What Are Some Side Effects of TRT (Testosterone Replacement Therapy)

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If you're thinking about undergoing TRT in the Boulder area, it's essential to have an understanding of the known side effects of testosterone replacement therapy. Millions of men undergo this FDA-approved treatment every year. While most patients won't have side effects, it's still important to be informed of the risks.

It’s important to have an honest conversation about testosterone replacement therapy (TRT) if you’re considering this treatment. Here at ThriveMD, our intention is to always empower our patients to get all the information they need to make informed decisions about care. We take pride in having important conversations about the benefits, expectations and side effects that can be involved with treatments. The conversation about side effects can be especially important for men considering hormonal therapies to treat low testosterone.

First, it’s important to know that millions of men have successfully undergone TRT with amazing results. In fact, it’s estimated that 2.9% of men in the United States have used TRT. Most men only experience the benefits of increased health and vitality that go along with restoring testosterone levels back to normal. However, a certain percentage of men using TRT may experience side effects. When you work with us here at ThriveMD, we’ll make sure that you’re aware of all potential side effects that have been associated with this treatment. We’ll also go over your full health history with you to confirm that you’re an excellent candidate for TRT based on what’s known about potential side effects.

Going over the side effects of TRT isn’t intended to cause hesitation or fear among men considering this option. TRT is a fully FDA-approved treatment for low testosterone. It has been thoroughly studied and researched for decades. What’s more, the ThriveMD team has seen the way this treatment has helped countless men feel like they are getting their lives back after long periods of struggling with low sex drive, erectile dysfunction, fatigue, muscle deterioration, weight gain, mood issues, brain fog, and other life-altering symptoms. We offer this treatment because we understand the devastating effect low testosterone levels can have on the quality of life. Next, take a look at some of the common side effects that are possible with TRT.


Yes, adult men can experience acne as a side effect of TRT. In fact, TRT can increase skin’s oiliness to cause breakouts. Do you remember when your skin always felt oily, bumpy, or inflamed back in your teenage years? The reason why TRT can cause acne really comes down to the same reason why males often experience acne when going through puberty. In fact, you may be experiencing dry skin if you’re currently operating with a testosterone deficit.

Testosterone stimulates the production of sebum. As a result, sebaceous glands can become inflamed. This can lead to an acne breakout. It’s also not unheard of for men going through TRT to experience whiteheads, blackheads, pustules, papules, and cysts. The good news is that your skin probably won’t experience changes that are as extreme as what commonly happens during actual puberty. However, there is a potential for noticeable blemishes to take shape even if you typically have very clear, smooth skin as an adult.

trt therapy louisvilleLow Sperm Count/Infertility

Yes, TRT can potentially lower your sperm count. It can even lead to infertility. This one comes as a surprise to many men when they hear it because TRT is often associated with helping to treat infertility. The reality of it is complicated.

The male body produces testosterone through a highly complex process that relies on hormonal interactions going perfectly. During the process, the brain is in a state of constantly monitoring testosterone levels to be able to produce something called gonadotropin-releasing hormone (GnRH) when levels dip. The release of GnRH triggers the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These steps all come together to signal the production of sperm and testosterone.

Enter TRT. The irony is that TRT’s effectiveness is precisely what threatens sperm count. If the brain doesn’t detect low testosterone levels because they are being elevated by TRT, the signal to produce more GnRH is never sent. This will prevent the body from producing its own testosterone. This also stops the body from producing more sperm.

Sterility caused by TRT is less likely to occur when men are working with qualified care providers to restore testosterone levels. When men abuse testosterone levels for long periods of time, they increase their chances of experiencing infertility. The best way to avoid low sperm count caused by TRT is to only take TRT for as long as is necessary to restore testosterone levels back to a healthy baseline. Even men who do experience reduced sperm count during TRT are often able to reverse the effects. However, a reversal can sometimes take anywhere from a few weeks to two years.

Elevated Risk for Blood Clots

“The findings suggest that testosterone therapy is associated with increased short-term risk of venous thromboembolism among all men prescribed the therapy,” according to a 2019 paper looking at the association of testosterone therapy with the risk of venous thromboembolism among men with and without hypogonadism. Venous thromboembolism (VTE) is a blood clot affecting the deep or superficial veins in the arms, legs, or pelvis. This type of clot does have the potential to travel to the lungs to become a pulmonary embolism (PE). The reason why TRT increases the risk for blood clots is that it increases red blood cell and platelet production. Elevated red blood cell counts can thicken your blood to slow down its venous flow.

