Feeling “off,” constantly tired, or noticing a dip in your drive and vitality can be confusing and frustrating. For many men, these subtle but persistent changes are symptoms of low testosterone. This essential hormone plays a critical role in everything from energy and mood to muscle mass and sexual health. When levels decline, the impact can be felt throughout your daily life. Fortunately, effective and sophisticated treatments, such as Testosterone Replacement Therapy (TRT), are available.
Testosterone deficiency, also known as hypogonadism, occurs when the body does not produce enough of this vital hormone. In men, testosterone is primarily produced in the testes and is responsible for developing male characteristics like a deep voice, facial hair, and muscle mass. It also regulates libido, bone density, fat distribution, and red blood cell production.
While often considered a male hormone, women also produce testosterone in their ovaries and adrenal glands, albeit in much smaller amounts. For women, testosterone is crucial for maintaining bone strength, ovarian function, cognitive clarity, and a healthy sex drive. A deficiency can lead to symptoms that are often mistaken for stress or normal aging, such as persistent fatigue, low libido, and mood swings.
Symptoms of low testosterone can be physical, emotional, and sexual. They may include:
Persistent fatigue and low energy levels
Decreased sex drive (libido)
Difficulty achieving or maintaining erections (erectile dysfunction)
Depression, irritability, and mood swings
Because levels can fluctuate, our providers may recommend more than one test to confirm a diagnosis.
The primary goal of treating low testosterone is to alleviate the symptoms that are impacting your quality of life. The objective is to restore your hormone levels to a normal, healthy range, allowing your body to function optimally again.
The specific goals of treatment include:
Restoring Energy and Vitality: Combatting the chronic fatigue that often accompanies low T.
Improving Sexual Function: Increasing libido and, for men, improving erectile function.
Enhancing Mood and Cognitive Function: Reducing irritability, lifting feelings of depression, and improving focus and memory.
Improving Body Composition: Helping to increase lean muscle mass and reduce body fat when combined with a healthy lifestyle.
Strengthening Bones: Increasing bone mineral density to protect against fractures and osteoporosis.
Boosting Overall Well-being: The cumulative effect of these improvements is a profound enhancement of your overall sense of health and confidence.
At our Phoenix clinic, every treatment plan is personalized. We partner with you to understand your specific symptoms and goals, ensuring the chosen therapy is the right fit for your journey toward better health.
Once a diagnosis of low testosterone is confirmed, the next step is to explore the available treatment options. The cornerstone of treatment is Testosterone Replacement Therapy, but other supportive therapies may also be considered. The path forward depends on your individual health status, preferences, and lifestyle.
Testosterone Replacement Therapy aims to supplement the body’s natural testosterone production, bringing your levels back into a normal physiological range. There are several different methods for administering testosterone, each with its own set of advantages and considerations. Our experienced team will guide you through these options to find the one that works for you.
Testosterone gels and solutions are clear, topical medications applied once daily to clean, dry skin, usually on the shoulders, upper arms, or abdomen. The hormone is absorbed through the skin and enters the bloodstream. This method is effective at maintaining stable hormone levels throughout the day, avoiding the “peaks and valleys” associated with some other forms of TRT. The medication can be transferred to others through skin-to-skin contact. It is crucial to let the gel dry completely, cover the application area with clothing, and wash your hands thoroughly after applying it to prevent exposing partners, children, or pets to the hormone.
Testosterone patches are another transdermal option. A patch is applied to the skin once a day, typically in the evening, and it slowly releases testosterone over 24 hours. To prevent skin irritation, the application site should be rotated daily among the back, abdomen, thighs, and upper arms. Patches are convenient and also provide stable hormone levels. However, some individuals may experience skin irritation, redness, or itching at the site of application.
Injectable testosterone has been used for decades and remains a highly effective and common treatment option. Injections are administered either into a muscle (intramuscular) or into the fat layer just under the skin (subcutaneous). Both short-acting and long-acting formulations are available.
Subcutaneous testosterone pellets are a “set it and forget it” option that provides consistent, stable hormone levels for several months at a time. This method involves a minor in-office procedure where tiny, rice-sized pellets are inserted under the skin, usually in the hip or buttock area. The pellets are made of crystalline testosterone and are slowly metabolized by the body, releasing a steady dose of the hormone over 3-6 months.
Medications like clomiphene citrate or human chorionic gonadotropin (hCG) can signal the body to produce more testosterone naturally. These are not replacement therapies but rather stimulatory therapies. Our providers can determine if this approach is suitable for your specific situation.
Living with low testosterone can affect more than just your physical health; it can impact your mood, confidence, and relationships. At Below The Belt, we recognize the importance of a holistic approach. We provide a discreet and supportive environment where you can openly discuss all aspects of your health. Sometimes, counseling or support can be a valuable complement to medical treatment, helping you navigate the emotional and psychological changes associated with hormonal imbalance.
No matter which method is chosen, consistent adherence to the prescribed schedule is key to maintaining stable hormone levels and achieving the desired therapeutic benefits. This is why treatment should always be conducted under the supervision of an experienced medical team. At Below The Belt, we closely monitor our patients to manage and mitigate potential issues.
Some potential side effects of TRT can include:
Skin Reactions: Acne or oily skin can occur. Patches may cause skin irritation at the application site.
Fluid Retention: Some individuals may notice swelling in their ankles or feet.
Changes in Blood Counts: TRT can increase red blood cell production. Regular blood tests are performed to monitor for this.
Prostate Health: Testosterone can stimulate the growth of prostate tissue. For men with pre-existing prostate cancer, TRT is generally not recommended. For others, regular prostate health monitoring is a standard part of the treatment protocol.
Sleep Apnea: TRT can sometimes worsen existing sleep apnea, a condition where breathing repeatedly stops and starts during sleep.
Infertility: Exogenous testosterone (testosterone from an outside source) signals the body to stop its own production, which also halts sperm production. Men concerned about future fertility should discuss this with their provider, as alternative therapies may be more appropriate.
Our licensed providers will conduct a thorough health assessment before starting therapy and will perform regular follow-up appointments and lab work to monitor your response to treatment and ensure your continued safety and well-being.
The timeline for experiencing the benefits of TRT can vary from person to person, but many individuals begin to notice positive changes within the first few weeks of starting therapy.
First Month: One of the earliest improvements is often in libido and sexual interest, which can increase within 3-4 weeks. Many people also report improvements in mood, a greater sense of well-being, and reduced irritability or depression.
1-3 Months: Energy levels typically begin to climb. You may notice it’s easier to get through the day without feeling exhausted. Improvements in focus and concentration may also become more apparent during this time.
3-6 Months: Changes in body composition start to become more noticeable. When combined with diet and exercise, you may see an increase in lean muscle mass and a decrease in body fat. Men may also see improvements in erectile function.
Throughout your treatment journey, our team will stay in close contact, scheduling regular check-ins to discuss your progress, review lab results, and make any necessary adjustments to your treatment plan.
Low testosterone is a common and highly treatable medical condition that can significantly affect your quality of life. Treatment is not a one-size-fits-all solution; it is a personalized journey that involves restoring hormone levels through methods like gels, patches, injections, or pellets. By working with an experienced team, you can find the right therapy to alleviate symptoms, restore your energy, and reclaim your sense of well-being. The key is to take the first step and seek a professional evaluation.
About the Author
Jake Shank, MD
Healthcare for
Every Stage of Life
