Testosterone Risks

I have had a great experience with HRT (TRT) overall.  It has been a life changer - positively of course - and helped me in my relationship with my wife, my career and I am convinced my general health and personal psychology.  That said, I had absolutely no idea what I was doing when I got on testosterone and no doctor ever told me about any of the risks associated with it.  I personally was blindsided by an issue, for example, that I will discuss below. 

Why do physicians not give full disclosure?  Well, many of them simply know very little about testosterone therapy and are on end the early stages of the learning curve.  Still others feel financially and time constraned.  Finally, it is clear to anyone following the industry that there are many out there who just want to grab your money before they tell you about any potential issues.  Many of you have seen very aggressive advertisements from testosterone manufacturers and HRT clinics for example.

NOTE:  HRT has its risks, but it also has incredible potential rewards.  I cover those in my page called The Benefits of Testosterone.

So "eyes wide open" as I always say and please scan through the STEP 10 of my Examining Your Testosterone Program, which includes these Ten Significant Risks of Testosterone Therapy and then discuss with a (hopefully knowledgeable) physician:

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1. What if Have to Go Off of HRT?  I was stunned one day by my HRT clinic.  They were the ones that started me on testosterone cypionate and cypionate powerfully changed my life for the better:  it vanquished my dysthymia (mild depression) and gave me morning erections for the first time in my life. My libido went through the roof; my boss commented how much easier I was to work with; and my erectile strength improved, etc.

However, everything came crashing down when my HRT clinic told me that I had a PSA read of 6.3 - my baseline was 1.4 or 1.5 - and that I had to immediately quit testosterone until I got urological clearance. I was horrified.  Not only might I have prostate cancer, but, even if I didn't, I had to have a prostate biopsy and no T for an indefinite period of time.  One month after quitting HRT, my testosterone was 111 ng/dl!  That was probably about an eighth of my average testosterone over the last year.  I was miserable when my testosterone was in the low 300's and I could not bear the thought of living with levels in the 100's and 200's for months and months.. 

The story has a happy ending.  I was able to go back on HRT - they found inflammation and no cancer during the biopsy - and all seems to be well as my PSA has since dropped down to 1.9.  But it was a very sobering experience and very stressful.  (You can read about the details in my page on High PSA But No Cancer.)

On the Peak Testosterone Forum, this is not a very common issue, but it certainly can happen. Furthermore, considering that prostatitis can raise PSA very significantly, the percentage of men on TRT facing the issue over many decades can probably be significantly magnified. In addition, there are other issues that I have seen take men off of HRT: high, persistent hematocrit / hemoglobin and high blood pressure. Some men cannot get these in line even if they donate blood and thus are forced off of HRT due to stroke/heart attack risk concerns.  Still other men find that testosterone raises their blood pressure and/or pulse.  So discuss these kind of risks with your physician before you go on HRT and find out how he or she handles it.

2. What If I Feel Nothing?  Being forced off of testosterone therapy (#1) is not all that common.  However, I quite often get asked the following question:  "when will I feel something?"  A significant percentage of men have one of two scenarios happen:

a) After three months, they notice little change from HRT, i.e. no real benefit.