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Common Myths About Testosterone Replacement Therapy: Separating Fact from Fiction

Testosterone Replacement Therapy (TRT) is becoming increasingly popular as more individuals seek to address symptoms associated with low testosterone. However, despite its effectiveness, there are many myths and misconceptions about TRT that can create confusion and fear. In this article, we’ll address some of the most common myths surrounding TRT and provide insights into its safety, side effects, and effectiveness.

Myth 1: Testosterone Replacement Therapy Is Only for Bodybuilders or Athletes

A widespread misconception is that TRT is used only by athletes or bodybuilders to enhance physical performance and build muscle mass. While testosterone plays a critical role in muscle development, TRT is primarily a medical treatment for men with clinically low testosterone levels, or hypogonadism. This condition can affect any man, regardless of whether they’re an athlete or not.

Low testosterone can lead to fatigue, depression, reduced libido, poor sleep, and loss of muscle mass to name a few. TRT helps restore normal testosterone levels and alleviate these symptoms, improving quality of life. TRT is a medically prescribed treatment, overseen by healthcare professionals, not simply a means to boost athletic performance.

Fact: TRT is designed for men diagnosed with low testosterone based on lab results and symptoms, not for athletic enhancement.

Myth 2: Testosterone Replacement Therapy Causes Prostate Cancer

This myth stems from early studies that suggested a potential link between testosterone and prostate cancer. In the 1940s, research suggested that increasing testosterone levels could stimulate prostate cancer growth. However, recent studies have disproven this idea.

According to the Journal of Clinical Oncology, there is no conclusive evidence that TRT increases the risk of prostate cancer in men who do not already have the disease. Numerous studies have shown no significant correlation between TRT and prostate cancer risk, though men with a pre-existing diagnosis should be monitored closely.  All men who use WellLife Medical Centers will conduct periodic lab work at a minimum of once every six months.  The lab work will always include key prostate labs that will show any prostate issues.

Fact: TRT has NOT been shown to cause prostate cancer, but men with prostate cancer should consult their doctors about treatment options.

Myth 3: Testosterone Replacement Therapy Leads to Aggression and “Roid Rage”

The term “roid rage” is often associated with the misuse or large/unregulated doses of anabolic steroids and/or testosterone. When testosterone increases significantly, estogen often increases as well.  We testosterone therapy is managed properly by a medical provider, they will be able to accurately, reduce estrogen to appropriate and healthy levels, which will certainly improve stress, fatigue, mood and overall feelings well-being.

Research has shown that TRT, when administered properly, can improve mood, reduce irritability, and alleviate symptoms like depression and fatigue. Aggression and “roid rage” are typically the result of excessive steroid abuse, not medically supervised TRT.

Fact: Properly administered TRT does not cause aggression; it often improves mood and emotional well-being.

Myth 4: Testosterone Replacement Therapy Causes Heart Attacks

Concerns about the cardiovascular risks of TRT stem from a 2010 study that suggested a possible increase in heart attacks among older men on testosterone therapy. However, newer research has clarified this issue.

A study published in the New England Journal of Medicine found no increased risk of heart attacks in men undergoing TRT for low testosterone. In fact, when testosterone levels are brought back to normal, it can have positive effects on overall health, including heart function. Nonetheless, regular monitoring by a doctor is essential.

Fact: When managed correctly, TRT does not increase the risk of heart attacks and may improve cardiovascular health.

Myth 5: Testosterone Replacement Therapy Is Only for Older Men

While it’s true that testosterone levels naturally decline as men age, younger men can also experience low testosterone due to medical conditions, such as hypogonadism, obesity, lack of sleep, stress, or head injury. Age is not the only determining factor for low testosterone.

The Endocrine Society has guidelines that recommend TRT for men of all ages who have been diagnosed with low testosterone and are symptomatic. Younger men suffering from fatigue, muscle loss, and low libido should consult a healthcare provider to determine if TRT is appropriate.

Fact: TRT is for men of all ages who experience low testosterone, not just older men.

Myth 6: Once You Start Testosterone Replacement Therapy, You Can’t Stop

Many fear that once they start TRT, their bodies will become dependent on the therapy, and they won’t be able to stop. While it’s true that discontinuing TRT may lead to a return of low testosterone symptoms, it is not addictive, and stopping is an option.

