Infinity Group Medical Director Dr Krish Rawal, dives into Testosterone Replacement Therapy, its functions and benefits in men and to a certain degree, in women as well.

This week I wanted to focus on something really interesting which I am sure most of us have heard of and now seems to be more and more in the media with claims of amazing benefits, and that is Testosterone therapy.

Testosterone replacement therapy (TRT) is an established medical treatment primarily used to restore physiological hormone levels in individuals with clinically low testosterone. In men substantial evidence from randomised trials and systematic reviews demonstrates that TRT improves sexual function, libido, and erectile performance, while also enhancing mood, energy levels, and overall quality of life. Physiologically, testosterone plays a central role in maintaining lean body mass, muscle strength, and bone mineral density; TRT has been shown to increase these parameters and reduce risks associated with osteoporosis and frailty.

In fact, large meta-analysis trials indicate improvements in fatigue and depressive symptoms, alongside effects on cardiovascular risk. Increasingly the medical world is recognising the benefits for mood and quality of life more than the libido effects and in many cases patients taking anti-depressants have been able to stop them when their testosterone levels have been boosted.

Beyond symptomatic relief, TRT in men also appears to confer broader metabolic and functional benefits. Evidence from contemporary reviews highlights improvements in insulin sensitivity, body composition, and vitality, particularly in men with baseline testosterone deficiency. Additionally, pooled results of trials report enhanced quality of life and sexual health without significant adverse effects on blood pressure, lipid profiles, or glycemic markers.  

These findings suggest that TRT not only addresses classical symptoms such as low libido and fatigue, but may also contribute to improved cardiometabolic health and physical functioning when used according to clinical guidelines.

In women, although the evidence base is more limited and still evolving, testosterone therapy is increasingly recognised for specific indications - most notably hypoactive sexual desire disorder (HSDD). Research indicates that women naturally produce testosterone, which contributes to libido, mood regulation, and musculoskeletal health. Emerging clinical evidence suggests that carefully dosed testosterone therapy can improve sexual desire, arousal, and overall well-being in selected women, particularly during menopause.

However, systematic reviews emphasise that while potential benefits may extend to energy, mood, and bone or muscle health, the strength of evidence remains variable and further high-quality trials are needed to clarify long-term safety and efficacy. Overall though, TRT offers meaningful benefits for both men and women when used appropriately, and many standard treatments are now being reviewed with TRT in mind, and doctors are now starting to have conversations about TRT with some patients.