Testosterone Therapy for Men: A Practical Guide
Testosterone therapy done properly is safe, effective, and monitored. Done improperly, it causes preventable harm.
Who qualifies
Diagnosis requires both symptoms (low libido, fatigue, erectile dysfunction, loss of muscle mass, mood changes) and two confirmed morning total testosterone measurements below the reference range. LH and FSH help distinguish primary from secondary hypogonadism; prolactin and ferritin are checked to exclude reversible causes.
Delivery routes and dosing
Options include weekly to bi-weekly IM injections of testosterone cypionate or enanthate, daily transdermal gel, or long-acting undecanoate injections every 10–14 weeks. Choice depends on lifestyle, preference, and stability of levels desired. Target trough testosterone in the mid-normal range.
Monitoring and side effects
Baseline PSA, hematocrit, testosterone, and lipid profile. Recheck at 3 months, 6 months, then annually. Rising hematocrit above 54% requires phlebotomy or dose reduction. PSA changes should trigger urology review. Fertility declines on TRT — discuss fertility preservation before starting if relevant.
Book a hormone consultation
Ready to discuss hormone therapy? Book an initial hormone therapy consultation or a perimenopause / menopause appointment, or contact us via our booking page.
Frequently asked questions
Does TRT cause prostate cancer?+
Current evidence does not show that TRT initiates prostate cancer, but active cancer is a contraindication and PSA is monitored.
Can I stop after starting?+
Yes, but symptoms typically return. Discuss a stopping plan with your clinician.