What Questions To Ask Your Doctor Before Starting Testosterone Replacement Therapy

What Questions To Ask Your Doctor Before Starting Testosterone Replacement Therapy

Thinking about starting Testosterone Replacement Therapy (TRT)? Here are the most important questions to ask your doctor before you begin. Having an open and honest talk with your doctor will help you understand the benefits, risks, and what TRT could mean for your health. This way, you can make the best decision for your body and your future.

Why It Matters

Testosterone is a hormone that plays a big role in your energy, mood, muscles, bones, and sex drive. When levels drop too low, a condition called testosterone deficiency or hypogonadism, people can feel tired, weak, and less motivated. In these cases, TRT can help. Research has shown that TRT can improve bone strength, mood, and overall well-being in men with low levels of testosterone (British Society for Sexual Medicine, 2023).

But TRT is not risk-free. Doctors warn that it can sometimes cause problems such as thickened blood (which raises the risk of blood clots), acne, changes in mood, or sleep apnoea. It can also affect the prostate and reduce fertility by lowering sperm production (NHS, 2022). Because of this, experts recommend regular blood tests and health checks while on treatment.

This article lists some questions you should ask your doctor and their expert answers. However, since each TRT case is different, we suggest getting specific answers from your doctor.

Understanding TRT: Benefits, Risks & Medical Basics

Before starting testosterone replacement therapy (TRT), it’s essential to understand what it actually does, how doctors decide if you need it, and what the possible upsides and downsides are. This knowledge helps you go into your doctor’s office ready to ask the right questions.

What Happens Before Starting TRT?

You don’t just “start” TRT after one blood test. Doctors usually do a full check first. This might include:

• Blood tests in the morning (when testosterone levels are highest)
  
  
• Checks on haemoglobin and haematocrit (to see if your blood is too thick)
  
  
• Liver function tests (to make sure your liver can process hormones)
  
  
• Prostate checks (such as PSA tests, especially for men over 40–50)
  
  
• Hormone balance tests (like luteinising hormone and prolactin)
  
  
• A physical exam and questions about symptoms

These steps help confirm whether your testosterone levels are really low and if TRT is the proper treatment for you. According to the British Society for Sexual Medicine, guidelines suggest a precise diagnosis before starting therapy.

The Possible Benefits

When appropriately used in people with low testosterone, TRT can bring some big benefits:

• More energy and reduced fatigue
  
  
• Better mood and less irritability
  
  
• Improved muscle strength and body composition
  
  
• Stronger bones and reduced risk of fractures
  
  
• Better sex drive and sexual performance
  
  
• Possible support for metabolic health (cholesterol, blood sugar, weight)
  
  

For example, studies have shown that men with testosterone deficiency who take TRT can see improvements in both muscle mass and bone strength over time.

The Possible Risks

Like any medical treatment, TRT also has side effects. These can include:

• Thickened blood, which may increase the risk of blood clots or stroke
  
  
• Prostate growth or raised prostate cancer risk (doctors monitor this closely)
  
  
• Reduced sperm count and possible infertility
  
  
• Sleep apnoea (breathing pauses during sleep) is getting worse
  
  
• Skin problems such as acne or oiliness
  
  
• Mood changes like irritability or aggression
  
  

Some studies suggest TRT does not increase short-term heart risk if appropriately monitored, but the long-term safety is still being studied (Harvard Health, 2023). This is why ongoing blood tests and check-ups are essential.

What Causes Low Testosterone?

Low testosterone (often called “low T”) happens when your body doesn’t produce enough of the hormone testosterone. This hormone is key for male development and health—it deepens the voice, stimulates facial and body hair growth, builds muscle mass and bone strength, and helps regulate mood, energy, and sex drive.

Low T can develop for a few different reasons:

• Testicular problems (primary hypogonadism): The testicles may not function properly due to injury, infection, or genetic conditions.
  
  
• Signal issues from the brain (secondary hypogonadism): The pituitary gland or hypothalamus may not send the right signals to trigger testosterone production.
  
  
• Age-related decline: Testosterone levels naturally decrease with age. In fact, about 40% of men over 45 have levels below the normal range.
  
  
• Health conditions: Obesity, type 2 diabetes, chronic illnesses, and hormone disorders can all contribute to low T.
  

