Thinking about starting TRT? Here’s how you should expect to feel better.
Men generally don’t know or appreciate the benefits of testosterone until it starts fading away. And it does fade. Regardless of a well-balanced diet and solid exercise regimen, your body changes as you age, and your hormone levels and testosterone naturally decline approximately 1 percent every year starting around age 30 (1).
Maybe you’ve been suffering the symptoms of low testosterone (such as low energy levels, fatigue, excess body fat, erectile dysfunction, and low libido). Perhaps Hone’s at-home test has revealed that you have a testosterone deficiency, and now you’re considering testosterone replacement therapy (TRT) to get back on track.
Or maybe you aren’t quite sure whether testosterone treatment is right for you, and you want to know more about what to expect from balancing your hormones, including outcomes and side effects.
Either way, we’ve got answers. We specifically reviewed scientific studies and consulted hormone health experts to help you make an informed decision.
About the Experts:
Joshua Calvert, M.D., is a board-certified urologist specializing in male infertility and low testosterone management.
Natalie Kunsman, M.D., an integrated health advisor and physician at Broad Health, Hone Health’s partnered medical practice. She specializes in family medicine as well as anti-aging and regenerative medicine in Colorado Springs, CO. She also has expertise in thyroid and hormonal health.
Alexander Watson, M.D. is a physician with board certifications in Physical Medicine and Rehabilitation and Obesity Medicine. He focuses on hormone health, longevity, and weight loss.
There are a lot of health benefits of testosterone, and advancements in TRT have provided men with a way to reclaim control of their bodies and their lives.
TRT isn’t some sort of miracle, overnight cure. You must understand going into the process that the journey to self-improvement is not a sprint, but a marathon. It’s also one that doesn’t really have a set finish line—and that’s all right.
“Testosterone therapy can be a life-changing experience for men with symptomatic deficiency, and a proper understanding of the benefits in the face of these uncertainties is critical for an informed decision,” says Alexander Watson, M.D.
As long as you follow the treatment prescribed by your doctor, you’ll stay ahead of the problem.
Let’s break down some of the biggest benefits of testosterone replacement therapy, share what you should expect to think and feel, and run through which effects of testosterone replacement therapy may take longer than others to notice.
Who doesn’t want a killer body? Diet, rest, and exercise are key to your success. However, when your testosterone levels dip below your normal range, your strength strains, your body mass gets mush, and your once-unbeatable endurance fades.
Testosterone helps with the heavy lifting to restore those areas. Increased lean muscle is one of the most consistent effects of testosterone therapy (3). Over the first three months of TRT, your body becomes leaner, muscles grow stronger, and your stamina improves significantly. Watson explains, “After starting TRT, men will notice feeling stronger in general, more motivated to exercise, and a better response to the exercise, as well. This healthier muscle responds to insulin better, especially when paired with exercise.”
Testosterone helps with the heavy lifting to improve those areas.
These effects typically begin to level off between six and 12 months of treatment, but it’s not unusual to see continued marginal progress over the next several years (2). Paired with a consistent exercise routine, TRT can help transform both your body and overall health.
If a snap-crackle-pop in your morning comes from your back and not your bowl of Rice Krispies, you may be feeling the effects of reduced bone mineral density (BMD).
The daily process in which your body adds new bone while breaking down old bone naturally slows down as you age. However, low testosterone levels can accelerate natural bone breakdown over bone formation which, left unchecked, can develop into osteopenia or, in more severe cases, osteoporosis.
Six months of testosterone replacement therapy treatment starts to decelerate bone breakdown, or resorption, giving new bone time to fortify (2).
). “This is because some T can be converted to estrogen, and that estrogen also helps bone density management,” says integrated health advisor and physician Natalie Kunsman, M.D.
The stiffness you’ve been feeling in your tendons and ligaments also lessens dramatically.
With continued treatment, the effects of improving your bone density can last three years or longer before they plateau (2).
Diminished sexual function—such as low sex drive and erectile dysfunction—is one of the most common reasons men seek treatment for low T (4). For good reason: research shows that libido and testosterone levels are strongly correlated (5).
Thankfully, TRT can quickly improve your love life. Increased testosterone levels often lead to heightened sexual activity and stronger, longer-lasting erections. “Once you add symptoms of poor libido and weak erections to fatigue or muscle weakness, the odds of low testosterone go up significantly, says Watson. “Fortunately, these symptoms typically respond very well to TRT. In some cases, erectile dysfunction resolves without needing additional medications like Sildenafil or Tadalafil.”
