Testosterone Replacement Therapy (TRT) involves administering exogenous testosterone to restore physiological levels in individuals with clinically diagnosed hypogonadism. It aims to alleviate symptoms such as low libido, fatigue, decreased muscle mass, and mood disturbances by activating androgen receptors. While effective for hypogonadism, its role in general healthspan extension for eugonadal men remains unproven and potentially risky.
Verdict
Effective for diagnosed hypogonadism; requires medical oversight due to risks.
HEALTHSPAN IMPACT
High Value
RISK LEVEL
Moderate
EVIDENCE GRADE
A
MONTHLY COST
$30 - $250
Protocol
- Injectable protocols often involve intramuscular or subcutaneous injections of 50-100 mg once or twice weekly.
- Transdermal gels or patches are applied daily to the skin, delivering varying doses based on product and patient response.
- Testosterone pellets may be implanted subcutaneously every 3-6 months, releasing the hormone gradually.
Flags
- May increase hematocrit (polycythemia) requiring therapeutic phlebotomy.
- Can suppress endogenous testosterone production and impair fertility.
- Potential for prostate enlargement or exacerbation of existing prostate conditions.
- Controversial cardiovascular safety concerns in some populations; requires careful assessment.
- Requires regular blood tests to monitor testosterone levels, hematocrit, and prostate-specific antigen (PSA).
- Possible side effects include fluid retention, acne, sleep apnea exacerbation, and mood changes.