Whether or not you continue TRT long-term depends on your individual symptoms and overall health. Some men may need long-term therapy, while others may use TRT for a specific period of time. This decision should be made in consultation with a healthcare provider.

Fact: TRT can be discontinued, but symptoms may return if testosterone levels drop again.

Myth 7: Testosterone Replacement Therapy Causes Infertility

It is true that TRT can suppress natural testosterone production, which may reduce sperm production and affect fertility. However, this effect is usually reversible once therapy is stopped. For men who wish to maintain fertility, there are additional treatments available, such as human chorionic gonadotropin (hCG), which can help preserve sperm production and natural testosterone production.

If fertility is a concern, it’s essential to discuss this with your healthcare provider before starting TRT, as there are ways to manage fertility while undergoing treatment.

Fact: TRT can temporarily affect fertility, but this is usually reversible after stopping therapy.

Myth 8: Natural Supplements Are Just as Effective as Testosterone Replacement Therapy

Many over-the-counter supplements claim to boost testosterone naturally. While some lifestyle changes, such as exercise, diet, and stress management, can support healthy testosterone levels, supplements typically do not contain enough active ingredients to make a significant impact.

According to the Mayo Clinic, the effectiveness of these supplements is often overstated in marketing campaigns, and they are no substitute for medically prescribed TRT. If you have clinically low testosterone, supplements are unlikely to restore levels to a healthy range.  Antecdotally, we have seen supplements improve a patient’s testosterone levels 20-30ng per deciliter, while the typical testosterone therapy prescription can increase levels accurately and dramatically, depending on the dosage. For example, if a patient comes in with a testosterone level 100ng per dl, it is easy to achieve healthy levels from 400-1000ng per dl, depending on the patient and the providers best judgment.

Fact: Over-the-counter supplements are not a replacement for TRT in men with diagnosed low testosterone.

Myth 9: Testosterone Replacement Therapy Is Unsafe for Long-Term Use

Some people believe that TRT is dangerous for long-term use, due to potential side effects. However, TRT is considered safe for long-term use when prescribed by a healthcare provider who monitors testosterone levels and overall health regularly. Side effects like increased red blood cell counts or fluid retention can be managed with routine checkups and adjustments to dosage and other medical treatments.

Fact: Long-term TRT is safe for many men when administered and monitored by a doctor. Note:  Ensure that you doctor is highly experienced in TRT, so they can properly avoid and/or address any health risks that could potentially arise.

Myth 10: Testosterone Replacement Therapy Is a Quick Fix for Low Libido or Energy

While TRT can improve symptoms such as low libido and energy, it is not an instant cure. It may take several weeks or months for testosterone levels to normalize and for patients to notice the full benefits of treatment. Additionally, low libido and fatigue can have many causes, including lifestyle factors, stress, or other medical conditions.

TRT is often just one part of a comprehensive approach to improving overall health and well-being.

Fact: TRT is not an overnight solution but can be an effective part of a long-term plan to improve quality of life.

Conclusion

Testosterone replacement therapy offers numerous benefits for men with low testosterone (and even women in certain circumstances), but it’s often misunderstood. By debunking these common myths, we can see that TRT is a safe and effective treatment when properly prescribed and monitored. If you’re considering TRT, talk to a healthcare provider at WellLife Medical Centers to learn more about how it can help you.

Citations:

  1. American Urological Association. “Evaluation and Management of Testosterone Deficiency.” 2018.
  2. The Journal of Clinical Oncology. “Testosterone Therapy and Risk of Prostate Cancer: A Review of Recent Research.” 2015.
  3. Harvard Medical School. “Testosterone and the Heart: Is There a Link?” Updated 2021.
  4. The Endocrine Society. “Clinical Practice Guidelines for Testosterone Therapy in Men.” 2018.
  5. Mayo Clinic. “Testosterone Therapy: Potential Benefits and Risks as You Age.” Updated 2020.
  6. New England Journal of Medicine. “Testosterone Therapy and Cardiovascular Risk.” 2016.

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