Several Hone customers have shared in our community forum that their sex drive returned within the first three to four weeks of treatment, along with noticeable improvements in erectile function.
Hone delivers treatments for low T to your doorstep, if prescribed.
GET STARTEDTestosterone Replacement Therapy has been shown to have significant positive effects on mental health, particularly for individuals with low testosterone levels. Low testosterone is associated with mood disturbances such as irritability, depression, and anxiety (6). By restoring testosterone to normal levels, TRT can help stabilize mood and improve emotional well-being.
In addition to mood improvement, TRT has been found to reduce symptoms of depression and anxiety, conditions that are often exacerbated by low testosterone levels. Several studies have demonstrated that testosterone plays a crucial role in regulating mood and managing stress (6).
“Testosterone can influence dopamine, serotonin, and GABA. Keeping those levels stable helps lessen depression and anxiety,” says Kunsman.
As testosterone levels are normalized, individuals often experience a reduction in anxiety, an increased ability to handle stress, and a more balanced emotional state.
TRT doesn’t have an immediate effect; you may not even notice a change at first.
But usually, you’ll start feeling better psychologically within three to four weeks of starting treatment (2).
One month in, you’ll likely find yourself more motivated to get off the couch and do more. “Patients who respond well to TRT often report a general feeling of vitality due to both increased physical and mental energy. This can directly improve work and home lives, boosting productivity, explains Watson.”
Testosterone plays a major role in cognitive performance, including memory, concentration, and reasoning. When your levels of testosterone are low, your mental function can suffer.
When you start TRT, the formidable cloud that has been hanging over your head will start to dissipate.
Your mental focus, cognition, and memory show signs of improvement after the first few weeks of treatment, while feelings of depression and sudden mood swings start subsiding within three to six weeks (2).
By 18 to 30 weeks in, your change in demeanor will support a radically improved self-confidence and clearer mindset, plus an inner strength that’s more ready to go toe-to-toe with whatever life throws your way.
“T also promotes higher-level brain functions such as decision-making, problem-solving, and planning,” adds Kunsman. “T also can increase BDNF which is a protein that helps neurons to survive and grow. In fact, partly because of this mechanism, budding research confirms testosterone can protect against Alzheimer’s disease.”
When you’re hypogonadal, your sensitivity to insulin can be compromised, your blood sugar levels can spike, and you have an increased risk of developing type 2 diabetes (7).
TRT increases your insulin sensitivity, enabling your body to absorb glucose, or sugar, from your blood more effectively after a meal. Improvements in blood glucose levels and insulin sensitivity are typically seen after about three months, with the full effect happening after a year (2).
“TRT can certainly improve glycemic control, and we know that eugonadal men are less likely to have metabolic disorders,” says Calvert. “While the potential therapeutic benefits are exciting, it’s important to still treat your diabetes with oral meds, diet, exercise, and good old-fashioned carb counting.”
Also remember: one little spark is all you need to motivate you into becoming more physically active, which also increases your insulin sensitivity.
Your body produces red blood cells through a process called erythropoiesis. Those cells made in your bone marrow contain hemoglobin, an essential protein that carries oxygen.
When you suffer from hypogonadism (low T), red blood cell production can slow to a crawl and even lead to anemia.
As your T level decreases, you’re left feeling progressively fatigued and weakened. Your blood pressure may also test higher than normal. The rest of your body has to work that much harder to get oxygen to your cells and keep your organs operating as they should.
TRT, fortunately, gets your red blood cell count back into the flow of things.
Results can vary based on your age and the dosage prescribed by your doctor, but the improved formation of your red blood cells will produce a noticeable effect after three months (2).
As that happens, those bouts of fatigue you’ve been fighting will lessen, and your blood pressure should stabilize closer to within the normal range.
Your maximal output should peak between nine and 12 months. By then, your body is producing enough hemoglobin on its own to keep you energized, and the measurement of your red blood cells (known as hematocrit) reaches its maximum level.
However, TRT can lead to increased red blood cell production (RBC), which thickens the blood and elevates hematocrit levels. “I recommend careful hematocrit monitoring of patients being prescribed testosterone therapy, with special care and attention for those with preexisting cardiovascular risk factors,” adds Calvert. “TRT can lead to increased RBC, which thickens the blood. I always encourage patients who have higher hematocrit levels than normal (>51%) to donate blood every three months while they are on TRT.”
Hone delivers treatments for low T to your doorstep, if prescribed.