If your testosterone is low, your doctor will likely order blood tests to pinpoint the cause and recommend treatment options.

What Are the Best Treatment Options for Low Testosterone?

The most common treatment for low testosterone is testosterone replacement therapy (TRT). This approach helps restore testosterone levels to a healthy range, often improving energy, mood, muscle mass, bone health, and sexual function.

TRT can be given in several forms, including:

• Gels or creams applied to the skin
  
  
• Patches worn on the body
  
  
• Injections are given every few weeks
  
  
• Pellets are inserted under the skin for long-term release
  
  
• Oral tablets (less common)
  
  

Millions of men worldwide use TRT, and it has become a widely recognised option for managing low T symptoms.

However, TRT isn’t the only answer. The best treatment depends on the underlying cause of your low testosterone. For example:

• If obesity, diabetes, or another health condition is lowering your testosterone, treating that condition may improve levels naturally.
  
  
• If a medication or lifestyle factor is contributing, your doctor may adjust your treatment plan.
  
  

Comparison of TRT Delivery Methods

Your doctor will help determine whether TRT or another approach is the safest and most effective option for you.

Which TRT Method Is Right for Me?

Testosterone replacement therapy (TRT) is available in several forms, and the best option depends on your lifestyle, preferences, and health needs.

Standard TRT methods include:

• Gels or creams: Applied once daily to the skin, where testosterone is absorbed into the bloodstream. Some gels are also available for use inside the nose.
  
  
• Skin patches: Worn on the upper body and replaced daily.
  
  
• Injections: Testosterone is injected into a muscle, usually every 1–2 weeks, providing a longer-lasting dose.
  
  

Each method can effectively raise testosterone levels, but they differ in convenience, cost, and side effects. For instance, gels may be easy to use but can sometimes transfer to others through skin contact, while injections typically last longer but may cause fluctuations in hormone levels. Some research suggests injections may have fewer cardiovascular side effects compared to gels or patches, but findings are still being studied.

The right choice isn’t one-size-fits-all. Talk with your doctor about the pros and cons of each method so you can find the treatment that fits your health, lifestyle, and comfort.

How Will My TRT Dose Be Determined?

Your TRT dose isn’t one-size-fits-all—it’s personalised to your needs. Your doctor will consider several factors, including:

• Your testosterone levels: How low your levels are at the start.
  
  
• Your age and overall health: Other medical conditions, medications, and risk factors.
  
  
• Your symptoms: The severity of issues like fatigue, low sex drive, or mood changes.
  
  

Once you begin treatment, your doctor will monitor your response through regular blood tests and symptom check-ins. Based on how your body reacts, your dose may be adjusted to keep your testosterone within a healthy range while minimising side effects.

Will I Need Regular Checkups During TRT?

Yes. Ongoing monitoring is an essential part of testosterone replacement therapy (TRT) to make sure the treatment is safe and effective.

Typical follow-up schedule:

• 3 and 6 months after starting TRT: Blood tests are done to check your testosterone levels and assess your bodyis response. Your doctor may adjust your dose if needed.
  
  
• Prostate health: Screening for prostate cancer risk is usually done before starting TRT, then again at 6 months, and once a year after that.
  
  
• Annual monitoring: Your doctor will continue to check your testosterone, red blood cell levels, and overall health every year while you’re on therapy.

Monitoring plans can vary depending on your doctor and clinic, so it’s essential to ask your provider about their monitoring schedule and recommended tests.

Are There Any Risks and Side Effects of TRT?

Like any medical treatment, testosterone replacement therapy (TRT) can have risks and side effects. Not everyone experiences them, but it’s essential to be aware.

Possible side effects include:

• Acne or oily skin
  
  
• Thinning hair or baldness (if you’re genetically prone)
  
  
• Breast enlargement or tenderness
  
  
• Reduced sperm production and infertility
  
  
• Shrinking of the testicles
  
  
• Increased risk of blood clots
  
  
• Potentially higher risk of heart attack or stroke (still being studied)
  
  

Because TRT can affect multiple systems in the body, doctors run a series of tests before starting treatment to make sure it’s safe for you.

TRT is usually not recommended for men with:

• Untreated sleep apnea
  
  
• Prostate or breast cancer
  
  
• Severe urinary tract symptoms
  
  
• Uncontrolled heart failure
  
  

Being open with your doctor about your medical history is key. Together, you can weigh the benefits against the risks and decide if TRT is the right option for you.

