At our practice, many male patients come to us with concerns about low energy, reduced libido, weight gain, and difficulty concentrating—symptoms that could be linked to low testosterone levels, a condition known as hypogonadism. Testosterone is a hormone essential to many functions in the male body, including muscle strength, metabolism, mood regulation, and sexual health. When testosterone levels drop below the normal range, and symptoms are present, testosterone replacement therapy (TRT) may be an appropriate and effective treatment.
In recent years, there’s been growing interest in both the benefits and safety of TRT. To help guide our recommendations, we rely on high-quality research from well-conducted clinical studies. Let’s take a closer look at three of the most important studies that highlight the benefits of TRT in hypogonadal men.
The first is a comprehensive systematic review and meta-analysis published in 2017 that examined data from 87 randomized controlled trials and 51 observational studies. This analysis found that TRT significantly improved key symptoms associated with low testosterone, such as reduced libido, erectile dysfunction, and mood disturbances. Men on testosterone therapy reported improvements in overall quality of life, including increased energy and reduced depressive symptoms. Crucially, the study also found that testosterone therapy did not significantly raise the risk of serious adverse events when monitored appropriately, making it a safe option for many men under the care of a physician.
The second major study is a long-term observational study that followed men on injectable testosterone undecanoate therapy for up to 11 years. The results were striking: men experienced sustained weight loss, reduced waist circumference, improved blood pressure, and better blood sugar control. These metabolic improvements can reduce the risk of developing type 2 diabetes and cardiovascular disease—conditions that men with low testosterone are more prone to. Not only did testosterone therapy help regulate these risk factors, but the study also showed a lower incidence of major cardiovascular events and mortality among those receiving treatment compared to men who remained untreated.
Finally, a large retrospective cohort study examined data from more than 133,000 hypogonadal men between the ages of 40 and 80. It found that those who received TRT had lower all-cause mortality and reduced rates of heart rhythm problems (such as atrial fibrillation), stroke, and even prostate cancer compared to those who did not receive treatment. These findings suggest that, far from being harmful, TRT may offer protective effects when carefully prescribed and monitored.
Taken together, these studies suggest that testosterone replacement therapy offers meaningful health benefits to men with clinically diagnosed low testosterone and related symptoms. It can improve sexual health, mood, body composition, and metabolic function, and may even reduce cardiovascular and overall mortality risks. However, TRT is not a one-size-fits-all treatment. It requires a thorough medical evaluation, including blood work to confirm low testosterone levels, and a conversation about your symptoms and overall health.
If you are experiencing symptoms of low testosterone, it’s important to speak with your healthcare provider. TRT can be a highly effective therapy when prescribed to the right patients and monitored closely over time. Our team is here to guide you through that decision, ensuring that any treatment aligns with your long-term health goals.
Bibliography
- Corona, G., et al. (2017). Testosterone and Metabolic Function in Men: A Meta-Analysis of Randomized Controlled Trials and Observational Studies. PubMed. https://pubmed.ncbi.nlm.nih.gov/29150464
- Saad, F., et al. (2019). Long-Term Treatment with Testosterone Undecanoate in Hypogonadal Men: 11-Year Data on Weight, Glycemic Control, and Cardiovascular Risk. International Journal of Obesity. https://www.nature.com/articles/s41366-019-0517-7
- Pastuszak, A.W., et al. (2024). Testosterone Therapy and Long-Term Health Outcomes in Hypogonadal Men: A Retrospective Cohort Study. Journal of the American Board of Family Medicine. https://www.jabfm.org/content/37/5/816.abstract