How to Start TRT: Steps, Testing, and What to Expect

At Centra Internal Medicine, we are committed to providing comprehensive care for men experiencing symptoms related to low testosterone, also known as hypogonadism. Our experienced healthcare providers offer thorough evaluations and evidence-based treatments to help restore your health and quality of life.

Testosterone Replacement Therapy is primarily intended for patients who have been diagnosed with clinically low testosterone levels. Hypogonadism may result from issues involving the testes, pituitary gland, or hypothalamus, and can lead to symptoms such as:

• Persistent fatigue
• Reduced libido or sexual performance
• Difficulty with erections
• Decreased muscle mass or strength
• Mood changes or irritability
• Loss of bone density

If you are experiencing these symptoms, our team can perform comprehensive blood tests and medical assessments to determine whether TRT may be appropriate for you.

Special Considerations
In some cases, TRT may also be beneficial for men who have lost normal testicular function due to injury, infection, or treatments such as chemotherapy or radiation. Our providers will work closely with you to review your medical history and ensure that any underlying conditions are addressed.

It is important to note that TRT is not recommended for individuals with normal testosterone levels, or for those seeking therapy solely for bodybuilding, athletic performance, or anti-aging purposes. At Centra Internal Medicine, our focus is on treating genuine medical conditions to improve your overall well-being.

Personalized and Monitored Care
Testosterone Replacement Therapy should always be guided and monitored by a qualified healthcare professional. Our team at Centra Internal Medicine will customize a treatment plan for you, regularly monitor your response to therapy, and prioritize your safety at every step.

Testosterone replacement therapy (TRT) can be an effective option for men with clinically proven low testosterone levels, but it is not suitable for everyone. Our providers carefully assess each patient’s unique health profile before recommending TRT, as there are specific situations where this therapy may pose significant risks.

Who Should Avoid Testosterone Replacement Therapy?

• Patients with Prostate or Breast Cancer: If you have a current diagnosis or a history of prostate or breast cancer, TRT is not recommended. Increased testosterone can potentially stimulate the growth of certain cancers.

• Individuals with Untreated Severe Obstructive Sleep Apnea: TRT can worsen sleep apnea symptoms, so it is important to address this condition before considering therapy.

• Men with Polycythemia (Elevated Red Blood Cell Counts): Testosterone therapy may further raise your hematocrit levels, increasing the risk of blood clots, stroke, or heart attack.

• Patients with Uncontrolled Heart Failure or Recent Cardiac Events: TRT can place additional strain on the heart and is not recommended for those with unstable heart conditions.

• Men Planning to Have Children: Exogenous testosterone can suppress natural sperm production, potentially leading to infertility. If you plan to conceive in the near future, TRT may not be the right choice.

• Individuals with a History of Blood Clotting Disorders: Those with known clotting disorders or a high risk for blood clots should use caution, as TRT may elevate this risk.

• Allergy or Hypersensitivity to Testosterone Products: Anyone with a known allergy to the ingredients in testosterone formulations should not use TRT.

At Centra Internal Medicine, your safety and well-being are our top priorities. If you are considering testosterone replacement therapy, please schedule an appointment to discuss your medical history, current medications, and overall health with one of our experienced providers. We will work with you to determine whether TRT is appropriate and safe for your specific needs.

If you are considering or preparing to start testosterone replacement therapy (TRT) at Centra Internal Medicine, it’s important to understand what you can expect throughout your treatment journey. Our experienced providers will begin with a comprehensive evaluation, including detailed blood tests, to assess your current testosterone levels and overall health status.

At Centra Internal Medicine, we offer a range of TRT options, including injections, topical gels, and patches, to best suit your individual needs and lifestyle. Once therapy begins, you may notice early improvements in mood, energy, and sexual desire within the first few weeks—though experiences can vary from patient to patient. Physical changes, such as increased muscle mass and reduced body fat, generally appear more gradually over several months.

Because TRT can lead to changes in your red blood cell count and other important health markers, routine blood tests are an essential part of your care at Centra Internal Medicine. Our team will closely monitor you to identify and address any potential side effects early, such as acne, mild fluid retention, or breast tenderness. While serious complications are rare, we will also keep an eye on cholesterol levels, blood clot risk, and any pre-existing health conditions, such as sleep apnea or prostate concerns.

Regular follow-up appointments are a key part of TRT at Centra Internal Medicine. During these visits, we will review your progress, check your testosterone levels, and make any necessary adjustments to your treatment plan. We encourage all our patients to adopt healthy lifestyle habits—including balanced nutrition and regular exercise—to help you get the most out of therapy.

Open communication with your Centra Internal Medicine provider is vital. Please let us know about any symptoms, concerns, or changes you experience. Our priority is to ensure your therapy is both safe and effective, tailored to your unique health needs.

Testosterone Replacement Therapy (TRT) is an effective treatment we commonly prescribe to help our patients regain their well-being. However, before starting TRT, it’s important to consider how this therapy might affect your fertility—especially if you wish to have children in the future.

When patients begin TRT, the body senses the boost in testosterone from external sources. This triggers the brain to reduce production of two key hormones—luteinizing hormone (LH) and follicle-stimulating hormone (FSH)—both of which are critical for natural testosterone and sperm production in the testes. As a result, TRT can lower sperm counts, sometimes leading to temporary infertility (and in rare cases, complete absence of sperm in the semen—a condition known as azoospermia).

While the extent of this effect varies among individuals, most men will experience reduced fertility during TRT. Fortunately, for many, sperm production can recover after stopping therapy, although it may take several months. In some cases, additional medication may be needed to help restore fertility.

At Centra Internal Medicine, your goals and future plans are always taken into account. If you are considering TRT and are concerned about fertility, we encourage you to discuss this with your provider. We can offer options such as sperm banking before starting TRT or explore alternative treatments that preserve sperm production if maintaining fertility is a priority for you.

Embarking on your Testosterone Replacement Therapy (TRT) journey at Centra Internal Medicine begins with a comprehensive, patient-centered evaluation. Board-certified physician Dr. Manish Sahni, MD, and his dedicated team will guide you through every phase of the process, ensuring your treatment is seamlessly tailored to your unique needs. Your first step involves a detailed, one-on-one consultation to discuss your symptoms and medical history. Next, Dr. Sahni orders in-depth diagnostic blood work to firmly establish your baseline hormone levels and assess your overall health. Using these precise results, he crafts a customized TRT plan designed to safely restore your vitality.

Your health and future are important to us. Contact our team at Centra Internal Medicine to schedule a consultation and get personalized guidance on TRT and fertility. We are located at 1003 Division Street Suite 4, Prescott, AZ 86301. We serve patients from Prescott AZ, Iron Springs AZ, Williamson AZ, Diamond Valley AZ, Prescott Valley AZ, and surrounding areas.