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Pros and Cons of Testosterone Replacement Therapy

longevity Jun 14, 2023
Pros and Cons of Testosterone Replacement Therapy

Hormones are special substances, manufactured by your body's glands, that travel around your blood and control how certain cells work.

One important hormone, called testosterone, is mainly produced in the testicles and gives males many unique traits, but women also have it in smaller amounts.

Testosterone takes care of important things like sex drive, muscle strength, fat distribution, and blood cell production.

When men have too little testosterone, they may experience a low sex drive, less sperm, trouble getting or maintaining erections, muscle loss, and swelling of breast tissue .

These symptoms would make any guy feel downright awful.

On the other hand, too much testosterone in men can lead to heart issues, prostate problems, irritability, aggression, and acne.

In women, excessive testosterone can cause hair thinning, irregular periods, and low desire for sex.

Sometimes, issues with testosterone can happen due to illness or as a natural part of getting older.

There's this crazy loophole in the FDA rules that lets pharmaceutical companies run advertisements telling men to "talk to your doctor" if you experience any sign that you might need testosterone replacement therapy, abbreviated as TRT.

I mean, seriously, everyone and their grandpa is asking about it now because those drug-advertising folks are on a rampage.

Heck, I've got all these middle-aged guys emailing me like, "Hey Coach Joe do you think I'm tired? Could it be low testosterone?"

It's like they're reading it off some script.

And don't get me started on the TV commercials for TRT or over-the-counter "testosterone-boosting" supplements.

It's like an ongoing pharmaceutical marketing blitz telling men they are somehow unworthy.

They always show these guys lifting weights, arm wrestling, and impressing their partners.

But let's be honest, if you need TRT to impress your partner, maybe it's time to work on your personality instead.

Now, I'm not a doctor nor do I provide medical advice; however, you should weigh the pros and cons if you're thinking about TRT. 

My attorney recommended I add this disclaimer:

Before considering testosterone replacement therapy (TRT) you should consult with your healthcare providers to discuss their individual circumstances and determine if the benefits outweigh the risks. Personalized evaluation, including thorough medical history, physical examination, and hormone level assessments, can help guide decisions regarding TRT.

In this lesson, you'll learn about the advantages and disadvantages of testosterone replacement therapy for men.

The Testosterone Trap

As a part of the natural aging process there may be a decline in testosterone levels, which can lead to various symptoms and health issues.

To check how much testosterone someone has, doctors can do a simple blood test.

But here's the tricky part: testosterone levels change throughout the day and the definition of "normal" testosterone has a big range.

So if the test shows a low level once, it might not mean anything if the person feels fine and had a normal level at another time.

Candidly, we need more research to understand when to measure testosterone, how to respond to the results, and when it's a good idea to try treatment even though it has some risks.

The term "Pandora's box" originates from Greek mythology, specifically from the story of Pandora, who was given a box containing all the evils of the world and unintentionally released them when she opened it, resulting in widespread suffering and misfortune.

In other words, Pandora's box is a metaphor for a situation or action that, once initiated, leads to unforeseen and often negative consequences.

Testosterone replacement therapy is often compared to opening Pandora's box because it can have both positive and negative effects on the body.

It requires careful monitoring and management by medical professionals to ensure the benefits outweigh the risks.

And once you start TRT, you're typically on it for life.

Just as opening Pandora's box unleashed both good and bad, TRT can bring positive changes but also has the potential to introduce new challenges and risks.

That's why it should be approached with caution and under the guidance of knowledgeable healthcare providers.

Pros and Cons of Testosterone Replacement Therapy

Many "older" men think it's impossible to achieve a lean, athletic body in your 40s, 50s, 60s, 70s and beyond without pharmaceutical help.

To combat this, many guys turn to TRT as a potential solution.

Are you experiencing a midlife crisis?

I mean, who needs a sports car when you can just inject yourself with a little bit of manliness, right?

TRT involves boosting testosterone levels through medication or other treatment methods.

However, like any medical intervention, TRT comes with its own set of pros and cons that individuals should carefully consider.

For what it's worth, I've never personally used anabolic steroids, growth hormone, TRT or anything like this. 

Not even one drop or pill or cream or whatever method they're peddling nowadays.

I'm north of 50 years and I continue to focus on things like smart training, mindful nutrition, managing stress, and getting deep sleep.

In fact, I follow the same habits of health that I've been teaching in my age-management program over the past 25+ years.

My personal, non-medical opinion for most 40-plus men (and women) is that you don't need any of this either; however, before you make a decision do your research and consult with your doctor.

The Pros of Testosterone Replacement Therapy

A few summers ago I'm relaxing at the country-club pool with my family and I saw an older gentleman, probably in his mid 70s, who was likely on TRT, and let me tell you, his muscles had muscles.

I mean, I've seen action figures with less definition. It's like he had a six-pack on his six-pack.

Really, he looked like a smaller version of Charles Atlas, famous for developing a highly successful fitness program in the 1930s.

TRT or not, that uber-fit old guy was working diligently and following a proven blueprint. 

His physique said that he was on point with his training, nutrition, and recovery no matter whatever hormone-replacement program he was on.

It's not like he just took a shot of testosterone and magically got strong and lean overnight.

Here are a few of the reasons men choose to pursue TRT.

