Patients who qualify for TRT should have their serum levels of free and total testosterone, estradiol, hematocrit, and PSA measured before starting TRT. Questionnaires, such as the Androgen Deficiency in the Aging Male (ADAM) questionnaire or the aging male symptoms (AMS) rating, can help evaluate the symptoms of hypogonadism. Dhindsa et al. found that 50% of obese diabetic men above 45 years old have low free testosterone levels (13). Grosman et al. found that hypertension, increased triglycerides and elevated waist circumference have the strongest association with decreased testosterone (12).
In men.65 years who have symptoms or conditionssuggestive of testosterone deficiency (such as low libido or unexplained anemia) and consistentlyand unequivocally low morning testosterone concentrations, we suggest that clinicians offertestosterone therapy on an individualized basis after explicit discussion of the potential risks andbenefits. In 2025, clinics like AlphaMan, a men’s health center specializing in hormone optimization, are rethinking how testosterone therapy fits into modern masculinity. You can stay on testosterone replacement therapy for as long as it’s benefiting your symptoms and not causing health issues. To allow the therapy to take full effect, healthcare providers typically wait 30 days after you start TRT to check your testosterone levels. Testosterone replacement therapy can improve many of the symptoms of low testosterone (male hypogonadism).
We know the prostate to be an androgen-dependent gland and conversely, anti-androgen agents can decrease prostate volume in patients with BPH. With this gradual decline, the beneficial effects of testosterone could be diminished and negatively affect physical and emotional well-being. Physician extenders do play an important role in the safe management of patients on TRT, as long as a proper treatment algorithm is established by the physician. Symptomatic hypogonadism is a common complaint in urology offices and TRT is the gold standard of treatment. Sharma et al. concluded that there was no increase in the risk of DVT after starting TRT (48).
Additionally, constant dieting or overeating may disrupt your testosterone levels. What you eat can affect levels of testosterone as well as other hormones. Resistance training, such as weightlifting, has been shown to boost testosterone levels in the short term.
The use of testosterone therapy in women is summarized in Table 6.64,65 A comprehensive meta-analysis of post-menopausal women found improvement in sexual function with testosterone therapy. Of note, there is no consensus on the necessity and timing of repeated PSA testing and digital rectal examination for men on testosterone therapy. Testosterone therapy has been shown to increase hemoglobin levels and correct anemia in a significant portion of older men with anemia of otherwise unknown etiology. No randomized controlled trial has demonstrated decreased cardiovascular events or mortality with testosterone therapy. Testosterone therapy consistently increases lean mass and decreases fat mass,25–27 but the effect sizes are small and studies have generally failed to demonstrate improvement in strength or physical function.22,23,25,26
You may need to have your blood taken more than once and at different times of the day, since testosterone levels change. If your doctor suspects your testosterone levels are low, they’ll give you a blood test, probably first thing in the morning. If you have symptoms of low testosterone and tests show you have an abnormally low testosterone level (below 300 nanograms per deciliter), your doctor may suggest treatment. Testosterone replacement therapy (TRT) is a shot, patch, or gel of the hormone testosterone to bring the level back to normal. Talking with your doctor is the only way to know if testosterone therapy is right for you.
Low testosterone, or male hypogonadism, doesn’t always announce itself with flashing neon lights. Research has also studied the increased risk of venous thromboembolism, and the results are mixed. For example, some studies suggest that TRT decreases your risk of heart attack over time, while others say it increases your risk. TRT involves taking manufactured forms of testosterone to regulate your levels of this hormone. Human chorionic gonadotropin, SERMs, estrogen antagonists and aromatase inhibitors stimulate the endogenous production of testosterone and improve symptoms of hypogonadism when the testis can respond. Because these modified androgens may not aromatize to estrogenic compounds, longer-term studies are required to demonstrate lack of adverse effects on bone health.93,100
Free testosterone (the active form) also matters, as does the patient’s overall health picture. "We run a full hormone panel and go deep into symptoms, lifestyle, and history. "We start with bloodwork," says Dr. Allen Lawrence, who brings over 35 years of hormone therapy experience to AlphaMan Clinic.

Gender: Female

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