Can I Boost Testosterone Naturally Without Medication?

Yes. In some cases, lifestyle changes can help raise testosterone levels, especially if your low T is linked to factors like excess weight, poor sleep, or stress. While these methods don’t work for everyone, they can improve overall health and may support healthy testosterone production.

Natural strategies that may help include:

• Maintaining a healthy weight: Regular exercise and weight loss (if you’re overweight) can significantly improve testosterone levels.
  
  
• Eating a balanced diet: Focus on lean protein, healthy fats, and complex carbs. Certain foods, like eggs, tuna, leafy greens, and nuts, are linked to healthier hormone levels.
  
  
• Managing stress: High stress raises cortisol, a hormone that can suppress testosterone. Relaxation techniques, mindfulness, or hobbies can help.
  
  
• Getting enough sleep: Aim for 7-9 hours of quality sleep each night. Sleep is when much of your testosterone is produced.
  
  
• Boosting vitamin D: Sun exposure, supplements, or vitamin D–rich foods (like salmon and fortified dairy) may help increase testosterone.
  
  
• Living a healthy lifestyle overall: Avoiding smoking, limiting alcohol, and staying active support hormonal health.
  
  

These approaches are generally safe and beneficial, even if they don’t dramatically raise testosterone. Your doctor can guide you on whether lifestyle changes alone are enough or if medical treatment is needed.

Additional Questions to Ask Before Starting TRT

Sometimes the smaller, practical questions are just as important as the big medical ones. Here are seven more things worth asking your doctor before beginning testosterone replacement therapy.

1. How quickly will I notice results?

Most men start to feel a difference in energy, mood, or sex drive within a few weeks, but changes in muscle strength and bone health may take several months. Improvements usually build up slowly, so patience is essential.

2. Will TRT interact with my current medicines?

Certain drugs, such as blood thinners or steroids, may interact with TRT. Always share your complete medication list so your doctor can check for possible risks or changes in dosage.

3. How much will TRT cost me in the long run?

The cost depends on the method; gels and patches are often more expensive than injections. Since TRT can be a lifelong treatment, ask about both NHS availability and private pricing so you know what to expect.

4. Will I need lifestyle changes alongside TRT?

Yes. While TRT can help with symptoms, it works best when combined with exercise, a balanced diet, good sleep, and reduced stress. Lifestyle changes may also allow for lower doses of testosterone.

5. Can TRT improve my mental health?

Low testosterone is linked with low mood, irritability, and brain fog. Some men report feeling clearer and more positive on TRT, but it is not a replacement for counselling or treatment if you have depression or anxiety.

6. What happens if I travel or miss a dose?

Missing a dose may cause testosterone levels to dip, leading to symptoms. If you travel often, ask about practical options like long-lasting injections or pellets that require less frequent dosing.

7. Can I drink alcohol while on TRT?

Moderate drinking is usually safe, but heavy alcohol use can harm the liver and lower testosterone further. Your doctor may suggest keeping alcohol within recommended limits to get the best results from TRT.

How to Prepare for Your First TRT Appointment

If your first testosterone replacement therapy (TRT) appointment is coming up, it’s normal to feel unsure about what to expect. Being well prepared will help you get the most out of your consultation and make confident decisions about your health. Here are some valuable tips:

• Bring all requested documents: This includes your recent blood test results, any medical history records, and a list of current medications or supplements.
  
  
• Write down your questions in advance: Keeping notes on your phone or paper ensures you don’t forget anything vital once you’re in the consultation.
  
  
• Consider bringing someone you trust: A partner, friend, or family member can help you stay calm, take notes, and remember the details of your doctor’s advice.
  
  
• Ask about all available treatment options: Injections, gels, patches, or pellets all have different pros and cons. Ask your doctor for their professional opinion on what fits your lifestyle best.
  
  
• Leave with a clear plan: By the end of your appointment, you should know why TRT is being suggested, what results to expect, how your health will be monitored, and what steps to take if problems arise.
  
  

Final Thoughts: Be Informed Before You Start TRT

Testosterone replacement therapy is a long-term treatment that you might need for the rest of your life to keep your testosterone levels normal. So, it's important to ask your doctor all your questions and clear up any confusion. This will help you feel more confident and sure about your decision.