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For example, the genitals may not enlarge, facial and body hair may be scant, and the voice may not deepen normally. Adolescent boys with too little testosterone may not experience normal masculinization. A "feedback loop" closely regulates the amount of hormone in the blood. They travel from one organ or another place in the body, usually through the bloodstream, and affect many different bodily processes.
TRT, or androgen replacement therapy (ART), is a treatment that doctors give to males with testosterone deficiency who show symptoms of hypogonadism. Millions of American men use a prescription testosterone injection or gel as forms of testosterone replacement therapy (often referred to as TRT therapy) to restore normal levels of the manly hormone. Testosterone replacement therapy (TRT) is an option for men who have low testosterone levels due to male hypogonadism. While there have been reports of metastatic prostate cancer in older men who are on testosterone therapy, these are mostly anecdotal. In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development. As such, prostate cancer incidence in men on testosterone therapy is similar to men not on testosterone therapy.18,19 Similarly, in a 3-year prospective trial, the incidence of prostate cancer was similar among men receiving TRT and controls.
However, many men with normal testosterone levels have similar symptoms, so a direct connection between testosterone levels and symptoms is not always clear. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. Men taking testosterone replacement must be carefully monitored for prostate cancer. At this time, it is unclear whether TRT increases the risk of prostate cancer or symptoms of benign prostatic hyperplasia. For women, testosterone therapy has a much narrower evidence-based use case, and treatment should remain within the female physiologic range rather than approach male-style replacement targets (Mulhall et al., Journal of Urology, 2018; Davis et al., Journal of Sexual Medicine, 2019). Although TRT offers benefits to people with low testosterone levels, it can cause many short-term side effects. The individual can expect improvements in their blood testosterone levels within a week, however, symptoms may take longer to improve.
Some men who have a testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement. Also, as men get older, their livers make more sex hormone binding globulin (SHBG), which binds to testosterone circulating in the bloodstream. In fact, as men age, testosterone levels drop very gradually, about 1% to 2% each year — unlike the relatively rapid drop in estrogen that causes menopause. Women with high testosterone levels, due to either disease or drug use, may experience a decrease in breast size and deepening of the voice, in addition to many of the problems men may have.
"I used to liken it to a drug—and I meant that facetiously—but people who were on it felt so elated and good. "I would love for it to be true that it helps with all those things, because we don't have a lot of other solutions, and it’s frustrating for people," she says. Yet it’s hard to draw conclusions about women based on these findings, experts say, since dosage isn’t the same (though it’s usually lower) and women’s bodies work differently.