For years you dreamed about having a smaller waist, larger muscles, and a better sex life. When you started testosterone therapy, you expected to see these changes. However, it has been a few months, and nothing has happened. It is time to find out why testosterone therapy is not working for you.
First, are your expectations realistic? Many men begin using testosterone without having a clear idea of what it can do for them. That is the first problem as unrealistic expectations are rarely met.
This is the first area we will cover in this article. If you are taking testosterone therapy for medical purposes – the treatment of testosterone deficiency – your health care provider should have discussed with you what to expect. Changes from testosterone replacement therapy (TRT) do not happen overnight. However, by the second or third month, you should be noticing significant changes in energy, sleep, mental focus, and mood. Most men find they have more drive and increased sexual desire. By the end of the third month, you should feel fewer aches and pains and notice some better muscle definition and even a little weight loss from your abdomen. A lack of these results could indicate testosterone replacement not working as it is intended. We will discuss the reasons why in the next section.
The other reason why testosterone therapy may not be working for you is the fact that you are taking it for the wrong reasons. If you are using testosterone for muscle building or strength training purposes without having Low T, please know that we do not approve. Testosterone used for those reasons is illegal and unsafe. You may not get the results you desire when using testosterone illegally, and you may even get more than you bargained for – in the way of negative side effects.
To know if testosterone therapy is working, you need to be realistic in your expectations.
Are You Taking the Right Amount of Testosterone Therapy?
Your doctor prescribed you to take a certain dosage of testosterone, either by injection, transdermal gel, skin patch, or transbuccal tablets that adhere to your gum. Some men may even undergo a surgical procedure to implant small testosterone pellets under the skin. Each of these types of treatment will present different reasons for testosterone therapy not working. Not taking the right amount of testosterone is often a cause.
With the pellets, your doctor will implant a certain dosage of testosterone-containing pellets under the skin. How your body metabolizes this testosterone is an unknown factor until a few months into treatment. If your body is not metabolizing the implanted testosterone properly, or if any of the pellets worked their way out from under the skin, you may not get the results you desire.
With both testosterone gel and patches, the testosterone must first enter the body through the skin before it can make its way to the bloodstream. Poor absorption is a common cause of not getting anticipated results from testosterone therapy. There is no way of knowing how well your body will absorb the testosterone through the skin until a month or two into treatment.
For people taking testosterone but not working as anticipated when using transbuccal tablets, there may be a problem with gum absorption. These tablets adhere to the gums, allowing testosterone to enter the body through delicate skin layers in the mouth. Salivary enzymes may interfere with the process. Not everyone will benefit from this form of TRT.
Next, we look at why testosterone therapy is not working when it is injected into the muscle. Here again, it has to do with how the body is metabolizing the testosterone. Until a few weeks or months after you begin treatment, the doctor will not know how your body will respond. You may require a higher dosage or more frequent injections of testosterone.
In all these instances, the doctor may need to change the prescribed dosage of testosterone. Do not attempt to alter your treatment regimen yourself. Your hormone specialist must be the one to make any changes to ensure you are using testosterone therapy safely while still getting desired results.
Dosage and metabolism/absorption of testosterone are common reasons why some people do not get the expected results.
Ways to Improve Testosterone Therapy Results
Your hormone specialist will also discuss a few different lifestyle habits that may be standing in the way of your treatment and its anticipated results. With testosterone not working as expected, we often look to see if a person may be unwittingly sabotaging any benefits. Some lifestyle habits are toxic to hormone production and function. For example:
- Not getting enough sleep prevents testosterone from carrying out many tissue repair and metabolic functions at night. That is when your body metabolizes the food you consumed during the day to create new energy sources. You need a minimum of 7 hours of sleep a night to facilitate the best possible testosterone benefits.
- Too much stress increases cortisol levels which is an agonist towards testosterone. When cortisol levels are high, testosterone often declines. As you decrease stress, you will reduce cortisol and allow testosterone levels and functions to improve.
- Cutting back on sugar is high on the list of improving testosterone benefits. Sugar is one of the most toxic substances you can put in your body. Focus on eating high-quality dietary fat, lean protein, fruits, and vegetables.
- Watch how you exercise. Physical activity is a great booster of testosterone levels during the day. However, if you are a man who engages in extended bouts of cardio activity, you are likely hurting rather than helping your testosterone levels. Limit aerobic activity to no longer than 30 minutes per day. Focus on high-intensity interval training. When weight lifting, choose exercises that manipulate multiple large muscle groups.
Finally, work with your hormone specialist to ensure that you are taking the correct amount of testosterone for your body. For additional information about why testosterone therapy is not working contact our hormone clinic with any questions.
Poor sleep and nutrition, lack of exercise (or over-exercising), and stress can all reduce testosterone effectiveness.
- Does your patient really need testosterone replacement?
J Fam Pract. 2016 December;65(12):864-866,873-875 By J. Andrew Hoover, MD Jeffrey T. Kirchner, DO, FAAFP
- Karim Sultan Haider, Ahmad Haider, Gheorghe Doros, Abdulmaged Traish. Long-term testosterone therapy improves urinary and sexual function and quality of life in men with hypogonadism: Results from a propensity-matched subgroup of a controlled registry study. The Journal of Urology, 2017.