HRT vs TRT: Which option is going to be best for you? First, let's look at the benefits and risks of each before we start making calls about which is better.

Are you feeling tired and run down? Do you have trouble focusing or feel like your libido is low? You may have low testosterone levels. Hormone replacement therapy is a treatment that can help increase your energy levels and improve your overall quality of life.

However, it’s important to understand the misnomer in the name itself.

In the case of hormone replacement therapy, the misnomer comes from that nothing is being replaced, rather supplementing.

In this blog post, we will discuss HRT vs TRT. What are the differences between the two and how you can make a scientific desicion about which would best for you.

Key Takeaways

  • While there are many hormones necessary for survival, Testosterone (an androgen) is the primary hormone needed to manage the male bodies natural aging mechanism.
  • Hormone replacement therapy is a common treatment for men and women who suffer from hormone imbalances
  • Aging males with low testosterone levels can benefit from testosterone replacement therapy. This treatment option typically comes with a limited number of risks.

Hormone Replacement Therapy

Hormones play an essential role in the human body for both men and women. While there is still a lot of controversy in the use of hormone therapy as a way to combat our bodies natural aging mechanism. [1][2]

Hormone replacement therapy is a treatment that replaces hormones in the body. It is typically a form of therapy used to help maintain adequate hormone levels, or to manage hormone-related conditions.

Women hormone replacement therapy is often prescribed to help relieve menopausal symptoms, such as hot flashes and vaginal dryness. But for men, there are is only one FDA-approved hormone therapy: testosterone replacement therapy.

It can also be used to improve symptoms of aging, such as fatigue, weight gain, decreased libido, and erectile dysfunction by maintaining a healthy balance of essential hormones in the body. For men, this hormone is typically testosterone.

Hormone replacement therapy can be delivered in a number of different ways, including injections, gels, patches, and pellets implanted under the skin. The method of delivery will be determined by the doctor based on the individual’s needs and preferences.

Male Menopause: What Is It?

Just like women experience menopause, in which their hormones decrease and eventually stop functioning, men experience what’s called andropause, or “male menopause”. This is where the gradual decrease in androgens (typically testosterone) over time.

The most significant distinction between female and “male menopause” is that for men, it is gradual and frequently a modest decrease over time versus the reduction in estrogen production in women only takes place in a few short months.


We’ve talked about androgens quite a bit here, but what exactly are they, you might be wondering.

Androgens are a group of sex hormones that play a vital role in the development and maintenance of sex characteristics. The main function of androgens are to help produce the primary sex hormones testosterone and estrogen for men and women.

However, because they play a role in production of two crucial hormones, a deficiency in androgens can also impact on bone density, muscle formation, and even sperm count.

Other important androgens to know:

  • Androstenedione
  • Dehydroepiandrosterone (DHEA)
  • DHEA sulfate (DHEA-S)
  • Dihydrotestosterone (DHT).


Although testosterone is commonly accredited to being the male sex hormone, females need it as well but in much lower quantities. It is primarily responsible for the development of male reproductive tissues, secondary sex characteristics like facial hair and a deepening of the voice, ability to build muscle, and sperm development.

Other important functions of testosterone is the main male hormone responsible for:

  • Maintaining muscle mass
  • Bone mineral density
  • Red blood cell production
  • Sex drive
  • Sperm production

Testosterone Replacement Therapy

When hormones are low and need to be replaced or restored to a healthy range, it might require help. For men, this hormone is typically testosterone.

Deficiencies in testosterone levels are usually treated with testosterone replacement therapy, where exogenous testosterone (testosterone from an external source) is introduced into the body so that there is a normal amount present.

When testosterone levels start to get low, it can lead to a variety of health risks for men. Symptoms of low testosterone levels include: low libido, erectile dysfunction, decreased sexual desire, anxiety, memory and cognitive function impairment, decrease muscle mass or strength, decreased bone mineral density, sleep disturbances, and even increased body fat [3].

