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Low testosterone, depression, low concentration, tired. TRT?

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General & Family Physician
Practicing since : 2003
Answered : 336 Questions
i need to know the side effects of under going TRT. Are they really proven, Is TRT worth risking the side effects. I have low testoterone and have the following symtoms. depression, unable to concentrate on work. loss of creativity. loss of music sense. loss of empathy. tired most of the time. Who can treat me in chennai,tamil nadu.

my age is 47 and weighing 63 Kgs. and a hieght of 164 cms. I am diabetic but under control.
Posted Mon, 23 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Deepak Anvekar 1 hour later

Here are some important side effects of testosterone replacement therapy.

1. Fluid Retention: Resulting in ankle or leg swelling, worsening of high blood pressure or congestive heart failure.

2. Liver Toxicity: More associated with oral supplements rather than transdermal patches.

3. Problems with Fertility: Spermatogenesis (the production of sperm) in all men is dependent on production of testosterone by the testes. If testosterone is given from outside, the testes will stop producing their own testosterone. This will shut down sperm production either significantly or completely in nearly all men. This may be a temporary or permanent effect. In your case, since you are above 40 years and probably finished your family this should not be a concern.

4. Tender breasts or enlargement of breasts: This is due to the conversion of testosterone to estrogen. This side effect can be overcome by decreasing the testosterone dose.

5. Increased Red Blood Cell Concentration (Polycythemia) or hemoglobin levels: Increased blood cell mass may increase thromboembolic events (heart attacks, strokes or peripheral clotting in the veins). This can be managed by decreasing the dose of testosterone and venepuncture if required. In addition, regular monitoring of hematocrit is also indicated.

6. Enlargement of Prostate: Increase in size of prostate can cause problems with urination. Hence before initiation of therapy, a digital rectal examination by a doctor and measurement of the PSA (Prostate Specific Antigen) levels will be essential.

7. Acne and oily skin.

8. Hair loss and/or thinning of the hair.

In order to prevent most of these side effects, you should work in close association with your doctor and would need titration of your dose at regular times.

Your physician would be able to explain regarding the risk involved for you after the detailed physical examination and investigations.

You can consult the following clinic:

Madras Andrology Clinic,
28, Brs Hospital, 4th Floor,
Cathedral Garden Road, Behind Hotel Palmgrove,
Chennai, Tamil Nadu 0000, India.

54, First main road, XXXXXXX nagar, Adyar, Chennai 0000.
Timings: Monday to Saturday 11 am to 1 pm
You can Call 0000 extn 4121 for appointments.

I hope I have answered your query.

Please feel free to consult me for follow ups if any.


Dr. Anvekar.

Above answer was peer-reviewed by
Follow-up: Low testosterone, depression, low concentration, tired. TRT? 19 hours later
while i understand the risks as mentioned by you. Still i need to be clarified the following.

1. already my sperm production is very very negligible. But i do not have any problem in erection . But the pleasure of having sex ( sensuality ) has declined.

2. My main concern is to become more concentrated on my work , which involves lot of creativity. Will TRT help in achieving this. I am becoming more indifferent to everything i love to see , hear and do. For example i love music , but now i do not enjoy the music and merely listening to it. Like this there many things which i have lost and i am sure they are all due deficency of testotrone. Will TRT help me.
3. Is there any possibilty that all the above side effects can be minimised or eliminated by careful monitring by doctor. will the the side effects be permanent or will go away if the treatment is abadoned.
4. will the treatment be continous for for considerable time ( how long to achive the results )
5. What is your opinion. Should i risk the side effects and go for TRT. Have there been any TRT treatments given in india ( espcially in chennai ) with reasonable success and minimum side effects.

Please try to answer all the queries as it is important for my carrier and life.


Answered by Dr. Deepak Anvekar 10 hours later

Though I am not a practising Endocrinologist I prefer to answer your questions this way.

1) Sensuality is clear perception from mind. It may not have anything to do with

2) I am not sure if TRT shall help you bring back your lost love towards music. The senses are unrelated to Testosterone replacement.

3) Once testosterone is started and if you are not benefitted by it, can be withdrawn and whatever side effects that you perceive shall go away physically.

4) I am not sure about the length of therapy and benefits of testosterone replacement for you.

It needs thorough evaluation first by an expert XXXXXXX / Endocrinologist.

Wish you Good Health.

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