Testosterone Replacement Therapy 101 – How It Works, Benefits & Who It’s For
Introduction
Testosterone is often associated with masculinity, but this powerful hormone plays a crucial role in both men and women. In men, it supports muscle mass, bone density, red blood cell production and sexual function. In women, testosterone (produced by the ovaries and adrenal glands) contributes to libido, mood, energy and cognitive clarity. Levels peak in early adulthood and gradually decline — typically about 1 % per year after age 30. For some, that decline is subtle. For others, medical conditions like hypogonadism, chronic stress or metabolic disorders cause testosterone levels to drop precipitously, leaving them exhausted, irritable and unable to build or maintain muscle. That’s where testosterone replacement therapy (TRT) comes in.
What Is Testosterone Replacement Therapy?
Testosterone replacement therapy involves taking a manufactured form of testosterone to restore healthy hormone levels. According to the Cleveland Clinic, TRT can improve many symptoms of low testosterone, including sexual function, lean body mass, bone density, mood and energy levels. It does this by supplementing the testosterone your body can no longer produce in sufficient quantities. TRT is generally prescribed for men diagnosed with hypogonadism — a medical condition in which the testicles, pituitary gland or hypothalamus fail to produce adequate testosterone. The U.S. Food and Drug Administration approves TRT for this purpose but does not approve it for “age‑related low T” or as an anti‑aging remedy.
The therapy is customized to your body and lifestyle. Options include gels applied to the skin, intramuscular or subcutaneous injections, patches, buccal tablets and implanted pellets. Each method releases testosterone at a different rate and requires different dosing schedules. Regardless of the method, TRT is a long‑term commitment: once you supplement with exogenous testosterone, your own testosterone production downregulates. If you stop therapy abruptly, your levels will drop and you may feel worse before your body recovers. This underscores the importance of working closely with a knowledgeable provider.
How Does TRT Work?
TRT does not fix the underlying cause of low testosterone. It simply supplies the hormone your body lacks. When you apply a gel or receive a shot, the testosterone enters your bloodstream, attaches to proteins and is transported to tissues throughout your body. There, it binds to androgen receptors and triggers the physiological effects you associate with feeling strong, energetic and sexually engaged. But supplementation suppresses your body’s own testosterone production. This is why proper diagnosis and ongoing monitoring are essential to ensure that the therapy is working and not causing harm.
Injections deliver a precise dose every one to two weeks (or up to every 10 weeks for long‑acting formulations). Gels and creams provide daily dosing and more stable levels, but you must avoid skin‑to‑skin contact while the gel is wet because the hormone can transfer to others. Patches deliver testosterone over 24 hours and must be rotated to prevent irritation. Pellets offer consistent dosing for three to six months but require a minor procedure to insert them under the skin. Buccal tablets adhere to the gums and release testosterone over 12 hours. Nasal gels are applied three times daily. Your provider will help you weigh convenience, cost and side effects when choosing a modality.
Who Is TRT Really For?
Men with hypogonadism: The American Urological Association defines low testosterone as total testosterone below 300 nanograms per deciliter (ng/dL) measured on two separate morning blood tests. Men who meet this threshold and experience symptoms such as reduced libido, erectile dysfunction, depression, fatigue or loss of muscle mass may benefit from TRT. Before starting therapy, your doctor will perform a physical exam and order blood tests — including liver enzymes, hemoglobin, PSA (prostate‑specific antigen) and luteinizing hormone — to ensure therapy is safe.
Women with low testosterone: Women produce far less testosterone than men, but deficiency can lead to reduced sexual desire, weight gain, anxiety, difficulty concentrating and bone loss. Causes include surgical removal of the ovaries, adrenal insufficiency, menopause and chronic stress. Low testosterone in women often accompanies other hormonal imbalances, such as low estrogen or progesterone, and may respond to a low‑dose bioidentical testosterone cream. Because women are more sensitive to androgens, dosing must be carefully titrated to avoid virilization (hair growth, deepening voice) and acne. At Total Health Pros, we use saliva and blood testing to assess not only total testosterone but free testosterone (the active form) and downstream metabolites to craft a personalized protocol.