It is crucial that men and medical providers be aware of the symptoms associated with low T as they age. This is not only to preserve a healthy equilibrium of this hormone in their bodies, but to guarantee a normal quality of life.

How does Testosterone Therapy Work?

Testosterone replacement therapy, much like hormone replacement therapy, works to restore this hormones level back to a normal range. It should ideally replicate the natural levels of testosterone in the body, as though they were produced naturally without any major drawbacks or safety concerns.

And most importantly, reduce the symptoms associated with having a low T.

Is Testosterone Replacement Therapy Right for Me?

According to data, prescription sales of hormones for hormone therapy have increased at about 25%-30% annually since 1993. [4]

However, like turtle necks aren’t for everyone, hormone therapy isn’t for every guy with low hormone levels. And, it is certainly not for guys trying to land a leading role in the next Avengers movie.

Hormones, like testosterone, are anabolic steroids and are therefore prescription-only medication. So, you’ll need to consult with your doctor to see if you’re a candidate for it.

It is not uncommon for men with pituitary gland issues to be placed on hormone replacement therapy to help treat symptoms related to having testosterone deficiency.

For this reason, it is important that, before starting any sort of hormone therapy, the benefits and risks are fully disclosed with the patient to rule out relevant prostate and other risk factors that could impact the course of treatment.

Benefits of Hormone Therapy

Restoring hormone levels back to normal numbers can reap many benefits on men diagnosed with hypogonadism (low T).

  • Improve desire and sexual function
  • Increase bone mineral density
  • Improve mood
  • Improve cognitive function
  • Help increase muscle mass, strength, and overall body composition

Risks of Hormone Replacement Therapy

Although the negative side effects from hormone replacement therapy are relatively low, there are still risks that can happen which depend on a variety of factors such as age, life circumstances, and other medical conditions. [5]

  • Infertility
  • Cause testicular atrophy (shrinkage of the testicle)
  • Gynecomastia (enlargement of breasts, aka male breasts)
  • Encourage growth of prostate cancer
  • Cause erythrocytosis (increase the number of red blood cells in your blood)

The Final Verdict

To sum up, don’t let aging affect your life negatively. Treatment for hormone deficiencies has evolved so much. Just in the last few decades, hypogonadism was something that went undiagnosed and testosterone therapy was non-existent.

Now that symptoms for low T are more clearly defined, the process for treatment is easier. There are also more options when it comes to types of therapy.

While there is no compelling evidence that restoring testosterone levels in men with low testosterone to normal is harmful, but it’s critical that you discuss the risks and benefits of associated with having a hormone deficiency with a hormone specialist as well as how hormone replacement therapy can help you.

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Heutling, D., Lehnert, H. Hormontherapie und Anti-Aging.Β InternistΒ 49, 570–580 (2008).

Kim YC. Testosterone supplementation in the aging male. Int J Impot Res. 1999 Dec;11(6):343-52. doi: 10.1038/sj.ijir.3900446. PMID: 10637467.

Baum NH, Crespi CA. Testosterone replacement in elderly men. Geriatrics. 2007 Sep;62(9):15-8. PMID: 17824721.

Bhasin S, Buckwalter JG. Testosterone supplementation in older men: a rational idea whose time has not yet come. J Androl. 2001 Sep-Oct;22(5):718-31. PMID: 11545281.

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2006 Jun;91(6):1995-2010. doi: 10.1210/jc.2005-2847. Epub 2006 May 23. Erratum in: J Clin Endocrinol Metab. 2006 Jul;91(7):2688. Erratum in: J Clin Endocrinol Metab. 2021 Jun 16;106(7):e2843. PMID: 16720669.


Jimmy Diaz M.S.

Jimmy Diaz M.S. | Writer

Jimmy is a Clinical Scientist from Los Angeles with a background in Chemistry and Reproductive Clinical Science. He is an adrenaline junkie who loves water, winter and wind sports. He is dedicated to advancing the field of reproductive science and providing the best patient care while also exploring new experiences and challenging himself.

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