Testosterone levels naturally decrease as men age, so maintaining healthy testosterone levels is imperative for ensuring longevity and wellness. There are many reasons testosterone is so intensively researched, with findings demonstrating that this key steroid hormone has a multitude of anabolic properties in the human body.
For example, research shows that testosterone potently inhibits amino acid oxidation and increases skeletal muscle protein synthesis. In layman’s terms, this means testosterone helps maintain (and build) lean body mass. If you're not seeing results in the gym despite a proper diet plan and exercise regimen, you might have low T.
And that’s just the tip of the iceberg...
Testosterone is quite literally what makes a man masculine. Hair growth, muscular size, jawline shape, voice pitch, libido, confidence, metabolism, bone density, the list goes on - it’s all related to testosterone in some capacity. As such, testosterone is characterized as an anabolic androgenic steroid (AAS).
Similar to human growth hormone (HGH), a myriad of factors affect your endogenous production of testosterone - positively or negatively. These factors typically include:
Positive regulators (these generally increase testosterone)
- Sufficient sleep
- Healthy body composition (leanness)
- Intense exercise (especially vigorous resistance training)
- Intermittent abstinence (up to 10 days)
Negative regulators (these typically decrease testosterone)
- Diabetes (specifically insulin-resistant/type II diabetes)
- Excessive alcohol intake
- Very-low-fat diet (fat is necessary for synthesizing androgens)
- Lack of sleep
- Chronic stress
- Sedentary lifestyle
- Prolonged cardiovascular (aerobic) exercise
Chances are you stumbled upon this article because you’re concerned about having low T (testosterone). The next section will cover some of the most common symptoms of low T.
Symptoms of Low T (Testosterone)
The list below details the most common signs and symptoms of having low T:
- Erectile dysfunction (impotence)
- Reduced libido/sex drive
- Decreased energy (fatigue)
- Reduced muscle bulk and strength
- Small or shrinking testes
- Poor concentration (brain fog) and recall
- Low red blood cell count (anemia)
- Brittle bones and general weakness
- Hot flashes
- Body fat increase
- Loss of body and pubic hair
- Sleep apnea (or other sleep disorders)
- Development of breast tissue (gynecomastia)
It’s important to note that while you may exhibit several (or all) of these symptoms, you should confirm that you have low T with proper blood work. A trained physician at Gameday Men’s Health can help order the appropriate lab tests and guide you through the process of restoring your testosterone to healthy levels.
What to Expect on TRT
If you’ve made the choice to start testosterone replacement therapy (TRT), you might be wondering what to expect throughout the process of getting your “manhood” back.
Depending on the form of testosterone used, many men notice a reduction of low T symptoms within as little as one month on TRT. For some, it may take longer before improvements in health and well-being become apparent. Several weeks or months might sound like a long time, but in the grand scheme of things, that’s actually very quick. It’s key to remember that TRT is a long-term solution to an otherwise long-term health problem.
Research suggests that the short-term benefits of TRT may include a heightened sense of vitality, increased libido, enhanced energy levels, more restful sleep, and other positive changes. The vast majority of TRT patients find that the initial waiting period for testosterone to kick in is well worth the wait.
What the Process Is Like to Get Started
The first order of business for starting TRT is to contact Gameday Men’s Health and schedule an initial consultation. During the initial appointment, you will be asked to detail your symptoms and learn more about what TRT does.
We require blood work from all prospective patients. This allows us to assess the quantitative values of your testosterone (and possibly other associated assays). It's essential to have blood work done before and during TRT to ensure your red blood cell counts, blood lipids, prostate-specific antigen, and other relevant biomarkers are in a healthy range.
Having a licensed physician oversee the process of starting TRT should put your mind at ease, though, as they are trained to properly medicate you and minimize side effects/health ramifications. If your blood work suggests you have suboptimal testosterone levels, you will likely be considered a viable candidate for TRT.
Should you move forward with beginning TRT through GameDay Men's Health, you will be given a shot of testosterone and taught how to inject yourself for future doses. Alternatively, you may come to the GameDay office for quick and easy weekly TRT injections.
What It’s Like to Inject Yourself
Afraid of needles? Don’t worry, injections are not nearly as petrifying as they may seem at first. We're not trying to sugarcoat this process, because injections are certainly a hurdle for many beginners on TRT. Even those who have been on TRT for years still have a little apprehension when it comes time to inject themselves.
In reality, though, the gauge of the needle is very small when injecting testosterone; once you get past the initial puncturing of the skin, the needle will glide smoothly into your muscle tissue without much sensation at all. The best advice is to take deep breaths and be steady when inserting the needle.
Intuitively, you might just think that jabbing the needle in as fast as possible will bypass any sort of sensation you might feel, but that’s also not a very controllable approach. Use a firm grip on the barrel of the syringe, breath, and firmly penetrate your skin. The needle will smoothly glide into your muscle, at which point you will apply pressure to the plunger and dispense the testosterone. (Your muscle might twitch slightly but it’s not a painful sensation for most people, more so a reflex.)
The entire injection process generally takes no more than 15 seconds. Always be sure to maintain a sterile environment. Wipe the injection spot with an alcohol wipe beforehand to disinfect the skin and do not reuse needles or syringes as this greatly increases the risk of infections.
