According to an article in American Family Physician, the average male’s T production goes down by about 1 to 2 percent each year.

TRT is an acronym for testosterone replacement therapy, sometimes called androgen replacement therapy. It’s primarily used to treat low testosterone (T) levels, which can occur with age or as a result of a medical condition.

But it’s becoming increasingly popular for non-medical uses, including:

  • enhancing sexual performance
  • achieving higher energy levels
  • building muscle mass for bodybuilding

Some research suggests that TRT may in fact help you achieve some of these goals. But there are some caveats. Let’s dive into what exactly happens to your T levels as you get older and what you can realistically expect from TRT.

Why does T decrease with age?

Your body naturally produces less T as you age. According to an article in American Family Physician, the average male’s T production goes down by about 1 to 2 percent each year.

This is all part of a completely natural process that starts in your late 20s or early 30s:

  1. As you age, your testicles produce less T.
  2. Lowered testicular T causes your hypothalamus to produce less gonadotropin-releasing hormone (GnRH).
  3. Lowered GnRH causes your pituitary gland to make less luteinizing hormone (LH).
  4. Lowered LH results in lowered overall T production.

This gradual decrease in T often doesn’t cause any noticeable symptoms. But a significant drop in T levels may cause:

  • low sex drive
  • fewer spontaneous erections
  • erectile dysfunction
  • lowered sperm count or volume
  • trouble sleeping
  • unusual loss of muscle and bone density
  • unexplained weight gain

How do I know if I have low T?

The only way to know whether you truly have low T is by seeing a healthcare provider for a testosterone level test. This is a simple blood test, and most providers require it before prescribing TRT.

You may need to do the test several times because T levels are affected by various factors, such as:

  • diet
  • level of fitness
  • time of day the test is done
  • certain medications, like anticonvulsants and steroids

If your T levels are only slightly low for your age, you probably don’t need TRT. If they’re significantly low, your provider will likely do some additional testing before recommending TRT.

How is TRT administered?

There are several ways to do TRT. Your best option will depend on your medical needs as well as your lifestyle. Some methods require daily administration, while others only need to be done on a monthly basis.

TRT methods include:

  • oral medications
  • intramuscular injections
  • transdermal patches
  • topical creams

There’s also a form of TRT that involves rubbing testosterone on your gums twice daily.

How is TRT used medically?

TRT is traditionally used to treat hypogonadism, which occurs when your testes (also called gonads) don’t produce enough testosterone.

There are two types of hypogonadism:

  • Primary hypogonadism. Low T results from issues with your gonads. They’re getting signals from your brain to make T but can’t produce them.
  • Central (secondary) hypogonadism. Low T results from issues in your hypothalamus or pituitary gland.

TRT works to make up for T that isn’t being produced by your testes.

If you have true hypogonadism, TRT can:

  • improve your sexual function
  • boost your sperm count and volume
  • increase levels of other hormones that interact with T, including prolactin

TRT can also help to balance unusual T levels caused by:

  • autoimmune conditions
  • genetic disorders
  • infections that damage your sex organs
  • undescended testicles
  • radiation therapy for cancer
  • sex organ surgeries

What are the non-medical uses of TRT?

Many countries, including the United States, don’t allow people to legally purchase T supplements for TRT without a prescription.

Still, people seek out TRT for a range of non-medical reasons, such as:

  • losing weight
  • increasing energy levels
  • boosting sexual drive or performance
  • raising endurance for athletic activities
  • gaining extra muscle mass for bodybuilding

TRT has indeed been shown to have some of these benefits. For example, a recent review concluded that it effectively increased muscle strength in middle-aged and older males.

But TRT has few proven benefits for people, especially younger males, with normal or high T levels. And the risks may outweigh the benefits. A small 2014 study found a link between high T levels and low sperm production.

Plus, using TRT to gain a competitive edge in a sport is considered “doping” by many professional organizations, and most consider it grounds for termination from the sport.

Instead, consider trying some alternative methods for boosting T. Here are eight tips to get you started.

How much does TRT cost?

The costs of TRT vary based on what type you’re prescribed. If you have health insurance and need TRT to treat a health condition, you likely won’t pay the full cost. The actual cost may also vary based on your location and whether there’s a generic version available.

Generally, you can expect to pay anywhere from $20 to $1,000 per month. The actual cost depends on a range of factors, including:

  • your location
  • type of medication
  • administration method
  • whether there’s a generic version available

When considering the cost, keep in mind that TRT simply boosts your T levels. It won’t treat the underlying cause of your low T, so you may need life-long treatment.

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