Those who have addressed lifestyle factors: Harvard Health points out that tiredness, low libido and mood issues often have multiple causes, such as poor sleep, inactivity, nutritional deficiencies, relationship stress or undiagnosed medical conditions. Before prescribing TRT, your provider should assess and optimize diet, exercise, stress management and sleep. Many men feel better simply by losing excess fat, lifting weights and getting seven to nine hours of sleep per night. At Total Health Pros, we integrate fitness coaching and nutrition planning to support hormone balance before, during and after therapy.
Benefits of TRT
Improved sexual function. TRT has been shown to improve libido, erectile function and overall sexual satisfaction in men with low testosterone. Many men notice their desire returning within a few weeks of starting therapy.
Increased lean body mass and bone density. Testosterone promotes protein synthesis and muscle growth. Research cited by Medical News Today notes that TRT can maintain bone density and improve muscle strength, though benefits are often modest and diminish once therapy stops. Coupling TRT with resistance training and adequate protein intake amplifies results.
Better mood and cognitive function. Men on TRT frequently report enhanced mood, motivation and a greater sense of well‑being. Some studies suggest modest improvements in attention and memory.
Energy and recovery. Restoring testosterone can reduce fatigue and improve recovery after exercise. Clients at Total Health Pros often describe feeling “like themselves again” — able to finish workouts without crashing and to participate fully in work and family life.
Metabolic health. Normal testosterone levels support healthy blood sugar regulation and body composition. When combined with a smart nutrition plan, TRT can aid weight loss and decrease visceral fat.
Risks and Side Effects
TRT is not without risks. Common side effects include oily skin or acne, mild fluid retention (ankle swelling), stimulation of the prostate leading to urinary symptoms, breast tenderness or enlargement, and smaller testicles. Because TRT suppresses sperm production, it can cause infertility — a major consideration for men planning a family.
Serious risks are rare but important. TRT can increase red blood cell count, making blood thicker and increasing clot risk. It may worsen sleep apnea or cause existing prostate cancer to grow. Long‑term cardiovascular effects remain controversial: older observational studies suggested increased heart disease risk, while more recent trials found no significant association. The bottom line is that a qualified provider should evaluate your medical history, monitor labs regularly and adjust or stop therapy if adverse effects arise.
Harvard Health emphasizes caution: misinterpreted test results can lead to unnecessary treatment, and lifestyle factors should be addressed before starting hormones. That’s why at Total Health Pros we begin with a comprehensive assessment that includes hormone panels, thyroid testing, inflammatory markers and nutrient levels. We also encourage clients to track blood pressure, heart rate variability and sleep patterns through our app. These data guide our approach and help us adjust dosing or incorporate complementary therapies such as nutrition tweaks, adaptogenic herbs or stress‑reduction techniques.
Different Forms of TRT
Injections: Injections deliver testosterone directly into muscle or subcutaneous tissue. Short‑acting shots are given every one to two weeks, while long‑acting shots can be spaced 10 weeks apart. Injections are inexpensive and allow for precise dosing but can cause peaks and troughs, leading to mood swings and energy fluctuations. Some men find weekly self‑administration inconvenient.
Transdermal gels and creams: Applied daily to the skin, gels absorb gradually and provide steady hormone levels. However, users must wash their hands after applying and avoid contact with partners or children until the gel dries to prevent accidental transfer.
Patches: These deliver testosterone over 24 hours and are replaced daily. They can irritate the skin and may not be cosmetically appealing. Patches are less effective for those with high body fat or heavy sweating.
Pellets: Small cylinders implanted under the skin provide a consistent dose for three to six months. They free you from daily or weekly dosing but require a minor surgical procedure and carry risk of infection or pellet extrusion.
Buccal tablets and nasal gels: Buccal tablets adhere to the gums and release testosterone over about 12 hours; they can cause mouth irritation. Nasal gels are applied three times per day and can cause nosebleeds or congestion. These methods are relatively new and less commonly used.
Holistic Health and TRT
Hormone therapy works best when supported by healthy habits. Testosterone is sensitive to sleep deprivation, chronic stress, nutrient deficiencies and sedentary lifestyles. Before considering TRT, focus on a protein‑rich diet with plenty of vegetables, healthy fats and complex carbohydrates. Strength training three to four times per week stimulates natural testosterone production and improves insulin sensitivity. Managing stress through mindfulness, breathwork or spending time outdoors helps regulate cortisol, which in turn supports optimal hormone balance. Adequate sleep (7–9 hours per night) is critical; low sleep is strongly associated with reduced testosterone and impaired muscle recovery.