When you inject testosterone, you’re putting a depot of oil into muscle tissue which is slowly dispersed into the bloodstream (for several days, or even weeks, depending on the ester). As a side effect of this, you might experience injection site soreness for a few days after the fact. Don’t worry, though; this is completely normal and subsides on its own. Massaging the muscle and applying a warm gel pack for 5-10 minutes can also help alleviate any soreness or stiffness at the injection site.
Do I Have to Inject Myself on TRT?
If you have trouble injecting yourself, GameDay Men's Health offers in-and-out injection appointments to our TRT patients. This is the most common option for many newcomers to TRT since you can just close your eyes and let us do the injection for you.
You may also ask a friend or family member to help with the first few injections if you prefer to do them at home.
In the long-term, it behooves you to become comfortable with doing TRT injections by yourself. It’s not always practical to find someone to inject you, especially if you live alone or want to maintain privacy about your TRT.
Just breathe and relax, you got this.
What Benefits You Notice First on TRT
Naturally, you’re going to be antsy to see benefits after your first TRT injection. We all want results yesterday, but as alluded to earlier you will need to be patient. TRT is not an overnight solution. It is a long-term investment in your health.
Nevertheless, a good amount of TRT patients notice positive changes in their health and well-being within the first month of starting TRT. Such short-term benefits may include:
- Increase in libido/sex drive
- Restoration of erectile quality
- Improvement in energy levels and concentration
- A better sense of vitality
- More restorative sleep cycles
Long-term benefits of TRT may include:
- Ability to recover from exercise more efficiently
- More confidence
- Support for healthy body composition
- Facial hair growth
- Improvement of bone and joint health
- More adequate red blood cell production
There may be other benefits to TRT, but it’s imperative to note that not everyone will have the same experience/response to testosterone. Some men notice a quicker onset of benefits on a small dose of testosterone; others may take a little longer to respond and might need a larger dose to achieve therapeutic benefits. If you experience no benefits or positive changes after several months of TRT, consult with your physician as there may be more diagnostic testing necessary.
TRT is an individualistic treatment and it’s not proper to compare your TRT regimen to someone else's. TRT takes a little trial and error, initially, and the time it takes for the benefits to become apparent varies between everyone.
Things You Didn't Expect on TRT
It would be remiss not to disclose some of the things you will experience on TRT that most males aren’t expecting. Exogenous testosterone is a drug and it can produce some side effects, much like any other drug.
When you start taking exogenous testosterone, your body will decrease its natural (endogenous) production of testosterone. This is due to the negative feedback loop your pituitary gland works through to regulate your production of testosterone.
In healthy individuals, the pituitary will produce luteinizing hormone (LH) and signal the testes to produce testosterone to keep levels in adequate range. The pituitary negative feedback loop is much like a “shutdown” mechanism of your body’s internal testosterone-producing pathway, since you’re getting all the testosterone you require through an exogenous source.
Naturally, your body doesn’t need to produce testosterone since it’s essentially being ‘fed’ with the hormone.
As a side effect of this, your testicles can shrink in size since less LH is being produced (and thus, testosterone synthesis in the testes decreases). You may also experience a reduction in sperm counts, which can be an issue if you’re trying to have children.
There are workarounds to these issues; one such protocol is to simultaneously use human chorionic gonadotropin (HCG) - an analog of the LH that your pituitary gland produces - along with TRT. HCG is normally made in females by the placenta during pregnancy. It is often used for "off-label" as a weight loss aid but also has documented benefits for enhancing fertility and testicle size in males (by promoting testosterone production from the testes, similar to the way LH normally would).
Take-Home Points about TRT
TRT is a big decision in a man’s life. Testosterone is the most potent androgen your body produces, and it controls your masculinity in every sense of the word.
From an evolutionary perspective, men needed higher testosterone to give them that ‘alpha male’ drive for hunting and protecting family. In modern culture, men with higher testosterone have been shown to live longer, have more vitality, and exude more confidence.
Naturally, having low T is something to be taken seriously as you are lacking the very substance that makes you a man. TRT is a life-changing protocol for many males, and the research backing its benefits is unambiguous.
Hopefully, this guide gave you a better idea of what to expect on TRT and how you can go about starting the process to restore your testosterone levels to a healthy range. Keep your eyes on the Gameday Men’s Health Blog for future posts addressing all your questions and concerns related to male health and wellness!
- Brodsky, I. G., Balagopal, P., & Nair, K. S. (1996). Effects of testosterone replacement on muscle mass and muscle protein synthesis in hypogonadal men--a clinical research center study. The Journal of Clinical Endocrinology & Metabolism, 81(10), 3469-3475.
- Bassil, N., Alkaade, S., & Morley, J. E. (2009). The benefits and risks of testosterone replacement therapy: a review. Therapeutics and clinical risk management, 5, 427.
- Dohle, G. R., Smit, M., & Weber, R. F. A. (2003). Androgens and male fertility. World journal of urology, 21(5), 341-345.
- Shores, M. M., Moceri, V. M., Sloan, K. L., Matsumoto, A. M., & Kivlahan, D. R. (2005). Low testosterone levels predict incident depressive illness in older men: effects of age and medical morbidity. The Journal of clinical psychiatry.