Longevity Medicine
What Is Testosterone Replacement Therapy?
Last reviewed: May 2026 · Haute MD Editorial Team
Testosterone replacement therapy (TRT) restores testosterone levels in men diagnosed with hypogonadism — clinically low testosterone — improving energy, libido, body composition, mood, cognitive function, bone density, and cardiovascular health. Methods include injections, topical gels, patches, pellets, and nasal spray.
Who is a candidate for TRT
Men with confirmed low testosterone on morning labs (typically <300 ng/dL on at least two occasions) plus symptoms of hypogonadism. Proper diagnosis requires evaluation of LH, FSH, SHBG, and estradiol in addition to total and free testosterone.
Delivery methods
Intramuscular and subcutaneous injections are the most common and provide steady levels with weekly or twice-weekly dosing. Pellets offer 3-6 months of steady release. Gels and creams require daily application.
Frequently Asked Questions
Is TRT safe?
When properly monitored, TRT has a strong safety profile. Regular labs assess hematocrit, PSA, and estradiol to manage potential side effects.
Does TRT cause prostate cancer?
Current evidence does not support a causal link between TRT and prostate cancer. Baseline PSA evaluation and monitoring are standard.
Does TRT affect fertility?
Yes. TRT typically suppresses sperm production. Men wishing to preserve fertility should discuss alternatives like clomiphene, hCG, or enclomiphene with their physician.
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