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.1 Why does that matter, you ask? In layman’s terms: Testosterone helps you maintain (and build) lean body mass while protecting the muscle tissue you already have. (Not seeing results in the gym? You might have low T.)
That’s just the tip of the iceberg, though. Testosterone is quite literally what makes a man masculine. Hair growth, muscular size, broad jawline, deep voice, raging libido, chiseled abs…Yep, that’s all related to testosterone (in some capacity). As such, testosterone is an anabolic, androgenic steroid (AAS).
Similar to human growth hormone (HGH), myriad 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 proper assays 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. (Testosterone is quite literally what makes a man manly, after all.)
Depending on the form of testosterone you are given for your TRT regimen, you can expect to see reversal/reduction of low T symptoms within as little as two weeks. For most males, it will take closer to one month of restoring testosterone levels to healthy ranges before noticing significant improvements in quality of life and wellbeing.
After the first few weeks of taking testosterone, you can expect to have a heightened sense of vitality, increased libido, enhanced energy levels, more restful sleep, and many other beneficial signs.2
Several weeks 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. The initial waiting period for testosterone to kick in and work its magic is well worth it (especially once you reach a stable dosing regimen and feel like you have your life back).
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.
You will be required to give a blood sample to assess the quantitative values of your testosterone (and possibly other assays). It is key to have blood work done before and during TRT to ensure your red blood cell counts, blood lipids, PSA, and other 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 comes back and signifies you have suboptimal testosterone levels, you will likely be considered a candidate for TRT.
Should you move forward with beginning TRT, you will be given a shot of testosterone and taught how to inject yourself for future doses.
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. (And I’m writing this as someone on TRT who – at first – would break into cold sweat at the sight of needles. Now injecting is basically like second nature to me.)
Injecting yourself (initially) is all a mind game. It’s only natural that your brain looks at a sharp needle and gets a little apprehensive about sticking it into your body (especially deep into muscle tissue). In reality, though, the gauge of the needle is 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.
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.
I’m 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. The best advice is to take deep breaths and go slow and 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; once you pass the outer skin layers, the needle will glide into your muscle with minimal pressure applied to the syringe. (Your muscle might twitch slightly but it’s not a painful sensation for most people, more so like a reflex.)
If you really have trouble injecting yourself, you can ask a friend or family member to help with the first few injections. This is common for many newcomers to TRT, since you can just close your eyes and let someone else do the injection for you.
However, in the long-term, you really are better off becoming comfortable with doing the injection process yourself. It’s not always practical to find someone to inject you, especially if you live alone or want to keep your TRT use private.
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 plunge with a testosterone-filled syringe into your body. We all want results now, but as alluded to earlier you will need to be patient coming out of the gate. Nevertheless, you can expect to see a variety of benefits in the incipient weeks of TRT.
For practicality purposes, the list below details the benefits you should expect to notice during the short-term of TRT:
- Increased libido/sex drive
- Enhanced erectile quality
- Improvement in energy levels and concentration
- Better sense of vitality, motivation, and confidence
- Having a more regular appetite
- Improved sleep quality
Longer-term benefits of TRT typically include:
- Ability to recover and build muscle more efficiently
- Easier time losing body fat
- Facial hair growth
- Improved bone and joint health
- More adequate red blood cell production
There are other benefits to TRT, and it’s imperative to note that not everyone will have the exact same experience/response to testosterone. Some males will notice rapid benefits on a small dose of testosterone; others will take a little longer to respond and might need a larger dose to achieve therapeutic benefits.
TRT is an individualistic treatment and it’s not apropos to compare your TRT regimen to someone else’s. This is not to say you shouldn’t expect to benefit from TRT like other males do; rather that TRT take a little trial and error initially, and the time it takes for the benefits to kick in 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. After all, exogenous testosterone is a drug and it can have some side effects.
It might come as a surprise, but when you start taking exogenous testosterone, your body will decrease it’s 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 (supplemental) 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.
Don’t fret, though, as there are workarounds 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 weight loss but also has properties for enhancing fertility and testicle size in males (by promoting testosterone production from the testes, similar to the way LH normally would).3
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 are shown to live longer, have more vitality, and exude more confidence.4
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 to back its benefits are irrefutable.
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.
- Seal, L. J. (2009). Testosterone replacement therapy. Medicine, 37(9), 445-449.
- 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.