Welcome to TRT at The Health Suite
You have been prescribed testosterone replacement therapy (TRT) to help restore your hormone balance, improve your symptoms, and support your well-being. This leaflet explains what TRT is, its potential benefits and risks, how and why we monitor your health, and what you can expect as your treatment progresses.
Benefits of TRT
When testosterone levels are low, TRT can help:
Increase energy and reduce fatigue
Improve mood and motivation
Enhance libido and sexual function
Support muscle mass and bone strength
Improve concentration and quality of life
Risks and Side Effects of TRT
As with any medical treatment, TRT has possible risks:
Raised red blood cell count (polycythaemia), which increases the risk of blood clots
Worsening of sleep apnoea
Swelling, acne, or oily skin
Breast tenderness or enlargement
Mood changes or irritability
Possible changes in cholesterol and liver function
Prostate Health:
Current evidence shows that TRT does not increase the risk of developing prostate cancer in men who do not already have the disease.
TRT may, however, speed up the growth of an existing, undiagnosed prostate cancer, which is why careful screening and ongoing PSA monitoring are essential.
All men on TRT require regular PSA blood tests and, if appropriate, prostate examinations.
Reduced fertility (TRT suppresses sperm production)
Rare risk of fluid retention or high blood pressure
“Testosterone therapy causes prostate cancer.”
TRT does not increase your risk of developing prostate cancer compared to men not on TRT. This is confirmed by large clinical studies and is supported by UK and international guidelines. Regular PSA testing and monitoring keep you safe.
How Dose Adjustment Works
Your TRT dose is tailored just for you and may need adjustment in the first few months.
Regular blood tests and symptom reviews help us find your ideal dose.
The aim is to reach and maintain testosterone levels within the mid-normal range for healthy adults, without causing side effects.
If your blood testosterone is too high or too low, or if you have side effects, your doctor may change your dose, the timing, or the type of TRT.
Your dose may also be adjusted if your blood count (haematocrit) or PSA rises.
TRT can only be prescribed or continued if you attend regular blood tests and monitoring appointments.
When Will I Notice the Effects?
Most men notice some improvement in symptoms (energy, mood, libido) within 3–6 weeks.
Changes in muscle mass, body composition, and bone strength may take 3–6 months or longer.
Full stabilisation of hormone levels and all benefits may take up to 6 months.
If you have not noticed improvement after 3–6 months, please discuss this with your clinician.
Time to effect varies with the type of TRT (gel, injection, etc.) and your individual health. Ongoing monitoring ensures you get the best results as safely as possible.
Why Monitoring is Essential
Regular blood tests and health checks are required to ensure TRT is both safe and effective.
TRT cannot be prescribed or continued without ongoing monitoring.
Monitoring helps to:
Check that testosterone levels are in the correct range
Detect side effects early, such as thickening of the blood or changes in the prostate
Monitor cholesterol, liver, kidney, and metabolic health
Ensure your treatment continues to be safe and tailored to you
We also monitor your blood pressure (BP) and weight because TRT may affect your cardiovascular health and body composition.
| Panel | When is it done? | What is checked? |
|---|---|---|
| Panel 1 | Before starting TRT | Testosterone & Free T, SHBG, LH/FSH, Prolactin, PSA, FBC, U&E, LFT, HbA1c, Lipids, TSH/T4 |
| Panel 2 | At 3 months and 6 months | Testosterone, FBC, PSA, LFTs |
| Panel 3 | Every year (annual review) | Testosterone, FBC, PSA, LFTs, Lipids, HbA1c |
Additional Monitoring
Blood Pressure (BP): TRT may increase blood pressure, so regular checks help protect your heart and kidneys.
Weight: Monitoring helps assess your overall health and response to therapy; TRT can affect body composition.
Prostate Health: A Digital rectal exam (if appropriate) may be recommended to check your prostate.
Why is Monitoring Required for Ongoing Treatment?
- TRT cannot be prescribed or continued without up-to-date blood tests and health checks.
- This is to keep you safe, avoid complications, and ensure the treatment remains right for you.
What Happens if a Result is Out of Range?
Your doctor may adjust your TRT dose or how it is given
Additional tests or specialist referrals may be arranged
In some cases, treatment may be paused for further investigation
| Test | Why is it important? |
|---|---|
| Testosterone & Free Testosterone | Confirm diagnosis, monitor if treatment is working, avoid over- or under-treatment |
| SHBG (Sex Hormone Binding Globulin) | Helps interpret testosterone levels and calculate “free” (active) testosterone |
| LH & FSH | Differentiate between types of low testosterone (primary vs secondary hypogonadism) |
| Prolactin | Rule out pituitary gland problems that can cause low testosterone |
| PSA (Prostate Specific Antigen) | Checks for prostate disease or changes that might need specialist review |
| FBC (Full Blood Count) | Detects anaemia or polycythaemia (raised red cell count—a risk with TRT) |
| U&E (Kidney Function) | Ensures your kidneys are healthy and can process medications |
| LFT (Liver Function) | Checks for safe metabolism of medication, monitors for side effects |
| HbA1c | Assesses long-term blood sugar control and diabetes risk |
| Lipids (Cholesterol & Triglycerides) | Monitors heart and metabolic health; TRT may affect cholesterol |
| TSH & T4 (Thyroid) | Thyroid problems can affect symptoms and testosterone levels |
Questions or Concerns?
If you have any questions about your results, side effects, dose adjustments, or the monitoring process, please contact The Health Suite team.
Remember:
Regular monitoring and good communication are the keys to safe, effective TRT. Please attend all blood test appointments and follow-up reviews.
The Health Suite – Your partner in men’s health and wellbeing.
References
- Jayasena, C. et al. (2021) ‘Society for Endocrinology guidelines for testosterone replacement therapy in male hypogonadism’, Clinical Endocrinology, 95, pp. 1–20.
- Hackett, G. et al. (2017) ‘British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency’, Journal of Sexual Medicine, 14(12), pp. 1504–1523.