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Getting more out of testosterone replacement therapy

How the right amount of exercise, good eating habits, and TRT can work together to improve testosterone levels.

Resistance training that focuses on large muscle groups may benefit testosterone levels.

Testosterone is the main sex hormone in males, essential to sexual health (including sperm production), bone density, muscle mass, and red blood cell production.

In males, testosterone is mostly produced by the testes, though some testosterone is also produced by the adrenal glands, a pair of hormone-producing glands located on the kidneys.

Levels of testosterone that are too low can impact a person’s health in negative ways. They may experience a decreased interest in sex or lose sexual function, lose muscle mass, lose strength, and lose bone mass. Depression, difficulty sleeping, and difficulty concentrating are other potential symptoms.

This condition is commonly referred to as low testosterone. The clinical term is male hypogonadism.

For men diagnosed with low testosterone, testosterone replacement therapy (TRT) can help. TRT involves taking medications that contain testosterone, which boosts the amount of testosterone in the body.

If you are treating low testosterone with TRT, the following strategies may help you get the most out of your treatment.

Follow your dosing schedule

In order to get the most benefit from any medication, the medication needs to be taken as prescribed. This is known as “adherence” and is often easier said than done.

There are many potential obstacles that can prevent a person from taking a medication as prescribed. Medications can be inconvenient to take and out-of-pocket costs for prescriptions can be high. Side effects, or concerns about side effects, can cause a person to discontinue a medication. These are just examples.

If you find that you are missing doses or having a difficult time following your treatment plan—or if you’ve discontinued your treatment—talk to your healthcare provider. They may be able to offer potential solutions to try. They may also be able to switch you to a different TRT.

There is no shortage of options when it comes to TRT—there are pills, injections, patches, subcutaneous implants, topical gels, and nasal gels. Not every method will be right for every person, but it’s still worth discussing with a healthcare provider.

Testosterone and lifestyle

Along with TRT, it’s important that your lifestyle supports healthy testosterone levels and your overall health. Here are some strategies for eating, exercise, sleep, and stress reduction.

  • Build strength. Exercise is key to maintaining a body composition that is conducive to healthy testosterone levels—greater muscle mass and less fat. In particular, resistance training that focuses on large muscle groups may benefit testosterone levels. HITT (high-intensity interval training) has also been shown to boost testosterone.
  • Do cardio, too. Cardiovascular exercise—even something as simple as walking more—can contribute to healthier testosterone levels. One study found that an exercise plan that included cardio, resistance training, and stretching improved response to TRT.
  • Don’t overtrain. Too much exercise with too little recovery can have the opposite effect you’re looking for and contribute to lower testosterone levels. This is sometimes found in male endurance athletes who train with high mileage or high intensity.
  • Eat well. People looking to maintain a healthy testosterone level should follow a healthy diet—plenty of fruits and vegetables, whole grains, lean protein, and healthy fats. They should also avoid junk food and restrictive diets.
  • Get enough sleep. There’s a need for more research on how exactly sleep impacts testosterone levels and testosterone production. But adequate hours of sleep are essential to physical and mental health, and sleep is essential to recovering from exercise and maintaining a healthy weight.

It's important to keep in mind that everyone is different. People experience low testosterone at different ages and for different reasons. Your best source of information will be a healthcare provider, who can guide you through your treatment options as well as lifestyle changes that can help you maintain healthy testosterone levels.

Article sources open article sources

You and Your Hormones. Testosterone.
NCI Dictionary. Adrenal gland.
MedlinePlus. Could you have low testosterone?
Mayo Clinic. Male hypogonadism.
Mayo Clinic. Testosterone therapy: Potential benefits and risks as you age.
Michael Grabner, Zsolt Hepp, et al. Topical Testosterone Therapy Adherence and Outcomes Among Men With Primary or Secondary Hypogonadism. The Journal of Sexual Medicine, 2018. Vol. 15, No. 2.
Byeongjin Kang, Maengseok Noh, and Hyun Jun Park. Compliance with Testosterone Replacement Therapy in Patients with Testosterone Deficiency Syndrome: A 10-Year Observational Study in Korea. The World Journal of Men's Health, 2022. Vol. 40, No. 4.
Abdullah Gul, Emrah Yuruk, et al. Factors affecting adherence to testosterone replacement therapy. Translational Surgery, 2018. Vol. 3, No. 2.
Sally M. Abilmona, Ryan M. Sumrell, et al. Serum testosterone levels may influence body composition and cardiometabolic health in men with spinal cord injury. Spinal Cord, 2019. Vol. 57.
Ruba Riachy, Kevin McKinney, and Demidmaa R. Tuvdendorj. Various Factors May Modulate the Effect of Exercise on Testosterone Levels in Men. Journal of Functional Morphology and Kinesiology, 2020. Vol. 5, No. 4.
Tadeusz Ambroży, Łukasz Rydzik, et al. The Effect of High-Intensity Interval Training Periods on Morning Serum Testosterone and Cortisol Levels and Physical Fitness in Men Aged 35–40 Years. Journal of Clinical Medicine, 2021. Vol. 10, No. 10.
Hiroshi Kumagai,1 Asako Zempo-Miyaki, et al. Increased physical activity has a greater effect than reduced energy intake on lifestyle modification-induced increases in testosterone. Journal of Clinical Biochemistry and Nutrition, 2016. Vol. 58, No. 1.
Francesco Del Giudice, Frank Glover, et al. Association of daily step count and serum testosterone among men in the United States. Endocrine, 2021. Vol. 72.
Dae-Yeon Cho, Jeong Kyun Yeo, et al. Exercise improves the effects of testosterone replacement therapy and the durability of response after cessation of treatment: a pilot randomized controlled trial. Asian Journal of Andrology, 2017. Vol. 19, No. 5.

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