Starting testosterone next week. What should I expect?

Starting testosterone next week. What should I expect?

Nelson, I know you wrote the book "Testosterone: A Man's Guide". I was diagnosed with low testosterone and do not know if I should do injections or gels. Also, what should I expect when it comes to sex drive and energy, etc? Thanks for your great work educating us in simple terms we can understand. Ah, my friends also told me I should be careful with heart attacks while on testosterone. Is that true? I do not want to screw myself up, just want to feel better since I have been tired and sex sounds impossible for me. My bf thinks I am not interested in him but I am really attracted to him but just lost my mojo and motivation.

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Response from Nelson:

I hope getting your testosterone blood level up will help you regain your mojo and stamina. But testosterone replacement therapy (TRT) is no magic solution and a cure-for-all. Some men expect huge differences right away and get easily discouraged.
To answer the question about how long TRT, a group of researchers reviewed a lot of the TRT studies published to date. Here is what they found:

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, no further increments beyond.

Changes in erections/ejaculations may require up to 6 months.

Effects on quality of life manifest within 3-4 weeks, but maximum benefits take longer.

Effects on depressive mood appear after 3-6 weeks with a maximum after 18-30 weeks.

First effects on erythropoiesis (increased red blood cells) after 3 months, peaking at 9-12 months.

Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase related to aging rather than therapy.

Effects on lipids appear after 4 weeks, maximal after 6-12 months.

Insulin sensitivity may improve within a few days, but effects on glycemic control become evident only after 3-12 months.

Changes in fat mass, lean body mass, and muscle strength occur within 12-16 weeks, stabilize at 6-12 months, but marginally continue to improve over years.

Effects on inflammation occur within 3 to 12 weeks.

Effects on bone detectable after 6 months but continue at least for 3 years.

Source:

So, as you can see, you have to be patient.

The decision of whether to use gels or injections is a personal one based on several factors:

- Cost and insurance coverage. Injections are cheaper by far but less convenient than daily gels. For best results, weekly injections of 100-150 mg of testosterone are better than 200 mg every two weeks since there are less pronounced peak and valleys.
- Fear of transferring testosterone to female sexual partners or kids by contact (gels). For many gay men, this is not an issue unless you have kids.
- Personal commitment. Are you OK with daily application? Are you afraid of needles?

You can read more about how to chose the best testosterone replacement options and how to prevent potential side effects on my new education website:
ExcelMale.con

Good luck in your new journey.
In health,
Nelson

 
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hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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