GET STARTEDLove to the lipids. These organic, water-insoluble compounds are key building blocks of your cellular membranes. They also serve as your body’s personal energy storage warehouse and help promote the signaling of electrical impulses throughout your brain.
When you suffer from testosterone deficiency, it can disrupt lipid metabolism, leading to higher cholesterol levels—a major risk factor for serious health problems like heart disease, heart attacks, and stroke. It typically takes about three months of TRT for your lipids to stabilize, restoring energy and sharpening your biochemically dulled brain. After 12 months, these effects reach their peak, bringing you one step closer to improved overall health (2).
While there’s excitement around testosterone’s potential benefits, especially regarding metabolic health, it’s important to note that TRT likely does not increase major cardiovascular events. Calvert notes, “Similar to diabetes above, we are more excited that testosterone likely does not increase major cardiovascular events. We know men who are eugonadal have less cardiovascular risk, but we don’t have data at this point to say that normalizing testosterone in hypogonadal men portends the same risk reduction.”
That’s why regular monitoring and collaboration with your healthcare provider are essential to ensure your treatment plan is optimizing your health without unintended risks.
Inflammation is your body’s ultimate defense mechanism, helping your immune system combat injuries, infections, toxins, or anything else that causes cell damage. However, when testosterone levels drop, the physical stress on your body can trigger more widespread inflammation—and for longer periods. Chronic inflammation has been linked to serious health conditions like cancer, Alzheimer’s disease, heart disease, and type 2 diabetes. Simply put, your body’s friend is overstaying its welcome, and it’s doing more harm than good.
TRT can help regulate chronic inflammation by restoring testosterone levels to a healthy range, reducing some of the inflammatory response. “Inflammation is such a buzzword pseudo-science term,” says Calvert. “We know that men who are eugonadal have fewer inflammatory cytokines in circulation, while men with low T have higher levels. There is some decrease in cytokines with T replacement, but we do not know if this translates to clinically significant changes across the board.”
It typically takes between three weeks to three months of treatment for blood tests to show improvements in biomarkers tied to chronic inflammation (2). While the potential benefits are promising, ongoing research will determine the full extent of TRT’s role in managing chronic inflammation.
TRT can significantly improve sleep quality by addressing several underlying issues caused by low testosterone levels. One key benefit of TRT is its ability to help regulate your body’s circadian rhythm—the internal clock that controls sleep-wake cycles (8). When testosterone levels drop, this rhythm can become disrupted, leading to fragmented sleep and difficulty falling or staying asleep. By restoring testosterone to healthy levels, TRT can help rebalance your natural rhythm and promote more consistent, restful sleep.
TRT can also have a positive impact on mood and mental health (9). Low testosterone is closely linked to depression and anxiety, both of which are known to interfere with sleep. Restoring hormonal balance through TRT can stabilize mood and reduce mental restlessness, making it easier to relax and get a full night of restorative sleep.
“Poor sleep raises hunger hormones that increase appetite (particularly for processed foods) and stress hormones like cortisol,” says Watson. So for some individuals, TRT may even reduce symptoms of mild sleep apnea by lowering body fat and improving overall muscle tone. While it’s not a direct treatment for sleep disorders, the combination of improved physical and mental health that comes with balanced testosterone levels often leads to better sleep and, ultimately, a higher quality of life.
When your body’s testosterone thins out, it’s common for your waistband to expand.
Low T is associated with increased fat mass, especially around your midsection, which can cause a vicious cycle as more fat cells can lead to lower testosterone levels. It’s also associated with gynecomastia, or an increase in body fat in the chest area, often known as “man boobs” (10).
Hormone replacement therapy works twofold to address this.
After three months, you not only start burning off fat mass, you also begin increasing lean body mass (2). The belly flattens and gynecomastia is reduced, while muscle builds, giving your testosterone even more of a boost.
“Increasing testosterone also enhances the impact of exercise and nutritional optimization,” says Watson. “Correcting low testosterone also improves sleep quality which makes it easier to stick to nutritional recommendations, be more active in the gym, recover well from exercise, and other factors that all translate into reduced body fat while building muscle.”
Before long, you can end in that vicious cycle of low T-increasing-fat-increasing-low T.
If you’re following your prescribed treatment, studies show your body can continue seeing the dual effects for a few years. Plus, you can look down and see your toes again.
Testosterone replacement isn’t an overnight fix. It’s crucial to follow your doctor’s plan and be patient. Dosages may be adjusted along the way to find your ideal balance, helping your body achieve lasting results so you can feel like yourself again.
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