Testosterone replacement therapy (TRT) has become one of the most discussed — and most misunderstood — medical interventions of the past two decades. Sifting through the noise to understand what TRT actually is, who it is appropriate for, and how it should be properly administered is essential for any man considering it.
TRT is the clinical administration of testosterone to men with documented hypogonadism — a condition in which the body does not produce adequate testosterone for normal physiological function. Hypogonadism can be primary (originating in the testes) or secondary (originating in the hypothalamic-pituitary axis). Distinguishing between the two has significant implications for treatment and for a man’s goals around fertility.
Several delivery methods are available: intramuscular or subcutaneous injections (weekly or twice-weekly cypionate or enanthate, or the shorter-acting propionate for more fine-tuned control), transdermal creams or gels applied daily, subcutaneous pellets (3–6 month duration), and nasal gels. Each has advantages and tradeoffs in terms of dosing flexibility, level stability, ease of use, and potential for transference (relevant for men with female partners or children).
Comprehensive pre-treatment labs are non-negotiable: total and free testosterone (ideally two morning measurements on different days), LH, FSH (to assess the hypothalamic-pituitary axis), estradiol, SHBG, DHT, CBC (hematocrit), PSA (men over 40), and a comprehensive metabolic panel. Monitoring labs should be obtained at 6–8 weeks post-initiation and regularly thereafter.
Properly administered TRT — with appropriate monitoring of estradiol, hematocrit, and prostate health — is safe and profoundly effective for men with clinical hypogonadism. The goal is not supraphysiological levels but restoration of optimal physiological function. Call 844-734-2112 or contact our team to get started.