Low Testosterone
If you or your child is showing signs of low testosterone, you should visit a doctor. Low testosterone isnt something that can be self-diagnosed or diagnosed based on symptoms alone. Patients must have their blood drawn and hormone levels accessed. Since testosterone levels are generally highest in the morning, this might mean a morning blood draw.
Doctors will likely measure a patients total testosterone level. If total testosterone levels are normal, but there are still signs of low testosterone, other blood tests might need to be performed, including free testosterone levels and SHBG levels. Your doctor will determine which type of blood test is best for you and your particular situation.
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What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain tests to check your body’s response to testosterone injection.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are receiving testosterone injection.
Do not let anyone else use your testosterone enanthate injection . Testosterone is a controlled substance. Prescriptions may be refilled only a limited number of times ask your pharmacist if you have any questions.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Side Effects Of Testosterone Injections
Some male patients may experience slight side effects including such as:
- fast hair growth on some parts of the body
- insomnia and mood swings.
Not all patients experience side effects while undergoing therapy. In any case, they are little and disappear once your treatment is over. The positive results for your health fully compensate for temporary inconveniences.
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Testosterone Therapy For Menopause
For women in menopause or perimenopause, testosterone therapy can help with emotional and psychological affects. Because dosages are usually lower in these cases, it may take 812 weeks for you to begin noticing results. Common results in menopausal women include increased sexual drive, reduced mood swings, and improved depression.
As with all medical treatments there are potential side effects of HRT. Regular follow up visits with your clinician are important to ensure proper dosage and no underlying health issues. Especially if you are seeking treatment for emotional or psychological symptoms, you may wish to keep written notes to track changes over time.
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What Are The Symptoms Of Low
- Impaired memory
The other thing you need to understand about testosterone therapy is that while you will see results, you will not suddenly have the physique of Superman after your first injection. The whole reason why testosterone therapy is given as a course of treatments over a few months, is that its effects are cumulative, and take time to be achieved. Be patient, you will see dramatic changes very soon!
If you are a man over the age of 40, and are feeling weak, depressed, are putting on weight, and are unable to build lean muscle even while exercising, there is a good chance you could benefit from testosterone therapy.
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Three Weeks After The Treatment Begins
So this is the time where youll probably start to notice some real differences.
At this stage, many men also see a decline in anxiety and aggression. They tend to feel more sociable, awake and attentive. Some report feeling more creative.
A reduction in inflammation typically begins around this third week too, and continuing to lessen throughout the remainder of treatment.
How Long Does It Take To Feel The Benefits Of Testosterone Replacement Therapy

When you are diagnosed with low testosterone, it is likely that you have a range of symptoms that you are keen to leave behind. These symptoms may include low energy, low sex drive, and even depression. Then, when you start testosterone therapy, you probably hope that these symptoms will quickly disappear. Its important to understand, however, that it can take some time for you to notice the benefits of the treatment.
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What To Expect From Testosterone Replacement
You just started testosterone replacement.
You involuntarily hold your breath in anticipation as you wait for the chemical cavalry to come and rescue your waning energy, buttress your failing libido, and transform your body into something worthy of an underwear model.
Too bad it doesnt exactly work that way. Testosterone can be an amazingly transformative drug in a variety of ways and while the transformations are quick, theyre not generally something youre going to experience in an hour, a day, or even a week.
Some, like sexual effects, happen relatively quickly, gradually ramping up over the weeks. Others, like changes to muscle, bone, and waist size happen more gradually, starting a few months after therapy begins and finally leveling off after two or three years.
We know this from experience and through the studies that have been conducted to gauge how fast testosterone replacement therapy works. Unfortunately, most of these tests have been conducted only on men, but most doctors and scientists, including those at Optimal Health Medical Group, feel that the general results apply to women, too, even though the exact time frames may differ slightly.
Lets take a look at some of the effects of testosterone replacement therapy and how long it takes for them to kick in:
Psychosocial Parameters
- Depression and listlessness Both of these parameters decrease by week 6, but maximum benefits take longer.
Sexual Benefits
Health Benefits
Positive Effects on Appearance
How To Learn More
If you want to learn more about testosterone-based GAHT, the best place to start is by talking to your healthcare provider. However, if you dont have one, you can find a local gender-affirming provider near you by visiting the WPATH provider directory or checking to see if you live a state covered by Plume, a telehealth company providing gender-affirming care, made by and for trans people.
Plume offers a mobile app where you can consult with a provider, develop an individualized treatment plan, and have your prescriptions delivered to your door, all for a flat monthly fee of $99 . You can learn more about Plumes GAHT services on their website.
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