Understanding the pros and cons of testosterone therapy is essential to making the best treatment choices.

Testosterone Therapy Pros and Cons: What Men Need to Know

by Charlotte

Cultural narratives are powerful and profoundly impact the course of our lives. Even when we understand they are false or damaging, it can be hard to shake them entirely. For men, many of those cultural narratives are tied to testosterone and the qualities it is purported to imbue—strength, energy, vitality, sexual prowess. Indeed, “testosterone” often becomes shorthand for masculinity itself. Which means that when a man is suffering from low testosterone, it can become a source of shame. 

But low testosterone isn’t a comment on your masculinity, and it should not be a source of shame. It is a medical condition that any man can experience, particularly as they age. And this medical condition often comes with a multitude of symptoms that can be draining, frustrating, and even painful. The fatigue, depression, anxiety, uncomfortable physical changes, and loss of interest in sex that so often result from low testosterone take a heavy toll. 

To begin healing from low testosterone, you must recognize the symptoms, accept a diagnosis, and find the right treatment. For most men, that treatment is testosterone therapy. Only testosterone therapy is proven to help men reliably raise their testosterone level, giving them the energy they need to live the lives they want. This isn’t for everyone, of course, and there are testosterone therapy pros and cons you should be aware of. Gaining that awareness is the first step toward making your decision. 

Understanding Low Testosterone

Men naturally have varying levels of testosterone. Normally, that level is between 300 ng/dL and 1000, ng/dL. When you drop below that, you are considered to have low testosterone and you may begin noticing physical and emotional changes. For some men, these changes are overt and undeniable. For others, however, they are subtle and easily brushed off. Over time, however, they are likely to increase in severity.

One of the most common causes of low testosterone in males is the aging process. Testosterone production generally begins to decline in your late 20s and continues to drop at a rate of approximately 1% per year. While this decline is natural, it isn’t necessarily benign; up to 40% of men over the age of 45 have clinically low testosterone levels. Of course, aging isn’t the only cause. Low testosterone can also be the result of:

  • Damage to testicles
  • Removal of (both) testicles
  • Pituitary gland disease
  • Chemotherapy
  • Reaction to medicine
  • Congenital hypogonadism
  • Genetic condition leading to lifelong low testosterone

There are also links between low testosterone and conditions such as obesity, diabetes, and high blood pressure.

The Physical and Mental Impact of Low Testosterone

Testosterone plays a critical role in a broad spectrum of physiological processes. As noted by the National Institute of Health, “it’s thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm.” Due to this broad impact, low testosterone can produce a multitude of primary symptoms and secondary impacts. 

Some of the symptoms of low testosterone include:

In addition to being troubling in and of themselves, these symptoms can also lead to serious long-term issues, such as obesity, diabetes, and other physical conditions. The symptoms of low testosterone can also have significant emotional and social effects, including damage to your self-esteem and disruptions in your most important relationships. In fact, your overall functionality may be impacted, and its effects can reverberate throughout your life.

Testosterone Therapy Pros and Cons

Because testosterone therapy is known to be the best treatment for low testosterone and can correct many of its symptoms and secondary impacts, it is typically a highly attractive option. Unlike over-the-counter testosterone “boosters”, testosterone therapy is prescribed by medical professionals and uses exogenous testosterone to bring levels into the normal range. However, as with any medical treatment, you should be aware of the pros and cons. 

The Pros of Testosterone Therapy 

There are a lot of positives to testosterone therapy. According to a 2009 metareview, “reports indicate that TRT may produce a wide range of benefits for men…that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease.” What does this mean for you? Often, it means:

In other words, testosterone therapy gives you back what you lost as your testosterone levels fell. 

The Cons of Testosterone Therapy

With any medical treatment, there are potential risks and side-effects that could outweigh the benefits for some patients. Testosterone therapy is no different. For most men, the side effects are minimal. A small number of men report experiencing acne, swelling of the breasts or ankles, and breathing disturbances while sleeping. However, these are not common.

More significantly, testosterone therapy may have long-term health implications for some men. Prostate health in particular has historically been believed to be impacted by TRT. However research results have been mixed, and a meta-review spanning 38 years of data found that while men taking testosterone therapy were more likely to detect prostate events, they were not more likely to actually develop prostate cancer. Data is also mixed on the effect of testosterone therapy on cardiovascular health, with a few studies suggesting that it may increase the risks of cardiovascular events while many others have found that it may reduce cardiac events. In light of this contradictory evidence, you should work with your health care practitioner to determine the best course of action. Additionally, testosterone therapy can reduce sperm count and compromise fertility during treatment. As such, it is not recommended for men who are planning to father biological children in the future.

Expert Guidance Can Help You Avoid Cons

If you are struggling with the symptoms of low testosterone, the first step to recovery is connecting with a hormone health specialist. They can ensure you get the tests you need to determine if your symptoms are related to your testosterone levels or caused by something else. They can also help you navigate testosterone therapy pros and cons for your individual situation and decide if you are a good candidate based on your symptoms, goals, and health status. If testosterone therapy is the best path, they can help you explore your treatment options to optimize your results and minimize side effects.  

Whatever treatment strategy you ultimately choose, the goal should be to feel your best. With the right approach and the right support, you can recapture your vitality and live a healthier, more fulfilling life.

If you are considering testosterone therapy, BodyLogicMD can help. The BodyLogicMD network is comprised of top medical professionals specializing in hormone health and hormone replacement therapy. A BodyLogicMD-affiliated practitioner will design a personalized treatment plan to address your symptoms and help you achieve your health goals using the best therapies available today. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz today. 

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.


  • Charlotte

    Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.