Testosterone Replacement Therapy (TRT)
How TRT works for men with low testosterone, what to expect, and how it's monitored.
Overview
Testosterone replacement therapy (TRT) restores testosterone to normal physiological levels in men with clinically confirmed low testosterone (hypogonadism). When testosterone is genuinely low, TRT can dramatically improve energy, mood, libido, muscle mass, bone density, and overall quality of life. At Lemon-AID Medical Management, we confirm low testosterone with lab testing before initiating treatment and monitor closely to ensure safety and effectiveness.
Key Points
- TRT is indicated only when low testosterone is confirmed by two morning serum testosterone measurements below 300 ng/dL.
- TRT is available in several forms: weekly injections, daily topical gel, transdermal patch, or subcutaneous pellets.
- TRT suppresses the body's natural testosterone production and can reduce sperm count — important for men considering fertility.
- Hematocrit (red blood cell count) must be monitored — TRT can cause polycythemia, which increases clotting risk.
- TRT does not cause prostate cancer, but is contraindicated in men with active prostate cancer.
Signs & Symptoms
- Persistent fatigue and low energy despite adequate sleep
- Decreased libido and sexual dysfunction
- Difficulty building or maintaining muscle mass; increased body fat
- Mood changes: depression, irritability, difficulty concentrating
- Decreased bone density and increased fracture risk
Causes & Risk Factors
- Primary hypogonadism: testicular failure from injury, infection, or genetic conditions (Klinefelter syndrome)
- Secondary hypogonadism: pituitary or hypothalamic dysfunction
- Age-related testosterone decline (late-onset hypogonadism) — testosterone decreases approximately 1% per year after age 30
- Obesity, type 2 diabetes, and metabolic syndrome — all associated with lower testosterone
- Chronic opioid use, which suppresses the hypothalamic-pituitary-gonadal axis
Treatment Options
When to See a Doctor
Schedule a hormone consultation if you have persistent fatigue, low libido, mood changes, or difficulty building muscle that is affecting your quality of life. We will confirm your testosterone level with lab testing before recommending any treatment — TRT is not appropriate for men with normal testosterone levels.
This article is for educational purposes only and does not constitute medical advice. Please consult a Lemon-AID Medical Management provider for diagnosis and personalized treatment.