Testosterone Replacement Therapy (TRT) can offer life-changing benefits for men with low testosterone. However, like any treatment, there are some common side effects to be aware of. These typically arise when testosterone levels increase too quickly or if the dose is too high.
At Hormn, we minimise risk by starting patients on a low dose and slowly increasing it based on regular blood work and patient-reported outcomes. We also use smaller, more frequent injections to help keep testosterone levels stable and reduce side effect risk.
Here are some of the most common side effects patients may experience:
1. Acne or Oily Skin
TRT can increase oil production in the skin, leading to acne—especially on the back, shoulders, or face. This usually occurs in the first few months as your body adjusts to higher testosterone levels.
What helps:
Use non-comedogenic cleansers.
Shower after sweating.
Dose adjustments may reduce severity if persistent.
2. Mild Fluid Retention
Some men notice puffiness, particularly in the hands, ankles, or face. This is often temporary and due to hormonal shifts.
What helps:
Reducing sodium intake.
Staying active and hydrated.
Reviewing blood pressure and blood markers if swelling persists.
3. Mood Changes or Irritability
TRT can influence mood. For some men, this means improved confidence and drive. For others, particularly early in treatment or if levels fluctuate too much, irritability or anxiety may increase.
What helps:
Maintaining stable testosterone levels through consistent dosing.
Lifestyle changes like sleep, exercise, and stress management.
Consulting your doctor if mood symptoms persist.
4. Nipple Sensitivity or Tenderness
Increased estrogen (which is a natural byproduct of testosterone) can cause nipple sensitivity or puffiness in some men.
What helps:
Monitoring estrogen levels through regular blood work.
Dose adjustments or other medications may be considered if symptoms persist .
5. Increased Red Blood Cell Count
Testosterone stimulates red blood cell production, which can sometimes lead to elevated hematocrit and haemoglobin. In rare cases, this can increase the risk of blood clotting if unmanaged.
What helps:
Ensuring proper hydration.
Donating blood every few months (if levels remain high).
Screening for sleep apnea or reviewing dosage if red cell counts are persistently elevated.
6. Hair Shedding
Some men may notice increased hair loss or thinning. This is mostly genetic and related to DHT (a byproduct of testosterone), not testosterone itself.
What helps:
Stabilising testosterone levels.
Avoiding DHT-blocking medications unless absolutely necessary due to the risk of side effects.
7. Changes in Libido or Erections
TRT typically increases sex drive and improves erections. However, some men may experience temporary fluctuations as hormone levels adjust.
What helps:
Time and consistent dosing.
Reviewing estrogen levels or treatment plan if symptoms persist.
8. Mild Insomnia
Some men may find it harder to fall asleep, especially in the early weeks of treatment or when levels are unstable.
What helps:
Injecting earlier in the day.
Maintaining good sleep hygiene.
Reviewing levels and adjusting treatment if sleep remains poor.
Summary
These side effects are usually mild and can often be prevented or resolved by adjusting dosage, monitoring blood work, and keeping hormone levels stable.
At Hormn, our doctors work closely with you to ensure safe, effective treatment that improves symptoms without unwanted effects.
If you experience a side effect that doesn’t go away or feels severe, always reach out through your patient portal.