Testosterone Replacement Therapy (TRT)
Testosterone replacement therapy (TRT) restores testosterone to a healthy level in men whose low testosterone is causing symptoms. Treatment is planned after blood tests and continues with regular check-ups.
In a man in his twenties, a healthy testosterone level is a sign that all is well. When the same man's level falls in his forties or fifties and he loses his libido and gains weight around his belly, that drop is often dismissed as "just age". We don't see it that way. If it is causing symptoms, it deserves to be assessed and, where appropriate, treated.
“Testosterone is not a vitamin. It's not something you buy online or use at the gym by guesswork. It must be used under medical supervision, with many parameters monitored before and during treatment. But in the right patient, it has very significant benefits.”
What Changed: The TRAVERSE Trial
For about a decade, there was concern that testosterone therapy might increase the risk of heart attack and stroke. The TRAVERSE trial, published in 2023, tested this in 5,246 men aged 45 to 80 with low testosterone and existing heart disease or a high risk of it. Over roughly three years of follow-up, major cardiac events were no more common in men taking testosterone than in men taking a placebo. In 2025 the US Food and Drug Administration (FDA) removed the heart-risk language from the boxed warning on testosterone products. The trial did find slightly higher rates of atrial fibrillation, pulmonary embolism and acute kidney injury, so careful monitoring remains essential.
Possible Benefits
- Better sex drive and sexual function
- Improved bone, muscle and overall metabolism
- Better mood, more energy and a feeling of strength
- Other sexual health treatments, such as shockwave therapy, tend to work better when testosterone is normal
Before Treatment
- Morning blood tests, usually on two separate days, to confirm low testosterone
- Assessment of symptoms, general health and medications
- Blood count, prostate (PSA) and other baseline tests
- A conversation about fertility, because TRT can reduce sperm production
During Treatment
- The dose is adjusted to your blood results, not guessed
- Regular check-ups monitor testosterone, blood count, PSA and blood pressure
- The plan is reviewed according to how you feel and how your results change
Who Should Not Have TRT?
- Men trying to conceive in the near future
- Men with untreated prostate or breast cancer
- Men with a very high red blood cell count
- Men with a recent heart attack or stroke, until assessed by their cardiologist
Frequently Asked Questions
Is testosterone therapy safe for the heart?
The TRAVERSE trial found no increase in major cardiac events in men treated with testosterone compared with placebo, and the FDA updated its labelling in 2025. Treatment still needs regular monitoring, including blood pressure and blood count.
Will TRT affect my fertility?
It can. Testosterone therapy can lower sperm production. If you want children now or in the near future, tell us, as there are other ways to raise testosterone that protect fertility.
Can I just buy testosterone online?
No. Using testosterone without testing, a measured dose and follow-up is risky. It should only be used under medical supervision.
How soon will I notice a difference?
Many men notice better energy and libido within a few weeks. Changes in body composition and bone take longer, over several months.
