Once You Start Testosterone Therapy Can You Stop?
30-Second Takeaway
- Testosterone replacement therapy (TRT) is used to treat low testosterone.
- If you stop TRT, your testosterone levels will decline, and you may experience symptoms of low testosterone.
- If side effects or cost are leading you to consider stopping TRT, your doctor can help you slowly lower the dose, stop treatment, or consider other treatments.
You’ve checked your hormones and found out you’re in need of testosterone replacement therapy to optimize your levels and get back to feeling like your old self. Now you’re debating whether the course of treatment is right for you—specifically, you’re wondering if this is a life-long treatment. Once you start testosterone therapy, can you stop? The short answer is yes, but there are a number of factors to consider attached with stopping TRT.
Why Start TRT?
Before you can understand why and how you might consider stopping TRT, it’s crucial to understand why you would start.
Testosterone replacement therapy is a prescribed course of treatment for men who have low testosterone production, or low T and symptoms of low testosterone.
The condition, medically called hypogonadism, occurs when your body doesn’t produce enough testosterone naturally. When that happens you’ll feel the effects in a variety of ways, including fatigue, poor memory, loss of muscle mass, and low sex drive.
While your testosterone levels start to decline naturally as you age, at a rate of about 1 percent per year after the age of 35, there are a number of external lifestyle factors that can also contribute to a lower testosterone count, including excess stress, poor diet, lack of exercise, and poor sleep hygiene.
While sometimes difficult to correct these issues, they’re not biologically fixed ones, so it is possible to make changes to your lifestyle, reverse the adverse effects of your low testosterone and see your levels rise naturally.
But if improving your diet, sleep, and exercise habits don’t help your levels rise, your doctor will likely advise you that TRT is your next best course of treatment.
KNOW YOUR T
How Long Into TRT Before You See Results?
This question is tricky because everyone’s body is different, biologically, so the length of time it takes to feel positive benefits will vary drastically from person to person.
Individuals who need a smaller boost of testosterone often report their low T symptoms improve in a matter of days. However, clinicians say that most patients should see appreciable improvement within two to four weeks of commencing a TRT plan.
That’s the time frame for your body to adjust to the additional testosterone you’re introducing and allow your body to stabilize. Every person responds differently to testosterone treatment, so if you’re undergoing treatment and it’s been four weeks and you’re not seeing the results you’d hoped for, that doesn’t mean TRT isn’t working for you.
Talk to your doctor about how you’re feeling and he or she can work with you to find the right levels of testosterone to achieve the results you’re seeking. Sometimes, a light adjustment to your dose is all that’s needed.
Checking your T levels with Hone’s at-home assessment is so easy you can knock it out before your AM coffee.
If the test shows you have low T, our physicians can help you feel better, fast.
Once You Start Testosterone Therapy, Can You Stop?
Yes, you can stop TRT, but not without consulting your doctor on the best method to do so. You should never abruptly stop your TRT on your own.
When you have been on TRT for a while, your body stops producing its own supply of testosterone. If you simply stop your TRT cold turkey, the shock of the sudden deprivation of testosterone will likely cause your energy levels and sex drive to drop. You’ll likely feel irritable and maybe even depressed or anxious.
Those symptoms might sound scary but they should resolve within a few weeks of stopping testosterone treatment.
In general, the longer you’ve been taking TRT, the longer it will take your body to adjust back to its normal testosterone levels when you stop.
Note that this is your body’s normal: If you have low T to begin with (hence why you started TRT), your T levels probably won’t be higher than when you started treatment. “For example, if your T levels were 200 ng/dL before treatment, they will only go back to this range when you stop TRT,” says Nick Dahl, D.O., a physician who specializes in hormones.
People who are on TRT for a short period of time typically have fewer symptoms when they stop than those who have been on the treatment longer. Rarely, it can take a few months or longer for symptoms to resolve (1).
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Why You Might Change Your Mind About TRT
Testosterone replacement therapy has a number of side effects that may dissuade you from wanting to continue with the course of treatment. Understanding these side effects can help you weigh whether TRT is right for you.
There are also a host of other reasons you may want to end a TRT treatment plan, including the cost of the medicine, concerns about fertility, or whether you’re feeling better and are ready to talk to your doctor about lowering or ceasing the dose.
Skin Issues
Men on TRT can see an increase in oily skin and acne as a result of the treatment. While annoying and perhaps embarrassing, much of this issue can be remedied with over-the-counter products.
Weight Gain
Testosterone can cause higher fluid retention, meaning you may feel and appear bloated, and your weight may increase when you start TRT. This side effect is typically short lasting and usually isn’t severe.
Prostate Complications
The prostate is a muscular gland that surrounds your urethra. Testosterone affects your prostate in several ways.
For starters, stimulation of the prostate tissue can cause an increase in the amount of urination and unusual patterns in your urination flow. A reduced flow is often reported, but neither of these issues are painful nor should they affect your daily life.
Some physicians have concerns that TRT can encourage prostate cancer cells to grow, but the evidence here is mixed. If you’re at risk for prostate cancer, or if you’ve had prostate cancer priorly, talk with your medical provider about these concerns to see what he or she recommends.
Fertility Considerations
While TRT does help boost your libido and some erectile dysfunction issues, it does also lower your sperm count significantly (2). Men who are interested in family planning should talk through the fertility considerations with their clinician before starting TRT. He or she may be able to prescribe other medications that can decrease the symptoms of low T without impacting fertility.
TRT Costs
The cost of TRT can vary based on factors including your geographical location, your insurance provider, the type of medication you’re using, the dosage, and the frequency of those doses.