At Total Health Pros, hormone therapy is one component of a comprehensive wellness plan. Clients work with our fitness coaches to develop resistance training routines tailored to their age, injuries and goals. Our nutritionists create personalized meal plans and macro ratios to support lean muscle gain and fat loss. We also offer education on supplements, stress‑reduction techniques and environmental toxins that can disrupt hormones (e.g., endocrine‑disrupting plastics, pesticides). This integrative approach helps maximize the benefits of TRT while minimizing the dose required.
When to Consider TRT: A Simple Checklist
You might discuss TRT with a provider if you experience some of the following symptoms for longer than a few months:
Persistent fatigue and lack of motivation despite adequate sleep and a balanced diet.
Decreased libido or erectile dysfunction unrelated to relationship issues.
Unexplained weight gain (especially increased body fat) and difficulty building muscle.
Mood changes: irritability, depression or loss of confidence.
Cognitive difficulties: trouble concentrating or memory lapses.
Decreased bone density (osteopenia or osteoporosis) or recurring fractures.
If you identify with several of these issues, schedule a comprehensive lab assessment. A total testosterone level below about 300 ng/dL on two morning tests plus symptoms may indicate hypogonadism. However, hormone balance is complex; other markers such as free testosterone, estrogen, DHEA, cortisol and thyroid hormones provide important context. Always work with a practitioner who understands this interplay.
Testosterone Therapy for Women
Though often overlooked, women can experience low testosterone. After menopause, ovarian production drops dramatically. Symptoms may include low libido, fatigue, weight gain (especially belly fat), depressed mood and decreased motivation. Women with adrenal fatigue, pituitary disorders or surgical removal of the ovaries can also have insufficient testosterone. A carefully calibrated dose of bioidentical testosterone cream or pellet can restore libido and energy. Because women’s tissues are sensitive to androgens, we start at very low doses and monitor regularly for signs of excess (acne, hair growth, voice changes). Combining testosterone therapy with lifestyle interventions — such as strength training, pelvic floor exercises and nutrition for insulin resistance — yields the best results.
Local Resources and Next Steps
Residents of Hurricane, West Virginia and surrounding counties don’t need to travel far for expert hormone therapy. Total Health Pros is located at 206 Chase Park, Hurricane, WV 25526 — a convenient drive from Charleston, Huntington and the Tri‑State region. Unlike franchised clinics, our practice is rooted in the community. Our team includes nurse practitioners, fitness professionals and nutrition coaches who live here and understand local lifestyles. We offer:
Comprehensive Hormone Testing. Our panels measure total and free testosterone, estradiol, progesterone, DHEA, thyroid hormones, cortisol, inflammatory markers and micronutrients. We use these insights to identify root causes rather than treating numbers in isolation.
Personalized Treatment Plans. If TRT is appropriate, we determine the ideal dosing and delivery method. We also consider complementary therapies such as thyroid optimization, adrenal support or gut healing.
Fitness & Nutrition Coaching. Members receive customized workout programs (with in‑person training or remote coaching) and meal plans that align with their hormone profile.
Ongoing Support. Regular check‑ins, app‑based tracking and a private online community ensure you never feel alone in your journey. We monitor labs every three to six months and adjust protocols as needed.
Telehealth. We serve clients across West Virginia and neighboring states via secure video calls, making hormone optimization accessible wherever you are.
Conclusion
Testosterone replacement therapy can be life‑changing when prescribed thoughtfully and supported by lifestyle changes. It restores libido, energy, muscle mass and mood for men and women diagnosed with low testosterone. However, it is not a cure‑all, nor is it a safe shortcut to eternal youth. A careful diagnosis, awareness of potential side effects and a holistic approach are essential. If you’re in the Hurricane or Charleston area and wonder whether low testosterone is holding you back, Total Health Pros offers the expertise and community you need. Contact us today for a consultation and take the first step toward balanced hormones and vibrant health.
