TRT Side Effects: What to Expect and How We Manage Them

Testosterone Replacement Therapy (TRT) has helped countless men regain energy, improve sexual function, and restore hormonal balance. While there are potential benefits of testosterone therapy, such as improved vitality and addressing age-related testosterone decline, these advantages must be carefully weighed against possible side effects.

However, as with any medical treatment, it’s important to understand that the effects of testosterone can be both positive and negative, and understanding these effects is crucial to making informed decisions. At Advanced Medical Wellness (AMW), we believe in complete transparency so patients can make confident, informed decisions about their health.

This educational guide explores common side effects of TRT (testosterone therapy), how we monitor and manage them at AMW, and what patients can expect during treatment.

What Is Testosterone Replacement Therapy (TRT)?

TRT, also known as testosterone supplementation or testosterone treatment, is a medical therapy used to restore testosterone levels in men diagnosed with low testosterone or male hypogonadism. It’s commonly administered through testosterone injections, topical gels, or other delivery methods to address symptoms such as fatigue, low libido, erectile dysfunction, and reduced muscle mass.

Testosterone use is typically reserved for men with clinically diagnosed low testosterone or male hypogonadism, and is not recommended for everyone.

Learn more about TRT at AMW

Why Do Testosterone Levels Decline?

Testosterone levels, also known as low testosterone levels when declining, naturally decrease with age, typically starting in early adulthood. This decline in testosterone levels is more significant in older men. Low levels of testosterone can affect men by causing symptoms such as fatigue, low energy, and increased body fat. While some healthy men may seek testosterone therapy to improve vitality, it is generally recommended only for those with a diagnosed medical condition. Other contributing factors include obesity, chronic illness, injury to the testicles, and some medications. Monitoring your testosterone level is important, as symptoms of low testosterone (“low T”) can significantly affect well-being and quality of life.

Common Side Effects of TRT

While many patients experience substantial benefits, it’s essential to be aware of potential side effects:

Testosterone replacement therapy (TRT) can lead to changes in body composition, including weight gain, weight loss, and increased body fat, depending on individual response and hormone balance. Water retention is another possible side effect, especially in patients with certain health conditions. Skin reactions, such as rashes or irritation, can occur with some forms of testosterone administration. TRT is often used to address symptoms like low energy and reduced sex drive. There is also an increased risk that some patients may experience certain side effects, which should be discussed with a healthcare provider.

1. Fluid Retention

Mild swelling in the ankles or feet can occur as a result of fluid retention, also known as water retention, especially early in treatment.

2. Acne or Oily Skin

Changes in hormonal balance may trigger skin reactions, including acne or increased oil production.

3. Increased Red Blood Cell Count

TRT can elevate hematocrit levels, which can lead to an increased risk of heart attacks and other cardiovascular events, including blood clots. Regular lab testing helps manage this. With proper monitoring and management, the risk of blood clots in TRT patients can be kept lower than or similar to that of the general population.

4. Sleep Apnea

In some cases, TRT may worsen obstructive sleep apnea. Pre-existing conditions must be disclosed during your consultation.

5. Breast Tenderness or Enlargement

Elevated estrogen levels may lead to gynecomastia (breast tissue growth), although this is uncommon with proper monitoring.

In rare cases, increased estrogen from testosterone therapy may be associated with a higher risk of breast cancer, but the relationship between testosterone, estrogen, and breast cancer development is not fully understood and requires further research.

6. Mood and Emotional Changes

Some men report increased aggression or mood swings when first starting TRT. These usually stabilize with dosage adjustments.

7. Reduced Sperm Production

TRT may suppress the body's natural production of testosterone, which in turn lowers follicle-stimulating hormone (FSH) and luteinizing hormone (LH), leading to reduced sperm production and affecting fertility.

8. Testicular Shrinkage

Since the body reduces its natural testosterone production, the testicles may decrease in size. This is often reversible if TRT is discontinued.

9. Potential Prostate Risks

Recent research indicates that testosterone replacement therapy (TRT) is not necessarily linked to developing prostate cancer. However, TRT may accelerate growth in men with undiagnosed prostate conditions. It is also important to consider benign prostatic hyperplasia (BPH) as a potential risk, especially in older men undergoing TRT. Additionally, studies have shown that very low levels of testosterone are associated with an increased risk of prostate cancer. We monitor prostate-specific antigen (PSA) levels as a precaution.

How AMW Manages TRT Side Effects

At AMW, safety is our highest priority. Studies suggest that careful monitoring can reduce the risk of serious side effects associated with the effects of testosterone therapy. We provide personalized care and extensive monitoring to minimize side effects and ensure optimal outcomes. More research is needed to fully understand the long-term effects of testosterone and the best management strategies.

Comprehensive Initial Screening

We conduct a comprehensive review of your medical history, symptoms, laboratory results, and lifestyle factors. This includes assessing testosterone levels, checking free testosterone levels, PSA levels, and ruling out any contraindications like untreated sleep apnea or prostate cancer.

Ongoing Monitoring and Lab Work

Patients receive regular follow-ups and lab testing while taking TRT to track red blood cell count, hormone levels, and overall progress. Adjustments are made as needed to prevent adverse effects.

Customized Treatment Plans

We tailor TRT protocols to each patient’s unique needs. This includes evaluating whether injections, topical testosterone replacement, or another method is most appropriate.

Transparent, Ethical Care

We offer an out-of-pocket model, meaning we do not accept insurance. This allows us to provide more personalized and flexible care without third-party limitations.

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TRT FAQs

Is TRT safe long-term?

When closely monitored, TRT is generally safe and effective. Regular lab testing and open communication with your provider are key to minimizing risks.

Can TRT cause heart problems?

Studies show mixed results. At AMW, we proactively manage heart health by tracking blood pressure, cholesterol, and hematocrit levels.

Will I lose fertility on TRT?

TRT can suppress sperm production. Men interested in preserving fertility may need additional treatment, such as hCG therapy.

Does TRT increase the risk of prostate cancer?

There is no conclusive evidence that TRT causes prostate cancer. We monitor PSA levels regularly and refer to specialists as needed.

How soon will I notice the results?

Many patients begin noticing improvements in energy, mood, and sexual performance within a few weeks, but optimal benefits often take a few months.

When to Contact Your Provider

Notify your provider immediately if you experience:

• Shortness of breath

• Leg pain or swelling

• Severe mood changes

• Sleep disruptions

• Signs of a blood clot or pulmonary embolism

Prompt attention to these symptoms helps ensure safe and effective therapy.

Why Choose Advanced Medical Wellness for TRT?

• Clinical Experience: Our team understands the complexities of hormone therapy.

• Local Access: Serving the Chandler and Gilbert, AZ, and East Valley communities.

• Full Transparency: We are upfront about cost, care plans, and potential risks.

• Supportive Monitoring: Your health is continually assessed to optimize results.

Visit us online to schedule your consultation.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider before starting any treatment.