The Side Effects Of TRT & How To Counter Them

Millions of men in America use testosterone replacement therapy (TRT) to restore and boost the levels of this manly hormone. The treatment can reduce and reverse some of the signs of low testosterone (T), offering a boost in energy, sexual vigor, and mental clarity. While the marketing blitz around the therapy promises startling results, TRT is by no means all positives and no negatives. As with all therapies, it is crucial to view the complete picture before plunging in. Today, we help you understand the side effects of TRT therapy and how to counter them.

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Why might I need TRT?

Testosterone replacement therapy, or TRT, can be a great way to revitalize yourself if your testosterone levels are low. Low testosterone can cause a rash of issues, ranging from physical problems to mental and behavioral ones.

Although TRT does have multiple benefits, here at Concierge MD, we believe in full transparency regarding the possible side effects and potential risks of the therapies we offer, which we help you assess when deciding if the therapy is right for you. Before looking at the possible side effects of TRT, what kind of signs and symptoms would make an individual a likely candidate for TRT?

Two criteria qualify an individual for possible TRT therapy: low T levels (less than 280 nanograms per deciliter (ng/dL) and several symptoms.

Some of the signs and symptoms that accompany low T levels are:

  • Depression
  • Difficulty concentrating
  • Reduced self-confidence
  • Disturbed sleep
  • A decline in muscle accompanied by an increase in body fat
  • Change in cholesterol and lipid levels
  • Fatigue
  • Lowering of hemoglobin and mild anemia
  • Osteoporosis (fragile bones)
  • Decrease in body and facial hair
  • Swollen and sensitive breasts (gynecomastia)
  • Lower sex drive
  • Difficulty sustaining erections
  • Fewer spontaneous erections

Individuals with one or more of these symptoms can benefit from TRT therapy, and in most cases, the benefits outweigh the possible side effects.

At Concierge MD, while considering your symptoms, we conduct several blood tests to rule out other possible underlying conditions or factors that might cause similar symptoms.

What are the side effects of TRT therapy?

According to this literature review, there isn’t yet any concrete scientific evidence about TRT side effects, especially with long-term use. As such, it is generally considered a safe therapy.

While some men experience immediate side effects after TRT, there are no comprehensive, long-term, and large-scale clinical studies to establish the long-term side effects of TRT. Nevertheless, scientists agree that as a hormone replacement therapy (HRT), there are some possible side effects and that anyone undertaking TRT should do so with caution.

Here are the possible side effects of TRT therapy.

Physical side effects

Physical side effects can occur immediately or with long-term use and require close monitoring. In some cases, physical side effects that appear disappear after some time as the body gets used to the therapy.

They include:

  • Acne or oily skin
  • Mild fluid retention due to possible enlargement of the prostate, which constricts the urethra
  • Breast enlargement and sensitivity
  • Decreased testicular size because TRT stops the natural production of testosterone in the testicles
  • Swollen ankles due to fluid retention

Physiological and psychological side effects

Physiological and psychological side effects are considered more of mid to long-term side effects and remain hypothetical due to the unavailability of long-term clinical studies.

They include:

  • Stimulation and growth of prostate tissue, which can increase urination problems
  • Changes in lipid and cholesterol levels
  • A decrease in sperm count, which can lead to infertility
  • A higher red blood cell count
  • A higher risk of developing prostate abnormalities, including the growth of benign and malignant cells
  • A heightened risk of developing blood clots due to high red blood cell counts can increase the risk of pulmonary embolism
  • Increased mood swings and aggression
  • May increase the risk of cardiovascular problems like heart attack, heart disease, and strokes

Impact on existing conditions

TRT is not indicated for men who have severe or uncontrolled underlying conditions. The hypothesis is that increasing testosterone can make these conditions worse, outweighing any possible benefits the therapy might have on the individual.

Some of the conditions that can worsen with TRT include:

  • Prostate cancer
  • Breast cancer
  • Severe urinary tract problems
  • Uncontrolled heart failure or heart disease
  • A history of stroke
  • Untreated severe sleep apnea

How to mitigate the side effects of TRT

Although TRT therapy has multiple possible side effects, they only affect a small percentage of the millions of men who undertake it.

Concierge MD undertakes a raft of mitigative measures to further reduce the possibility of TRT side effects occurring, including:

Thorough screening

All clients undergo thorough screening where we perform comprehensive lab tests to understand their hormonal profile. We also screen for prostate and breast growths (both malignant and benign), heart, and urinary tract health.

Graduated therapy

All therapy sessions go through graduated phases where we administer lower amounts of testosterone initially while monitoring you closely. If you respond well, we bring up the therapy to the ideal levels that provide maximum benefit.

Therapy stacking

Sometimes, some side effects (like oily skin and acne) can be treated with an additional therapy, which we offer by combining multiple therapies.

Correct testosterone measurements

Like other hormones in the body, testosterone levels fluctuate throughout the day. As such, taking readings at the wrong time can provide a false reading. We follow hormone measurement best practices and measure T levels between 7 AM and 10 AM when levels peak, which gives us accurate readings.

Full transparency

We transparently and candidly discuss possible side effects ensuring individuals have all the information they need to make an informed decision. Since we put our client’s health first, we do not push the therapy if an individual has reservations and opts to decline it after learning all the possible side effects.

In-home treatments versus clinics

When receiving medical treatments, you probably envisage going to a medical center or clinic. However, many treatments can now be administered at home by licensed medical professionals, including TRT. Let’s look at the pros and cons of clinics and in-home treatments.

In-home treatments

The main benefit of a concierge service is convenience. A licensed clinician will visit you and provide in-home services, eliminating your commute time and allowing you more flexibility in your schedule.

Many in-home services offer comprehensive hormone lab testing, monthly telemedicine consultations, at-home lab draws, and will ship your hormone replacement kits directly to you.

Convenience isn’t the only benefit of TRT treatment at home. Concierge services also offer privacy and discretion. Some men wish to keep their medical services more private, and concierge medicine is the best way to accomplish that.


Many people find a lot of value in speaking with a doctor face-to-face, and that experience can’t be replicated by video calls or online consultations.

Clinics will, of course, provide the same assessments, lab draws, and consultations that concierge doctors do. However, it is the patient’s responsibility to pick up their prescription from their local pharmacy. The patient will also need to commute to and from the clinic.

A clinic also may not offer telemedicine services for ongoing consultations, requiring additional appointments to speak to the doctor.

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