Cons of Testosterone Therapy: Weighing the Benefits and Risks

Testosterone therapy has its pros and cons which you should consider before the treatment. Consult with your doctor about all the pros and cons of TRT so that you can decide whether you should consider this treatment or look for other options to recover your testosterone levels. Learn about the cons of Testosterone replacement therapy in this article to properly discuss this therapy with your doctor. You can contact us by visiting our clinic or visiting our website at


Cons of testosterone therapy

While testosterone therapy has many benefits, it also causes many side effects. Here’s a list of these below:

  1. Risk of prostate cancer: Researchers found a potential link between testosterone therapy and prostate cancer. Some studies found that high testosterone levels achieved from TRT may stimulate malignant growth in the prostate, which can increase the risk of prostate cancer. However, this has not been proven accurate for every male on TRT. In a small study in the United Kingdom, 13 men with untreated prostate cancer were monitored for 2½ years while on TRT. At the end of the study, researchers found that TRT didn’t increase their testosterone levels and had no effect on the study group’s PSA levels. Other studies suggest that even though TRT may not cause prostate cancer, it may increase cancer growth in men with pre-existing prostate cancer. So, due to the various statistics gathered from these studies and the possibility that TRT may affect prostate growth in some men, researchers recommend that physicians should first advise the males about the increased risk of prostate cancer and then recommend TRT treatment.


  1. Elevated risk of blood clots: As TRT increases the red blood cell concentration, it may increase the risk of cardiovascular problems due to the effect of testosterone on erythropoiesis. An increase in red blood cell production may improve energy levels, but too many red blood cells can lead to a condition called erythrocytosis, which causes the blood to thicken and increase the risk of blood clots forming. However, studies are looking at the effect of TRT on cardiovascular risk and have conflicting results.

A study from 2019 suggests that TRT may increase the risk of heart attacks, strokes, and other clotting issues in the first 2 years of treatment. After that time, your risk may return to normal pre-treatment level. Other research found that TRT lowers the risk of cardiovascular disease. A study from 2017 looked at the cardiovascular risk of 44,000 hypogonadal men after receiving TRT, their risk was 33% lower compared to the control group.


  1. Acne and hair loss: Testosterone can impact the production of sebum, which is an oil-like substance secreted by sebaceous glands inside the skin pores that help to provide elasticity and a youthful appearance. However, when testosterone levels get high, it can overstimulate the sebaceous glands to increase oil production, negatively affecting the skin. Increased oil production can make it easier to carry dead skin cells to the surface of your skin, and when the pores become clogged, it triggers acne to occur.

Similarly, testosterone is synthesized into various types of testosterones to regulate various areas of the body and one of them is dihydrotestosterone (DHT), which is used to develop and strengthen follicles during hair growth in certain cases. When the DHT levels get too high, it harms hair growth, causing the follicles to weaken and break from the scalp. That’s why some men experience hair loss after getting TRT treatment, so if you’re prone to hair loss then TRT may increase the rate at which you lose your hair.


  1. Estrogen side effects:

One of the most common short-term side effects you may experience with TRT often include:

  • Gynecomastia
  • Fatigue and low energy
  • Water retention
  • More emotions
  • Low mood and anxiety
  • Spots and acne.

Keep in mind that these symptoms are the most common side effects of the medication, and it is not guaranteed that you may get them during your treatment. Only some men experience these immediate adverse effects.


  1. Affects your fertility: Increasing blood testosterone levels can lead to infertility because permanently high testosterone levels can restrain the production of follicle-stimulating hormones via the hypothalamic-pituitary axis. FSH stimulates sperm production, so restraining its production reduces your sperm count. However, this side effect of TRT is no longer a problem because doctors these days prescribe a medication called hCG alongside your testosterone treatment. This drug can stimulate the hypothalamic-pituitary axis and maintain normal sperm production, regardless of high testosterone levels.


Need help with your testosterone levels declining, visit our endocrinology clinic in Brooklyn to get professional medical help. You can schedule an appointment with Doral Health and Wellness Urology Center’s best urologist in Brooklyn and inquire about your concerns. Our specialists will work with you in managing your condition. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call 1-347-384-5690. You can also visit our website at