TRT can range from as low as $20 to as high as $1,000 per month. If your TRT expenses end up on the higher end of that spectrum, that can be a sizable reason to reconsider whether to continue.
You Feel Better
Once you’re underway on TRT and starting to feel the positive benefits of the treatment, you may feel like the testosterone has done its job and you’re ready to stop and simply enjoy your newfound happiness. Unfortunately, to keep feeling the positive effects of testosterone replacement therapy, you’ll need to continue the treatment.
When you stop TRT, you’ll revert back to how you felt before you started treatment.
THE POWER OF TRT
The longer you’ve been taking TRT, the longer it will take your body to adjust back to its normal testosterone levels when you stop.
Minimizing Side Effects From Stopping TRT
Plenty, actually. What’s crucial is to follow your doctor’s medical advice for any and all requisite testing to understand potential issues and plan ahead to mitigate those. Many of the commonly reported issues are often mild and your doctor can work with you to find methods and solutions to offset those problems.
If you are experiencing negative side effects as a result of your TRT, don’t suffer in silence. Talk to your doctor about what you’re feeling so a course correction can immediately be implemented.
What Happens When You Stop TRT?
The short answer is your body will revert to how it was before you started TRT. Your low T symptoms will return. Unlike the gradual onset of your symptoms of low T, when you’re coming off TRT, the onset of these negative symptoms will be more rapid. If you felt lethargic and a loss of libido before, that’ll come back in a much more intense way after your TRT ends.
In some cases, your pre-TRT body and feelings are preferable to how you feel and react to the TRT. That personal decision is one to make with your doctor.
How Do You Stop TRT?
Gradually and under a doctor’s care. Your doctor will recommend a series of doses that successively lower and taper off over time, so the shock to your system is not a drastic one. Weaning off testosterone will take several weeks—or longer—and is the safest way to cease a course of TRT.
Long-Term TRT Use
During this transition phase, you’ll often notice withdrawal symptoms, such as moodiness, decreased motivation and energy, a slower libido, increased recovery time after exercise, more noticeable and lack of sperm production, or spermatogenesis.
“To stimulate Spermatogenesis again, I prescribe Clomiphene oral and/or HCG (Human Chorionic Gonadotropin) to stimulate sperm and testosterone production to help avoid the ‘crash,’” says Dr. Lester Lee MD, a preventative and regenerative medical doctor and specialist in hormone replacement therapy. Consider this to be post-cycle therapy, which can be immensely helpful.
It’s best to be optimistic and patient with the transition phase, and keep in mind, it won’t last forever. However, duration and severity of symptoms does increase the longer you’re on TRT before deciding to stop. “The longer you’ve been on TRT, the longer it may take to restimulate your production of sperm,” Dr. Lee explains.
So, if you’re taking it long-term, you may want to take more breaks in order to better manage withdrawal symptoms. A TRT medical specialist will help advise here, too.
Post Cycle Therapy Plans After Stopping TRT
Post cycle therapy (PCT), can help minimize side effects of stopping TRT while your body returns to its normal testosterone levels. The protocol can include both medications and non-drug tactics, says Dahl.
One recent study found that Metformin, a medication often used to control high blood sugar in people with diabetes, helped to mitigate the side effects (3)—including sexual side effects—of stopping TRT.
“Clomid would also be an option for a man who wanted to discontinue TRT but was worried about his T levels moving forward,” says Dahl.
He’s not the only one thinking along these lines; one study suggests that Clomid might stimulate T production (4) in men discontinuing TRT.
Medications aren’t the only option; exercise has been shown to keep T levels higher longer after stopping TRT (5).
Long-Term TRT Use
For men with low testosterone levels, long-term therapy usually outweighs any potential risks. However, like any long-term treatment, researchers are still studying the impacts of long-term use.
Some research suggests men who have been on TRT for long periods of time are at a higher risk for cardiovascular disease, but the evidence is mixed. Other studies link long-term TRT with prostate cancer, but here again, the evidence is mixed. When talking to your doctor about TRT, discuss your personal and family history, so that you can make the best decision together.
The Bottom Line
If you are considering stopping TRT because of costs, side effects, or fertility complications, don’t end treatment on your own. Your doctor can help you decide if your dose needs to be adjusted, suggest alternate treatment options, and, if you decide to end TRT, slowly lower your dose to minimize side effects.
Checking your T levels with Hone’s at-home assessment is so easy you can knock it out before your AM coffee.
If the test shows you have low T, our physicians can help you feel better, fast.
References:
1. Yassin A, et al (2016). Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity, voiding function and prostate safety parameters. https://pubmed.ncbi.nlm.nih.gov/26742589/
2. Patel, Amir Shahreza et al (2019). Testosterone Is a Contraceptive and Should Not Be Used in Men Who Desire Fertility. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305868/#
3. Krysiak R, et al (2021). Hypothalamic-pituitary-gonadal axis and sexual functioning in metformin-treated men after discontinuation of testosterone replacement therapy: A pilot study. https://pubmed.ncbi.nlm.nih.gov/34490645/
4. Roshirl Francisco, et al (2019) Clomiphene for hypogonadism complicated by polycythemia. https://www.tandfonline.com/doi/abs/10.1080/08998280.2018.1526570
5. Cho DY, et al (2017). Exercise improves the effects of testosterone replacement therapy and the durability of response after cessation of treatment: a pilot randomized controlled trial. https://pubmed.ncbi.nlm.nih.gov/27427553/