Improved Sexual Function: One of the most common benefits reported by men undergoing TRT is an improvement in sexual function.

Testosterone plays a crucial role in libido, erectile function, and overall sexual satisfaction.

By increasing testosterone levels, TRT can enhance these aspects of male sexual health.

Increased Muscle Mass and Strength: Testosterone is a key hormone for muscle development and maintenance.

TRT can lead to an increase in muscle mass and strength, making it appealing to men who are looking to improve their physique or fight muscle loss due to aging or other conditions.

Enhanced Mood and Cognitive Function: Testosterone has been associated with mood regulation and cognitive function.

TRT may help alleviate symptoms of depression, anxiety, and fatigue in men with low testosterone levels.

Additionally, some studies suggest that TRT could improve cognitive abilities such as memory and spatial awareness.

Increased Bone Density: Testosterone plays a vital role in maintaining bone health.

Low testosterone levels can contribute to bone loss and increase the risk of osteoporosis in men.

TRT has the potential to improve bone density, reducing the risk of fractures and improving overall bone health.

The Cons of Testosterone Replacement Therapy

To be clear, TRT does not cure low testosterone, so your symptoms may return if you stop taking it.

In other words you will be on TRT indefinitely, thus the Pandora's box metaphor.

Potential Side Effects: Like any medication, TRT carries the risk of side effects.

Common side effects of TRT include acne, fluid retention, breast enlargement (gynecomastia), and increased red blood cell count.

Severe or long-term use of TRT can also have implications for cardiovascular health, such as an increased risk of blood clots or stroke.

Suppression of Natural Testosterone Production: When undergoing TRT, the body's natural testosterone production can be suppressed.

This means that if an individual decides to discontinue TRT, their testosterone levels may remain low, requiring ongoing therapy.

Additionally, the suppression of natural testosterone can lead to testicular shrinkage. In some cases, the testicles will shrivel up to the size of Raisinets.

Cost and Accessibility: Testosterone replacement therapy can be costly, especially if it involves regular injections or implants.

Insurance coverage for TRT varies, and not all individuals may have easy access to these treatments due to geographical or financial constraints.

Ethical Considerations: Some argue that the use of TRT to boost testosterone levels in otherwise healthy individuals may be unnecessary and potentially unethical.

They believe that the benefits of TRT should be reserved for individuals with medically diagnosed testosterone deficiency rather than those seeking performance enhancement.

TRT or Not, You Must Focus on the Fundamentals

And let's talk more about those TRT commercials on cable TV.

Have you seen them?

They always show these 60-something guys before TRT, looking all tired and miserable.

Then they get on the treatment, and suddenly they're climbing mountains, bench-pressing Buicks, and high-fiving strangers on the street.

I mean, come on, who needs a gym membership when you can just inject yourself with testosterone, right?

Whether or not you choose to use TRT, you will have to continue to follow several habits of health.

  • Mindful Nutrition: You must make wise nutrition choices 90% of the time, consisting of fresh, unprocessed foods that you can get at a regular grocery store. Fun foods the other 10% of the time. Lots of filtered tap water.
  • Smart Training: Four days per week, stick to the principles of progression and overload. Focus on resistance training exercise, with barbells and dumbbells. And short-burst metabolic conditioning, like hill sprints. Stretching at the end.
  • Quality Sleep: Every single night you must get the deep restorative sleep that bathes your cells in regenerative hormones, naturally of course. Getting a good night's sleep is one of the best ways to slow aging.
  • Stress Management: De-frazzle your nerves via strength-training workouts, prayer, relaxation, and sound sleep.
  • Coaching: A professional coach can help you achieve your goals faster and with less frustration than going about it on your own. Generally speaking, spouses and friends are poor coaches because, well, they aren't proper coaches. Also, it's a conflict of interest to lean on your loved ones to coach you up. Bottom line: You must invest for success. When you pay, you pay attention. 
  • Accountability: Weekly accountability check-ins with a professional coach help keep you on track and focused on your goals.

Some people genuinely need TRT, and it can be life-changing for them.

Just remember fellas, there's more to being a man than having sky-high testosterone.

It's about character, integrity, and how you treat others.

Also, if you want to be lean and strong, you must take imperfect action and do the work.

Somedays you do a little work and other days you do a lot.

Each day wake up and attempt to do your best.

Admittedly it's not always sunshine and blue skies. Some days will be tough.

And that's why you need to play the long game.

But most importantly, you must suspend your disbelief.

Get out of your own way and simply get started. 


Testosterone replacement therapy (TRT) can be a viable option for men with low testosterone levels, offering potential benefits such as improved sexual function, increased muscle mass, enhanced mood and cognitive function, and improved bone density. Some say TRT is like a midlife crisis in a syringe. However, it's crucial to weigh these advantages against the potential side effects, like the suppression of natural testosterone production, the associated costs, and ethical considerations. Ultimately, a well-informed choice should be made based on an individual's specific needs, preferences, and the guidance of medical professionals.

To your success,

Coach Joe



Joseph Arangio helps 40+ men and women get leaner, stronger, and happier. He's delivered over 100,000 transformation programs to satisfied clients around the globe. If you want to lose weight from home, with the best online personal trainer, or you want to visit the best personal trainer in the Lehigh Valley, you can take a free 14-day trial.

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