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Treating testosterone deficiency with testosterone replacement therapy

Dr Dushyant Sharma
Written in association with: Dr Dushyant Sharma Endocrinologist in Liverpool
5.0 |

2 reviews

Sources: Top Doctors GB
Published: 14/10/2025 Edited by: Karolyn Judge on 28/10/2025

Testosterone plays a vital role in men’s health, influencing muscle mass, bone strength, mood, energy levels and sexual function. When the body produces too little of this hormone, a condition known as testosterone deficiency or hypogonadism, it can cause a wide range of physical and emotional symptoms. Testosterone replacement therapy (TRT) is an effective treatment that helps to restore normal hormone levels and improve quality of life for men with this condition.



What causes testosterone deficiency?

Testosterone levels naturally decline with age, typically beginning in a man’s 30s or 40s. However, deficiency can also occur due to medical conditions that affect the testicles, pituitary gland or hypothalamus. Common causes include:


  • Age-related hormonal decline (late-onset hypogonadism)
  • Testicular injury or infection
  • Genetic conditions such as Klinefelter syndrome
  • Pituitary gland disorders
  • Long-term illness or obesity
  • Certain medications or steroid use


Symptoms can include fatigue, low libido, reduced muscle mass, mood changes, poor concentration and decreased bone density.



How is testosterone deficiency diagnosed?

Diagnosis begins with a detailed history and physical examination. A blood test measuring testosterone levels, usually taken in the morning, when levels are highest, confirms the diagnosis. Because symptoms can overlap with other conditions, doctors often check for related issues such as thyroid disorders, anaemia or depression before starting treatment.



What is testosterone replacement therapy (TRT)?

TRT restores testosterone to normal physiological levels using medically approved methods. It's available in several forms, including:


  • Topical gels or creams applied daily to the skin
  • Intramuscular injections given every few weeks
  • Transdermal patches placed on the skin and changed regularly
  • Implantable pellets inserted under the skin for long-term release
  • Oral or buccal tablets, though these are used less frequently


The choice of treatment depends on the patient’s lifestyle, preference and medical history.



What are the benefits of TRT?

When appropriately prescribed and monitored, testosterone replacement therapy can lead to:


  • Improved mood, motivation and mental clarity
  • Increased energy levels and reduced fatigue
  • Enhanced libido and sexual function
  • Greater muscle mass and bone density
  • Reduced fat accumulation
  • Better overall wellbeing and confidence


Many men report noticeable improvements within weeks, though full benefits may take several months.



Are there any risks or side effects?

Like any medical treatment, TRT carries some risks and requires careful monitoring. Possible side effects include acne, increased red blood cell count, fluid retention or changes in cholesterol levels. Regular blood tests are performed to ensure hormone levels remain safe and balanced.


Men with certain conditions, such as prostate cancer or untreated sleep apnoea, may not be suitable candidates for TRT.

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