When should a man start hormone replacement therapy?

A man should consider starting hormone replacement therapy (HRT), often referred to as testosterone replacement therapy (TRT), when he experiences symptoms of low testosterone (hypogonadism) and a confirmed diagnosis of low testosterone levels. Testosterone naturally declines with age, typically starting in the 30s, but some men experience significant drops earlier or more acutely, leading to noticeable changes in health and quality of life.

Common symptoms of low testosterone include fatigue, decreased libido, erectile dysfunction, reduced muscle mass, mood swings, irritability, and mental fog. If these symptoms persist, a healthcare provider will typically perform a blood test to measure testosterone levels. If levels are low and symptoms are severe, TRT might be recommended.

Men should start HRT when the benefits clearly outweigh the risks. TRT can improve energy levels, sexual function, muscle mass, and overall mood. However, it also carries risks, such as increasing red blood cell count (raising the risk of blood clots), potentially worsening sleep apnea, and affecting prostate health.

Before starting therapy, men should undergo thorough medical evaluation and discuss their health history and potential risks with a healthcare provider. TRT is not for everyone, and should be used carefully under medical supervision.