What Does Testosterone Replacement Therapy Do?

Testosterone replacement therapy (TRT) is usually recommended for the benefits such as:

• Increase in energy
• Improved sex drive
• Improved quality of erection
• Increase in bone density and muscle mass
• Improved insulin sensitivity

Although TRT may be able to reverse the effects of hypogonadism, it is not clear if this therapy benefits older men who are otherwise healthy.

Most men respond positively but in varying degrees to TRT. Only 1 in 10 men experience "ecstatic" results from TRT. Some men believe they feel younger and more energetic if they take testosterone medication. However, there is little evidence that testosterone can be used in otherwise healthy men. 

According to the American College of Physicians, TRT may improve some male sexual functions, but there is little evidence that it provides any other benefits, such as increased energy and vitality.

Some areas where the changes may be noticeable as testosterone replacement therapy (TRT) progresses to include the following:

Physical changes

Some physical changes caused by TRT include:

• Skin becomes thicker and greasier
• Pores increase in size with increased oil secretion
• Urine smell changes
• Severe acne may occur on the face
• Muscles and soft tissues of the chest may have masculine features
• Hips and thighs start to lose weight
• Arms and legs will have more muscle definition
• Facial fat shifts and decreases
• Eyes and face may develop a masculine appearance
• Bone structure changes
• Vocal cords thicken, leading to a lower voice
• Voice may become hoarse
• Body hair becomes thicker and darker or grows faster
• Depending on family history or age, men may experience hair loss, male-pattern hair baldness, or thinning
• Changes in taste buds or perception of certain scents may occur

Emotional changes

You may encounter a second puberty and experience a rollercoaster of emotions. Some people experience little to no changes in their emotional state. Most people find that things settle down over time.

Although psychotherapy may not be for everyone, many people benefit from talking to a therapist. This can allow you to explore new thoughts and feelings and get to know yourself better.

Sexual function changes

You may notice an increase in your libido soon after starting testosterone replacement therapy. Some people notice changes in their sexual preferences, attraction, or orientation when they take testosterone.