Testicle Shrinkage

No, it’s not just an urban legend that TRT can make your testicles shrink. The term for when this happens is testicular atrophy. The reason why TRT has the potential to cause testicular shrinkage is that TRT can sometimes stop the production of GnRH. When this happens, the pituitary gland stops producing LH. Putting the brakes on LH means that the testicles are no longer secreting testosterone. Ultimately, this will create a noticeable reduction in testicle size. When TRT is administered under the guidance of a doctor, treatments like human chorionic gonadotropin (HCG) can be used to stop the problem of shrinkage.

Increased Breast Size

Can TRT cause you to grow breasts? You’re not the first person to ask this question to ThriveMD. The answer is that TRT can cause enlargement of breast tissue. The term for this is gynecomastia

The reason why breast tissue can become enlarged is that TRT can trigger a rise in E2 (estradiol) levels. Gynecomastia doesn’t really pose any physical or health complications. However, it can cause psychological distress and self-consciousness in men. Gynecomastia is often treatable.

trt therapy louisvilleIncreased Risk of Heart Attack and Stroke

This is the area where men typically have the most questions. Is it true that TRT can actually increase your risk for heart attack and stroke? The truth is that this is a hard question to give a quick answer to simply because you may already be familiar with the extensive research linking low testosterone with increased risk for heart attack, cardiovascular issues, stroke, and overall heightened mortality.

“TRT may increase the risk of cardiovascular events in aging men with low testosterone levels, particularly in the first 2 years of use,” according to a 2019 study on cardiovascular and cerebrovascular safety of testosterone replacement therapy among aging men with low testosterone levels. Information about the risks associated with TRT should be balanced with data showing that declining testosterone levels are associated with elevated all-cause mortality and cardiovascular (CV) risk. We also know that low testosterone levels are also linked with an increased risk for developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes.

The intricacy of risk levels only highlights the need for proper screening. This is one of the reasons why we put so much time into evaluating each patient on a case-by-case basis instead of putting every patient who enters our office on the fast track to hormonal therapy. Our comprehensive approach to evaluating each patient’s strength as a candidate for TRT includes a consultation, medical assessment, health history analysis, and serum level testing.

Is TRT Worth It?

Many men see incredible improvements in how they feel, look, and perform after undergoing TRT. If you’re currently struggling with symptoms of low testosterone, you already know what a profound impact this condition can have on quality of life.

Some of the common symptoms of low testosterone that are targeted using TRT include:

  • Low sex drive.
  • Erectile dysfunction.
  • A diminished sense of well-being.
  • Anxiety and depression.
  • Irritability.
  • Moodiness.
  • Reduced muscle mass.
  • Loss of muscle strength.
  • Interfertility.
  • Concentration issues/brain fog.
  • Memory issues.
  • Fatigue.
  • Decreases in body hair.
  • Increased body fat.
  • The development of breast (gynecomastia).

If you’re looking for ways to restore testosterone levels without using TRT, this is a conversation we can have with you when you’re a patient of ThriveMD. In some cases, men aren’t good candidates for TRT due to underlying health issues. In other cases, men are motivated to try alternative methods of elevating testosterone levels without using TRT. It is sometimes possible to help reverse low testosterone levels without hormonal therapies if the reason for the dip is some kind of lifestyle or environmental factor. Ultimately, the best thing you can do is to work with a team with a broad and holistic understanding of low testosterone symptoms.

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Book Your Appointment for Low Testosterone Treatment Near Boulder

Let’s have an important conversation about suspected low testosterone symptoms when you book an appointment with ThriveMD in Louisville, Colorado. We’ve helped countless men throughout Louisville, Superior, Lafayette, Boulder, and Broomfield get TRT. ThriveMD’s unique approach to TRT allows you to undergo consistent monitoring and serum checks without the need to constantly check-in at the office for visits. Our team also takes a proactive approach to TRT that relies on a mix of test results and feedback from each TRT patient to make any necessary adjustments for the successful completion of this therapy.

If you want to talk to a Boulder doctor because you have concerns about the side effects of TRT, we’ll be happy to go over all of the risks and benefits to help you feel more informed. Following an evaluation, we can alert you to any specific risk factors that could affect your decision to undergo TRT. The good news is that the odds of experiencing serious negative side effects of TRT are drastically reduced when you’re working with a doctor compared to men who might try to self-administer testosterone products that they procure from questionable sources.

Don’t spend another day wondering what life could be like if you weren’t struggling with the physical, mental, and emotional side effects of having low testosterone. Dr. Nick Hamilton and the rest of the ThriveMD team are ready to help you get answers. You can book your appointment by calling (720) 534-2333 or filling out a form online.

Ready for an expert opinion? Get in touch today!

Eliv8 MD is the leading provider of regenerative medicine, hormone therapy, and medically-assisted weight loss in the North Denver-Metro area. Give us a call at (720) 591-9466 or book a free consultation online today!

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