TRT is indicated for hypogonadism — a clinical condition defined by consistently low testosterone levels combined with symptoms. TruVera requires a baseline lab panel (total testosterone, free testosterone, hematocrit, estradiol, LH, FSH, and PSA) before any prescription is issued. A clinician will diagnose low T based on your lab values alongside your reported symptoms. Symptoms alone are not sufficient; lab confirmation is required. Most guidelines define low total testosterone as below 300 ng/dL, though free testosterone levels and symptom severity also factor into the clinical decision.

FDA-approved brand-name testosterone products (such as AndroGel, Testim, Depo-Testosterone, and Aveed) come in fixed concentrations and delivery formats. Compounded testosterone, prepared at a licensed 503A pharmacy, allows a clinician to specify a precise dose, concentration, and formulation — for example, a cypionate concentration suited to subcutaneous injection rather than deep intramuscular, or a topical cream base optimized for absorption. Compounded formulations are not FDA-approved as finished drug products, but the active pharmaceutical ingredient (testosterone) is the same. Compounding is particularly useful when commercially available dosing increments don't match the patient's clinical target.

TruVera's program supports three delivery methods, with your clinician recommending the best fit based on your labs, lifestyle, and preference. Injectable testosterone cypionate (subcutaneous or intramuscular) is the most common — typically administered once or twice weekly — and offers the most precise dose control. Topical creams and gels are applied daily to the skin and absorbed transdermally, ideal for patients who prefer to avoid needles. Subcutaneous pellets are implanted every 3–6 months for sustained, steady-state release. Each method has different pharmacokinetic profiles; your clinician will review the tradeoffs with you.

Most men begin noticing improvements in energy and mood within 3–6 weeks of starting TRT, as testosterone levels rise toward the therapeutic range. Libido and sexual function typically improve within 3–6 weeks as well. Changes in muscle mass, body composition, and bone density are slower — meaningful gains are generally observed over 3–6 months of consistent therapy. Cognitive improvements (concentration, verbal memory) often follow the energy and mood improvements. Full hormonal optimization — where your levels are stable in the target range and symptoms are resolved — typically takes 3–6 months and may require one or two dose adjustments guided by follow-up labs.

TRT is well-tolerated for most men when properly dosed and monitored, but several effects require ongoing lab surveillance. Erythrocytosis (elevated hematocrit) is the most common dose-dependent effect — testosterone stimulates red blood cell production, and hematocrit above 52–54% increases the risk of blood clots and cardiovascular events. This is monitored at every follow-up and managed through dose reduction or therapeutic phlebotomy if needed. Estradiol elevation can occur due to aromatization of testosterone; symptoms include gynecomastia, water retention, and mood changes. Your clinician monitors estradiol and may recommend an aromatase inhibitor if levels are elevated. Testicular atrophy and sperm suppression occur because exogenous testosterone suppresses the HPG axis, reducing endogenous production and spermatogenesis — men who want to preserve fertility should discuss this with their clinician before starting. Acne, oily skin, and scalp hair changes are possible due to androgenic effects. Injection-site reactions are mild and transient with proper technique. PSA must be monitored as a prostate safety marker.

Yes. You can pause or cancel at any time through your TruVera patient portal — no phone calls, no cancellation fees. Because abrupt discontinuation of TRT can cause a temporary drop in testosterone below baseline while your HPG axis recovers, your care team recommends a brief clinical conversation before stopping so they can advise you on the expected timeline and, if desired, discuss options such as a tapering protocol or post-TRT support.